Prisons examine
treating mentally ill

But the State Hospital lacks
the tight security that
criminals require

---

By Helen Altonn
haltonn@starbulletin.com

State health and public safety officials are exploring the possibility of developing a treatment program at an Oahu prison for dangerous mentally ill criminals sent to the State Hospital in Kaneohe.

State Health Director Bruce Anderson said he recently sent a team to the prisons to see if the proposal was feasible. "I'd rather see a treatment program at the state prison than turn the State Hospital into a prison," he said in an interview.

"There are no alternatives now for those who need treatment other than the State Hospital," he pointed out.

"Almost invariably, the problems we have at the hospital are associated with people who probably shouldn't be there in the first place, but there are no alternatives."

Public Safety Director Ted Sakai said a lot of issues would have to be resolved. He cited three major concerns:

>> "No. 1 is, we're overcrowded (in the prisons). Can we make room?

>> "No. 2, I really can't say that the facilities are appropriate for treatment, physically, because they are really built as correctional facilities, not as a hospital."

>> Third, he said, patients acquitted of crimes by reason of insanity have not been convicted of anything.

Sakai said he has asked the attorney general to look at the legal issues. "We would have to consider if it is legal, and legal implications of such a treatment facility in a correctional facility."

Another major concern, Sakai said, is whether a consent decree with federal oversight of the State Hospital would follow patients in a prison treatment program. The consent decree imposes staffing, treatment and other requirements on the hospital.

The prison has psychiatrists, psychologists and social workers to help mentally ill inmates, "but our thrust is to help them adjust to their setting," Sakai said. "We can't do intensive treatment to make them well."

Halawa Medium Security Prison has six beds for mentally ill inmates, and the Oahu Community Correctional Center has a 35-bed module for mental health patients, he said.

Under law, convicted people who need hospitalization for mental health problems can be referred to the Department of Health for treatment at the State Hospital, Sakai noted. But, he said, "They're kind of crowded, too."

He said the Hawaii prison population totals 3,800, with another 1,200 on the mainland.

Anderson said there are 21,000 seriously mentally ill people in Hawaii at any given time, with 7,000 seeking professional help. Of those, the Health Department serves about 4,000. The hospital is only one part of the system, with about 160 patients, he said.

Among those hospitalized are some people acquitted of serious crimes whose bids for release have been rejected by the court because of concerns that they are dangerous.

One is Warren Miller, committed about 21 years ago. He raped a tourist with a beer bottle and threw her off Waialae Iki Ridge in 1977.

Another is Randall Saito, acquitted of stabbing and fatally shooting a woman in the face at Ala Moana Center in 1979.

Among patients who recently escaped from the hospital was Leonard Moore, who left twice in two months and was free for 39 days. He was caught in the Kahala area, where he is suspected of a series of burglaries and auto thefts.

What to do with criminals who need mental health treatment has been a long-standing problem.

"It's the same issue, but a little bigger," Sakai said.

Prosecutor Peter Carlisle said it "makes sense" to have a prison treatment program for mentally ill criminals.

He said the safety of the community and of the patient must be considered if a patient is repeatedly leaving the hospital.

"They're walking out of there like a sieve," he said.

Anderson said the rate of unauthorized leaves from the hospital has dropped over the past three years. Last year there were 16; so far this year, there have been seven.

He said the escape rates from Hawaii's hospital are well below the average rate at comparable mainland facilities.

An alternative, Anderson said, would be to build a treatment facility at the Oahu Community Correctional Center or the Halawa Correctional Facility.

During a recent tour of the hospital with other lawmakers, Kaneohe Rep. Ken Ito said he would work with the Public Safety and Health departments to expand OCCC to provide a more secure facility for criminal patients.

"We know that mental health is one of the big issues for us in corrections," Sakai said. "It's a national problem."

Carlisle said the issue was "highlighted by the guy who terrorized Kahala." Leonard Moore escaped twice from the State Hospital and was recaptured in May in Kahala after a manhunt.

Carlisle said all of Sakai's concerns "are legitimate. ... There isn't any doubt in my mind, if I were a prison administrator, the last thing I'd want to do is bring this additional difficulty to a facility I was managing.

"It's a situation where good points are to be made on both sides."

There should be a way to find some middle ground, Carlisle said, "provided it's done in a fiscally responsible manner, and in a manner that also ensures the safety of the community and addresses the needs of somebody who is mentally ill."