Brett Buican, left, and Dr. Will Spaulding, both of
Nebraska, enter one of the buildings used by the community
transition program at the State Hospital in Kaneohe.
Hospital officials
tout Pookela
The goal is to help
By Helen Altonn
mental-health patients
become adept at 'good
community living'
Star-BulletinA State Hospital patient destroyed three doors, seven pipes and 12 faucets, shredded her clothes and assaulted staff before she was selected for a new treatment program.
Now, she goes to classes with homework prepared. She exercises, watches her diet, budgets her money and isn't as abusive.
This case was among those cited by hospital officials yesterday at a news conference to illustrate progress being made under the Pookela program.
It's still in the early stages, and the hospital won't meet a January deadline for program improvement required in a 1991 settlement of a lawsuit by the U.S. Justice Department, officials said.
But Dr. Richard Hunter, consulting psychologist monitoring the program, said he's "encouraged by the enthusiasm of the staff in the unit and the support of the administration."
He said he believes the Department of Justice will be pleased with the reforms.
An internationally recognized program created by Dr. William Spaulding in Nebraska, Pookela aims to help patients develop work and behavioral skills.
Rather than long-term care and medication, "the ultimate goal is long-term good community living," said Linda Fox, chief of the state Health Department's Adult Mental Health Division.
The Justice Department in a September status report to the court expressed concerns about the program and stability of the administration after the removal of the hospital administrator, Marvin O. St. Clair.
Staff members complained of increasing patient assaults on employees after the program began with 48 patients in two units. One employee was seriously injured and hasn't returned to work, officials said yesterday.
Wayne Law, the hospital's interim administrator, said there was a peak in incidents, largely caused by two patients, but "we're actually seeing a definite decrease."
The Hawaii Government Employees Association last month began investigating patient assaults on State Hospital employees, who blamed the new treatment program. Some took their concerns to Gov. Ben Cayetano.
Law said the facility is investigating all incidents and providing intensive staff training to improve safety by altering aggressive behavior. "Medication simply doesn't cut it."
He's opening communications hospital-wide and giving the staff opportunities to raise issues, he said. "We're working with a number who have major concerns." He said employee morale ranges from "very excited" to "very low."
Dirk Elting, recently hired as the hospital's director of psychological rehabilitation, implemented a similar program in Nebraska.
"It's important to realize we're working with a critical population," he said, pointing out there were injuries before the program began 2-1/2 months ago.
Elting said staff training is critical to understand why patients do what they do and help them to change their behavior.
Hunter estimates it may be three to five years to implement the program throughout the hospital. "A lot depends on the resistance of the staff," he said.
Spaulding, on his fourth visit to the State Hospital, said he's impressed that the concerns aren't coming from the program staff but from elsewhere in the hospital. He believes they're due to misconceptions and "outright inaccuracies" about the program.
Unrest and anxiety are to be expected with changes, but the problems have "settled down ... to a significant degree," he said.
Hunter said he's been in the mental health field for 35 years and is "very proud" of Spaulding's work. He said the Justice Department's earlier concerns were "an artifact of bad timing," based on "very exaggerated claims."
