The Queen's Medical Center recently opened a facility on Nuuanu Avenue providing outpatient psychiatric services. From left, patient Shannon Kong, art therapist Jannah Goodell and patient Don Ricks talked in June about art drawn in group therapy.

Mental clinic
opens in Nuuanu

Queen's invests in community
outpatient psychiatric services

By Helen Altonn

While hospitals across the country are closing mental health programs, the Queen's Medical Center is expanding outpatient psychiatric services in a community-based facility.

The two Ambulatory Behavioral Health Services departments -- Counseling Services and Day Treatment Services -- have moved from the hospital into a renovated three-story building at 1374 Nuuanu Ave.

Manager Ken Hansen said hospital mental health programs nationally have dwindled from thousands to hundreds due largely to below-cost government reimbursements.

With Medicare often rejecting payment for services needed by patients, Queen's hired consultants to help figure out how to document cases to meet reimbursement criteria, he said.

Medicaid also will not pay for certain services, but some coverage is available for uninsured patients under contracts with the state Health Department's Alcohol and Drug and Adult Mental Health divisions and the Judiciary's Adult Probation Division, Hansen said.

"The staff and I have a great sense of pride working for an institution like Queen's that is committed to the mission," he said.

Patients like the facility because it is easily accessible with parking and it is cheerful and spacious, he said.

Bright colors, plants and nature artwork by photographer Steven A. Kastner throughout the rooms create a tranquil atmosphere, a big change from the previous hospital quarters, Hansen noted. "It was nicely decorated, but dark in the basement -- not very uplifting."

Dr. Tom Hester, state adult mental health administrator, said Queen's outpatient facility is an important part of the mental health system with "a long-standing commitment ... to meeting needs of persons with severe mental illness.

"In particular, I appreciate their capacity to address needs of mentally ill persons who suffer addictions."

The new outpatient facility, which opened in May, is named Kaheiheimalie in honor of the second wife of Kamehameha I and grandmother of Kamehameha IV.

Hansen said the biggest change is that each department has one floor: "It was a labyrinth before."

Day Treatment provides partial hospitalization (treatment five hours a day, five to seven days a week) and intensive outpatient services for acutely or chronically ill patients, those diagnosed with both psychiatric and substance abuse problems and others with crisis situations.

When he started with Queen's in 1993, the day treatment program had five to seven patients per day, Hansen said. Now it has up to 70.

The counseling department provides a wide range of services and individual or group therapy. About 20 patients a day receive help with marital or family problems, depression, anger or other difficult situations.

It's planned to increase psychological, geriatric, child and adolescent testing, do more work with patients on medication management and expand research programs, Hansen said.

The ground floor has a recreational center and laundry facility and accommodates programs such as Alcoholics Anonymous.

Security was improved and training provided to all the staff on management of aggressive behavior, crisis prevention and intervention, Hansen said, noting many details in the design reflect staff involvement.

In response to neighborhood board concerns, the staff accepts only patients they are familiar with for urgent care (one step below emergency care), Hansen said.

Expanded services will include a psychosocial rehabilitation program to help build social and job skills for patients who are not prepared to work after discharge from the State Hospital or Queen's psychiatric programs.

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