The toll that the economic crisis is taking on the mentally ill should be expected, but states' budget problems are making matters worse across the country. Mental health treatment, especially for the seriously mentally ill, should be among the priorities that require special attention as the crisis continues.

Hawaii health officials “;have made cuts they had to make”; in mental health services in expectation of a budget shortfall, said Marya Grambs, executive director of Mental Health America. “;It's now up to the governor and the Legislature to figure out whether these people are a priority or not.”;

Grambs told the Star-Bulletin's Helen Altonn that “;a very small minority”; of mentally ill people, “;when untreated, can become a danger.”; Michelle Hill, acting chief of the state's Adult Mental Health Division, said she has not noticed an increase in deaths, harm to individuals or other acts of violence since January, but it's too early to see a trend.

That does not mean that cuts in services for the mentally ill during the crisis will not create major problems. In Utah a budget crunch is expected to require the elimination of about 170 state mental health jobs, mainly caseworkers.

“;In this economy, it's the worst time to cut back on services for people who are on the edge of being destitute,”; Adam Trupp, legal counsel for the Utah Association of Counties, told the Salt Lake Tribune.

The economic stimulus bill recently signed by President Barack Obama includes $1.6 billion for projects to help the homeless, including support services for the mentally ill and those with substance-abuse problems. However, the government receives far more applications for grant money than it can approve, said Shaun Donovan, secretary of housing and urban development.

The problem was evidenced last month when a 25-year-old man diagnosed with schizophrenia was charged with murder for the stabbing death of Waianae High teacher Asa Yamashita at the Ewa Town Center. A 2001 study by the Justice Department determined that 16 percent of inmates in state prisons and jails were mentally ill, with nearly 80 percent receiving therapy or counseling.

Hawaii has been under federal court order in recent years to provide community services designed to keep mentally ill people out of hospitals and jails. The state Department of Health provides mental health treatment to about 16,000 residents — limited to 3 1/2 hours per patient per month — having disbanded teams that provided specialized services to seriously mentally ill people last fall.

“;Now, instead of redesigning the system to address the needs, they're throwing out the core of the system,”; said Tina McLaughlin, chief executive of CARE Hawaii — Child and Adolescent Resources of Education.