Micronesia has one of the highest suicide rates in the world (WHO, 2016) with numbers reaching alarming and epidemic-like heights for decades (Lowe, 2019). Within this population, research has identified the CHamoru people (e.g., Indigenous Pacific Islanders of the Northern Mariana Islands and Guam) are at the highest risk for suicide attempts and death. Yet, there is a paucity of literature on CHamoru mental health with only a handful of research studies examining the mental health experiences of the CHamoru people. Thus, little is known to help counseling psychologists understand the mental health of the CHamoru community. Utilizing constructivist grounded theory and liberation psychology, this mixed-method research study aims to offer foundational insight on how CHamoru Cultural Knowledge (e.g., ethnic identity and consciousness) and colonial mentality impact mental health outcomes of CHamoru people. Quantitative results from this study indicate that ethnic identity and consciousness improved depression and anxiety symptoms and demonstrated that higher levels of consciousness decreased depressive symptoms. Qualitative findings corroborated these results while also further elucidating these findings. These findings provide initial documentation on the impact of colonial mentality and CHamoru Cultural Knowledge on the mental health of CHamoru adults.