Cayetano and the state's health director, Dr. Lawrence Miike, said they believe the accreditation will be instrumental in persuading U.S. Justice Department officials to end their oversight of the mental health facility.

For the past five years, the Hawaii State Hospital has been operating under a settlement agreement with the Justice Department over the facility's poor conditions, shortage of essential medical staff and a lack of policies and procedures.

And less than two years ago, U.S. District Judge David Ezra cited the state for contempt for not fully solving problems at State Hospital.

But in May, Justice Department officials acknowledged that there have been improvements at the facility, Miike said.

The accreditation, Cayetano said, "assures that Hawaii residents will have a mental health-care facility that meets the highest professional standards. Hawaii now has a hospital it can be proud of."

Twenty-two years ago, the isle facility was slapped with 80 citations by the accreditation group, Miike said.

The latest inspection ended with only three citations issued, he said. Keys to the Hawaii State Hospital's rise in standing was the construction of a new facility 10 years ago, linkages with the University of Hawaii's Medical School and social work, nursing, psychology and psychiatry professionals and the hiring of a new and respected administrator, Marvin St. Clair, said Miike.

There is also more individualized treatment of patients, Miike added.

Accreditation means the facility meets the 1996 standards of the health care accreditation commission, including providing a safe environment and competent care.

The Hawaii State Hospital is licensed to treat 203 patients, but usually has a patient population of 165 to 170.

The facility has a staff of 550, said a hospital administrator.

What makes the accreditation significant, said Cayetano, was that it was accomplished at a time when the state is facing fiscal constraints that resulted in the Health Department absorbing a 9 percent budget cut.

Now, said Miike, Hawaii is one of the top three states in terms of staff ratio at its mental health facility.

Sherry Harrison, state adult mental health division chief, said at one time staff was regularly turning over at the State Hospital and it was almost impossible to recruit replacements.