Mental clinics Changes in state mental health services for children have reduced the number of island youths in Hawaii and mainland psychiatric hospitals to 14, from 70 in 1998, U.S. Magistrate Kevin Chang has pointed out in a report to federal court.
see drop in youths
A new state approach reduces
the number of hospitalized childrenBy Helen Altonn
haltonn@starbulletin.comChang is special master for Chief U.S. District Judge David Ezra in overseeing improvements in the adult and child mental health system required under a consent decree with the Department of Justice.
In a report filed in federal court Friday, Chang said the DOJ generally is encouraged by the Child and Adolescent Mental Health Division's achievements and compliance with court orders.
He said the significant drop in children in psychiatric hospitals reflects the goal of the division, headed by Christina Donkervoet, "to minimize long-term hospital-based residential services for children and to promote the placement of children in homes and community family-based centers."
If there are no problems when DOJ consultants return for a site visit Sept. 23, Chang said he will meet with the parties and consider recommending partial dismissal of the children's residential facilities from the federal lawsuit.
Anita Swanson, state Health Department deputy director for behavioral health administration, said children ended up in hospitals for psychiatric care in past years because Hawaii had no therapeutic foster homes or specialized group homes.
Since such facilities have been developed, she said, "Children can stay in more of a family environment. Research shows kids don't get any better in a hospital and make a lousy transition back to their own homes."
The 14 children in state-funded beds are at the Queen's Medical Center and Kahi Mohala in Ewa.
On the adult side of the mental health system, DOJ and state health representatives and Kris McLoughlin, court-appointed special monitor in the case, will meet today and tomorrow to work on a community mental health services plan.
Chang rejected a plan drafted by a panel of experts, saying it was too vague and lacked detail on how it was to be implemented.
Swanson said the department restored and modified a community plan it had developed several years ago, "taking into consideration what we thought the judge was looking for when he charged experts to develop a plan."
The plan will address actions needed over the next two to three years to develop community resources for patients diverted or discharged from Hawaii State Hospital, she said.
For example, she said there is no funding for a 72-hour crisis facility where people could be placed during an emergency instead of hospitalizing them.
Also, Kauai and Maui do not have teams such as Oahu has to coordinate care for hospital-discharged patients, she said. So patients with families or jobs on the other islands must be discharged to Oahu where teams can help them, she said.
Swanson said she appreciates Chang's acknowledgment of the Kaneohe hospital's hard work in opening the old Guensberg Building and moving patients there to relieve overcrowded units.
She noted that the hospital has not had any elopements, or escapes, since Paul Guggenheim become administrator last October.
She said that is a tribute to his management, to additional security at the facility "and, to a large extent, the confidence the staff has that they can do their job and they know how to do it."
Dr. Thomas Hester, Adult Mental Health Division chief, said he is "very pleased" with Chang's findings of progress at the hospital.
"However, I am also aware of his call for continued work and the need to develop the community plan," Hester said, "and we are certainly supportive of the judge's call for the state to work closely with the DOJ and Special Monitor Kris McLoughlin in this case."