State notes gains on mental health
State health officials say they are concerned about Hawaii State Hospital's excess population and lack of forensic services, but also note they have made "positive gains" in improving the mental health system.
In a report filed by state attorneys yesterday in federal court, officials said they are committed to implementing a community mental health services plan by June 30 -- a deadline U.S. Magistrate Kevin Chang said he doubted the state would meet.
Chang is special master in a case arising from a U.S. Justice Department lawsuit in 1991 alleging unconstitutional conditions at the state hospital for the mentally ill.
The hospital was released from court oversight in December 2004 because of improvements, but the Health Department still was required to complete a community mental health system.
Chang, in his recent report, said he feared patient overcrowding at the hospital would have "catastrophic effects" on its progress.
In their response, state officials said they recognize having an average of 193 patients in a hospital licensed for 190 and configured for less than 178 "stretches available resources to the point where extraordinary measures must be taken."
They said admissions began to spike in the second half of last year because of increased court commitments, including patients readmitted after being on conditional release and patients with methamphetamine-related mental health problems waiting for fitness-to-proceed determinations.
State officials noted Chang's concern about the high cost of hospitalizing 40 state patients at Kahi Mohala but said the additional beds are necessary and that the costs are about the same as those for patients at Hawaii State Hospital -- about $800 per patient per day.
They said they are looking for beds in private hospitals for clients who might not be admitted to the State Hospital.
The Adult Mental Health Division advocates establishment of a treatment-based conditional release program as part of a statewide program for forensic services and a community mental health system.
It is not required by the community plan, but would benefit patients and "slow down what is often seen as a revolving door from the hospital to the community and into the hospital again," health officials said.
Mental health professionals would serve as monitors as well as probation officers, they said.
Health officials identified six key parts of a Hawaii Conditional Release program, ranging from adoption of a tool to assess a patient's danger risk or re-offending to development of individualized treatment plans and appropriate placement and services in the community.