Compared to other major ethnic groups, Hawaii’s indigenous people, Hawaiians, suffer a host of deleterious outcomes ranging from higher rates of substance abuse and youth suicide to higher mortality rates for heart disease and cancer. In an effort to gather data concerning the mental health of Hawaiian adolescents, the current study used a modified random sampling technique to survey 619 students, 590 of whom were chosen at random and 29 of whom were chosen due to their elevated risk of suicide. DSM-III-R diagnoses were made for the participants based on their responses to the Diagnostic Interview Schedule for Children-Version 2.3. Any diagnosis was calculated for prevalence rates and weighted for ethnicity; meta-analysis compared the Hawaiian sample to four community-based studies and two studies of high-risk populations. The findings indicated that Hawaiians had higher mental disorder rates than non-Hawaiians and that Hawaiian adolescents tended to follow similar mental health diagnostic patterns as other high-risk youth groups in America. The results also suggested that Hawaiian girls exhibited higher rates than boys for any diagnoses; this finding was mainly attributed to the higher anxiety disorder rates for Hawaiian girls. Clinical implications are discussed and include the need for culturally competent diagnostic assessments and treatments for Hawaiian youths. Future research should focus on identifying risk and protective factors for Hawaiian youth. Figure, tables, references