No Nā Pua: A Hawaiian Culture-Based Approach to Rebuilding
First Responder Wellbeing
Honoring Native Intelligence and Indigenous Science
component of effective mental health interventions. The presence or absence of moʻolelo (stories), oli (chants), and cultural grounding shaped how participants perceived their work in loko iʻa, shifting it from a routine task to a deeply restorative practice. This demonstrates that cultural practitioners do not simply provide context; their knowledge systems actively shape the outcomes of interventions, proving essential to meaningful healing and well-being.
The contributions of these knowledge holders are integral to this work and should be acknowledged with the same respect afforded to academic and institutional scholarship. Their insights not only inform and enhance this research but also serve as a critical foundation for the culturally grounded approaches we seek to advance.
Vibrant Hawaiʻi acknowledges Roxane Keliikipikaneokolohaka, Kalāhoʻohie Mossman, Luka Kanakaʻole, Lehua Kamaka, Kuʻulei Keakealani, Chad Wiggins, and all leadership and kiaʻi loko of the Edith Kanakaʻole Foundation and Hui Aloha Kīholo for their unwavering stewardship, generosity in sharing ancestral knowledge, and commitment to the restoration of both loko iʻa and the well-being of our communities Their ʻike, rooted in generations of practice and care for ʻāina, has been integral to the success of this work and serves as a guiding force in restoring balance and connection. Their work reaffirms that the well-being of people and ʻāina are inextricably connected. The guidance of the kiaʻi and cultural practitioners was not supplemental but foundational to this effort. We honor their leadership and remain committed to ensuring that their knowledge is not just acknowledged but centered in shaping the future of holistic, culturally grounded approaches to well-being.
No Nā Pua: Introduction
continued learning, teaching, and the transmission of knowledge, with the understanding that future generations are observing and inheriting these lessons. Through this repetition, we not only strengthen the physical structures that sustain our communities but also cultivate a legacy of perseverance, stewardship, and collective responsibility.
Through the restoration of a loko iʻa (traditional Hawaiian fishpond), No Nā Pua investigated how cultural practices like moʻolelo (traditional stories), ʻoli (chant), and mālama ʻāina (caring for the land) could provide a meaningful, holistic approach to mental health care. By embracing cultural restoration, participants were given the opportunity to share experiences, reconnect to culture, and build community. This approach provided an alternative form of mental health support, demonstrating the healing power of culture and connection in restoring balance and resilience in the lives of first responders.
One participant stated, “It's good for your soul kind of work, but also that the staff shared so much and made it fun, but very, very peaceful working down there ” , while another said, “I think it's just like a, not an escape, but a way to sort of relax for me, at least relax my mind and maybe get my mind off of the job.” Others shared, “I just know how I felt while I was there, during my time there. And it was very like relaxing, I would say.” “I think um, mentally, it gave me a chance to kind of take a big breath and relax for a while.”
Study Background
A Hawaiian Culture-Based Intervention for First Responders
Social prescribing offers a holistic approach to mental health. Rather than focusing solely on addressing symptoms, social prescribing embraces broader social, cultural, and environmental influences. For first responders, who may find traditional therapy disconnected from their lived experiences, this approach offers a pathway to healing through action
No Nā Pua applied the principles of social prescribing by examining the effects of restoring a loko iʻa a practice that intertwines cultural traditions, community service, and the healing power of nature. First responders engaged in this process, directly experiencing its impact on their mental and emotional well-being.
To measure these effects, the study employed both quantitative and qualitative measures. PTSD symptoms and overall well-being were tracked through the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the Brief Inventory of Thriving (BIT). Additionally, participants completed the Firefighter Assessment of Stress Test (FAST) before each session to monitor stress levels over time. The findings revealed promising reductions in PTSD symptoms and notable improvements in overall well-being, highlighting the potential of culturally rooted practices as a viable approach to first responder mental health support.
One of the most profound experiences for participants was engaging in guided cultural practices during the restoration of the loko iʻa. Lehua Kamaka, a kiaʻi of Kīholo fishpond, led them in a traditional Hawaiian chant as part of the restoration work After completing their work on the fishpond walls, Lehua shared the deeper meaning behind the chant - emphasizing its role in ensuring the stones were set firmly in place
“Lehua had the group go on both sides of the wall and place their hands on the pōhaku. She explained the chant that she was about to do, what it meant and how we are to tap the pōhaku like a drum while we chant. A chicken skin moment is the best way to explain how it felt doing the chant and tapping the pōhaku. After the chant, Lehua explained, ‘This is cultural practice, we learn as we build and restore. And when the wall falls again, we practice again and we pass this down to the next generation. Just like in life, we build and restore and when things fall apart, we practice again.’” Firefighter Participant
“Even though we were doing work, just like I said before, being entrenched in that environment, being surrounded by water and in the water while we were doing the work, it was very relaxing and therapeutic You’re in the water, you ’ re feeling the tides, you ’ re hearing the tides go in and out and splashing against the rocks. It kind of coaxes your own mental and bodily rhythm to become one with nature.” —Firefighter Participant
Camaraderie Without Alcohol
One of the unexpected but profound outcomes of this intervention was the opportunity for first responders to connect with their peers in a social setting that didn’t revolve around alcohol. Many participants acknowledged that in their profession, social events often center around drinking, which can sometimes limit the depths of their relationships The restoration work at the fishponds offered a restorative solution by providing a space where colleagues could bond in an informal, alcohol-free environment
One participant reflected, “I know there’s functions that firefighters or EMS responders attend and get to hang out with each other, but a lot of those functions involve alcohol. For me, I think it was super beneficial to partake in something like that where alcohol wasn’t involved and it’s just a positive setting.” Another added, “I knew, a lot of us hang out, but a lot of that is social parties or whatever. And there’s a lot of drinking and stuff involved. But it was nice to be able to not drink and hang out and talk story and that kind of stuff. So it was good.”
By shifting away from the traditional social norms of their profession, participants were able to form more meaningful connections The experience demonstrated how camaraderie and connection and
“I know there’s functions that firefighters or EMS responders attend and get to hang out with each other, but a lot of those functions involve alcohol. For me, I think it was super beneficial to partake in something like that where alcohol wasn’t involved and it’s just a positive setting.”
Firefighter Participant
Implications for the Future of First Responder Wellness
The success of this study underscores the immense value of social prescribing as an innovative approach to addressing the mental health challenges faced by first responders. By integrating cultural practices and community engagement into the healing process, social prescribing offers a meaningful complement to traditional clinical treatments Its potential for expansion is significant both within Hawaiʻi and beyond offering a transformative model for improving first responder well-being in diverse settings
“We do have a high stressful environment at times. But when you go somewhere like Kīholo where it's a place where you don't have to have any worries. It's just simple. It's breathtaking in its own way. I think that was a great place to kind of get grounded.”
The findings reinforce the effectiveness of social prescribing as a mental health intervention, particularly for those working in high-stress environments. Engaging in activities that reconnect participants to their culture, peers, and the natural world resulted in significant reductions in PTSD symptoms and meaningful improvements in overall well-being.These results align with broader research underscoring the importance of social and cultural connections in mental health care. Given the isolated nature of their work, first responders stand to benefit greatly from interventions that nurture a sense of community and shared purpose.
“Being with other firefighters was helpful because we're all in this together in a way, and so it was almost like a vessel to try to expand our thinking and move through issues together as a group but also separately A lot of times I feel, we feel alone and we feel like we're the only one that has this problem or this issue or you don't want to show weakness to your coworkers When it's in the fish pond, it's like if I can't lift a 50-pound rock by myself out of the bottom of the pond, I'm going to ask for help. So I think it's almost a metaphor for life just asking for help when you need it and sometimes you don't know you need help until um, you're in that spot and you're stuck. It's like, what can I do? I can't do this alone and just, you know, asking for help.”
Looking ahead, scaling up this model and integrating it into formal mental health programs for first responders could yield long-term benefits to the individuals and community alike. While further research and long-term studies are needed to fully understand the impact of culturebased interventions, early results suggest they hold great promise in promoting mental resilience and emotional recovery.
Conclusion
“No Nā Pua is more than just a study it’s a movement that challenges us to rethink how we support the mental health of first responders,” said Janice Ikeda, Chief Executive Officer of approach tes that true ding
“And for me, I just said, I'm going to fish pond. This is my therapy.” Firefighter Participant
Acknowledgements
Vibrant Hawaiʻi would like to acknowledge the time, effort, and openness of all of the participants involved in this study, and retired firefighters Lance Uchida and Jesse Ebersole who were essential in recruiting and communicating with participants. We would also like to extend our sincere appreciation to the Hawaiʻi Firefighters Association and the leadership at the Hawaiʻi Fire Department for supporting this study and providing essential services to the people of Hawaiʻi County.
About Vibrant Hawaiʻi
Vibrant Hawai'i is a community-driven organization founded in 2018 with a mission to build resilience across Hawai'i. We design and support initiatives that enable residents to take collective action. By acting as an intermediary to encourage cross-sector collaboration and serving as a central hub for resources and information, Vibrant Hawai'i helps action teams develop and implement strategies for a thriving Hawai'i. All initiatives are co-designed and led by dedicated volunteer teams, united by a shared vision of community abundance and vibrancy. Vibrant Hawaiʻi, the kiaʻi loko of Kīholo and Hale o Lono, and volunteer fire personnel are all committed to building on the pilot study and conducting a full study beginning in the Summer of 2025. For more information, or to request a copy of the full manuscript, email Janice Ikeda, Vibrant Hawaiʻi Chief Executive Officer at janice@vibranthawaii.org.
