The same organization that recognized Hawaii two years ago as one of the mentally healthiest states in the country on the basis of treatment records now reports that a survey of people indicates that islanders are indeed the sunniest of all. If the respondents were candid — which may be suspect — the survey indicates that Hawaii's access to mental health care is paying dividends.

The report by Mental Health America combines results from surveys conducted from 1993 to 2001 and from 2003 to 2006 by the Centers for Disease Control and Prevention, encompassing 1.2 million people in each survey. The people were asked whether their mental health includes stress, depression and emotional problems, and “;for how many days during the past 30 days was your mental health not good.”;

According to the survey, to be published in the June issue of the American Journal of Preventive Medicine, 10.2 percent of respondents reported frequent mental distress, defined as at least 14 mentally unhealthy days a month. Only 6.6 percent of Hawaii respondents reported having bad days amounting to two weeks in a month.

Marya Grambs, executive director of Mental Health America of Hawaii, has doubts about whether Hawaii's respondents were entirely upfront. “;Perhaps people in Hawaii aren't as willing to acknowledge these feelings or don't recognize them,”; she told the Star-Bulletin's Helen Altonn. “;It may be a cultural issue ... I think perhaps people in Hawaii underreport a little bit.”;

Perhaps not. A report two years ago by the same organization ranked Hawaii behind only South Dakota in low rates of depression and suicide. The report noted that it should come as no surprise that states such as Hawaii with fewer barriers in gaining access to mental health care have lower rates of depression.

That 2007 report by Mental Health America showed that Hawaii had the lowest percentage of people reporting that they could not get mental health care because of cost and, as a result, Hawaii had the lowest percentage reporting unmet needs of treatment or counseling.

Of a more concrete nature was the 2007 report's observation that Hawaii had, by far, the nation's lowest prescribed antidepressants use per capita and percentage of people receiving mental health treatment — 8.2 percent, compared with other states ranging from 10.7 percent to 16.4 percent.