addresses problems, administrator says
By Helen Altonn
"Isn't it beautiful?" Administrator Barbara Peterson asked, looking at the misted mountains and peaceful surroundings of Hawaii State Hospital from "The Village Green" at the center of the grounds.
Despite the beauty and serenity of the setting, controversy swirls over safety and conditions at the Kaneohe hospital for the mentally ill.
The Hawaii Government Employees Association recently filed a grievance alleging the four patient units are "dangerously overcrowded, unsafe and not a therapeutic milieu."
This isn't obvious to a casual visitor. In fact, the facilities appear spacious and cheerful, with patients engaged in various activities.
But the latest report by a court-appointed monitor for the hospital, being administered under a consent decree, says there are serious problems.
The units are designed for 108 patients and some classrooms have been converted for bedrooms to accommodate a population of 152. Units are coed with red lines as visual barriers to rooms of the women, who comprise 30 percent of the population.
"It can get tense at times," said Kent Gerkewicz, neuro-training therapist who has worked at the hospital 26 years and teaches integrated psychological therapy. "But personally, I think things are good. I've seen a lot of great changes over the year. ... The classes are great."
Judy Harvey, psychiatric nurse working with Gerkewicz to give patients skills needed when they return to the community, said the units are "pretty crowded now" and some staff members feel "nothing is going right."
But, she said, "We actually see progress in the work we're doing. Folks are doing better and better." She plans to go into the community and work with families after release from the hospital, she said.
"Eventually, we will bridge into the community," Gerkewicz said.
"Change is always difficult for people," Peterson said of problems since the move from Guensberg. Some staff members have increased or different responsibilities, she said. Others "have been put in a different place and we have to make sure they have the skills to do the job effectively," she said.
She said the hospital is addressing what are believed to be the issues, and factors involved, but often what is thought to be an issue really isn't when evaluated. "For instance, if we believe the issue is safety for the patients and staff ... the issue may not be safety. It may be training and education so people have skills to do their job.
"It's not easy trying to put a system of care into place," Peterson said.
However, all of the things at the hospital that resulted in a Department of Justice lawsuit against the state 10 years ago "essentially don't exist today," she pointed out, adding that the DOJ and federal court have played a significant role in the hospital's progress.
"Ten years ago we were in a different building, a different time, a different zone," she said. Significant changes have occurred, including greater knowledge of the brain, different medicines and earlier and more effective intervention, she said. Yet, she said, myths persist.
On the wall of her office are large sheets of paper filled with writing, part of a strategic four-year plan for the hospital.
The Legislature gave the Health Department an additional $8 million in the next fiscal year and $14 million the year after to develop community mental health programs and facilities.
The hospital is training staff in community mental health centers and other agencies and intends to move patients into the community as soon as it's appropriate for them and resources are available, Peterson said. "The idea is that services should be available where the client is."
The hospital is working with The Queen's Medical Center to ensure that people who choose voluntary hospitalization go there, Peterson said.
She anticipates an increase in admissions with shorter stays in 2 1/2 years. The hospital would remain "a safety net" for those needing to return, but fewer patients will be readmitted as they adjust to the community, she said.
She said changes are constantly being made, such as turning the hospital into a smoke-free environment Aug. 1. "We're doing a lot of work getting ready," she said, with education, programs and medicines to help patients quit.
"We evaluate every quarter what we did; how we want to resolve things," she said. "It's an ongoing and forever kind of thing. If looked at as a journey, this is the road map. The destination is somewhere out there. We continue to grow. We can do better."
Peterson is a nurse with 25 years experience as a hospital chief executive officer. She came here last November under a one-year contract from Ohio, where she administered the Fallsview Psychiatric Hospital.
The state Health Department is recruiting for the hospital administrator's position when her contract ends.
"It's absolutely clear to me I am welcome to be a candidate," she said. As to whether she will be, she said, "It is a personal decision."
However, she added, "I find a wealth of opportunities here. There is a large number of very talented committed staff here who understand what it takes to develop a system of care."