Mental health success should end oversight

THE ISSUE A federal magistrate is recommending that a judge end federal oversight of Hawaii's mental health system.

AFTER 15 years of federal oversight because of severe inadequacies, the state's mental health system is among the best in the nation. U.S. Magistrate Kevin Chang is recommending that federal Judge David Ezra bring the oversight to an end on Nov. 30. Legislators and the state administration should refrain from complacency to assure continuing sound mental health services in the future.

The Hawaii State Hospital for the mentally ill in Kaneohe was in dismal condition when the Justice Department filed suit against the state in 1995 alleging civil rights abuses of patients, who were seen lying unattended on concrete floors. Two years ago, federal Judge David Ezra lifted federal supervision of the hospital, which had come to look "like a well-kept college campus."

However, Ezra had expanded federal oversight to include all community services provided by the state Adult Mental Health Division. Those deficiencies were made glaring by 16 deaths, including six suicides, among mental health patients during a two-month period early last year.

As recently as March, Chang, whom Ezra had named special master in the case, described community services for the mentally ill as "egregious." Ezra observed "backsliding on all fronts" but denied a request by the Justice Department's Civil Rights Division to impose sanctions. The judge warned state officials "that this indeed is their last, best and only opportunity to avoid a federal takeover."

The state agreed a year ago to reach substantial compliance by June 30 for a community health plan. In a report to Ezra this week, Chang said he could not say that the state had met the deadline but concluded that it had reach "substantial compliance."

In the years of oversight, the state has tripled the funding for the State Hospital. The number of citizens receiving mental health services has risen from fewer than 4,500 to more than 10,000 receiving ongoing mental health services and 2,000 receiving partial services, according to Dr. Thomas Hester, the division's chief.