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Monday, March 12, 2001

Hawaii State Seal

$60 million more
needed to treat
mentally ill

Expansion of some resources
would be spread over
four years

By Helen Altonn

A $60 million increase in state funding is needed to provide an appropriate system of services for Hawaii's seriously mentally ill, according to a report being released today.

Since that would double the annual budget for the state Health Department's Adult Mental Health Division, funding increases will be proposed gradually, health officials said.

A major shift in funding, with big increases for community living and rehabilitation and vocational training, also is recommended in a comprehensive needs assessment for the seriously mentally ill.

Those are the priority needs identified by more than 600 representatives of consumers, families, service providers, staff and advocates who attended 36 statewide focus groups, said Anita Swanson, DOH deputy director for behavioral health administration.

The study recommends increasing Health Department funding for community living resources to $45 million, or 37 percent of the DOH budget, from $7.5 million, or 12 percent.

It proposes boosting rehabilitation and vocational training to $17 million, or 14 percent of the budget, from $2.9 million, or 5 percent.

The needs assessment was prepared by Technical Assistance Collaborative Inc. and the Human Services Research Institute. It provides the basis for a statewide implementation plan, also completed, and funding to address needs of the seriously mentally ill.

The assessment and plan were required under an agreement settling a U.S. Justice Department lawsuit 10 years ago alleging civil rights violations at Hawaii State Hospital.

State Health Director Bruce Anderson said the assessment and plan are "a positive step forward and good news. ...

"With proper funding, we could look forward to lifting the weight of federal oversight and eventually addressing the settlement agreement issues."

Mental illness is a dynamic process, with patients often moving from one level to another -- from independent living to the hospital, a group home or residence, then back to the hospital, he said. Many hospital patients would be better off in a community setting, and the goal is to have a full array of services, he said.

"What we need to work on now is building up community resources so we have a way to support patients when they're discharged from the hospital."

The new plan focuses on expanding community mental health resources over four years.

Swanson said the DOH wouldn't attempt to develop the entire system immediately because of limited state resources, lack of residential programs and lack of infrastructure in the Adult Mental Health Division to monitor management or use of services.

The House-proposed state budget includes $8 million requested for 2001-2002, on top of the division's current $60 million, to begin two or three demonstration projects. A supplemental request will be made in the summer for $16 million to expand the projects in 2002-2003, Swanson said.

She said the assessment confirmed that the state has about 3,800 seriously mentally ill people -- the number already identified by the DOH.

It listed 39 specific areas needed to provide comprehensive 24-hour care as people go through stages of acute and chronic mental illness. They include such services as housing, rehabilitation, vocational training, community support and hospitalization.

Swanson said the State Hospital has 168 beds and about 160 patients.

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