EDITORIAL
Outpatient care for mentally ill is critical
The story of Lloyd Vasquez is an extreme and unfortunate example of how someone can become lost in the state mental health system.
Advertiser courts writer Ken Kobayashi detailed how Vasquez, arrested in 1979 for a crime punishable by a five-year prison term, was acquitted because of his mental illness and sent to the state hospital for treatment. He was released and readmitted repeatedly over the course of 26 years, due to a lack of adequate monitoring of his treatment while living outside the hospital confines.
Although his case has languished far longer than most, Vasquez' experience shows the critical need for better community mental-healthcare.
State health officials have laudably worked hard in recent years to bring the Hawai'i State Hospital within compliance of patient treatment standards, leading a federal judge in December to lift federal oversight of the hospital that resulted from a Justice Department lawsuit. And they have appropriately acknowledged falling behind on plans for improvements to the other component of mental-healthcare: outpatient services.
This is where the state must redirect its focus: The courts still maintain jurisdiction over state services to the roughly 7,000 people living in the community with serious mental illness. Federal Magistrate Kevin Chang correctly observed in a February report that progress in this area is "slow and not remarkable."
To their credit, officials have filled key posts at five of eight community centers and have tightened up "hand-off" procedures to prepare community providers for the hospital patients released to their care.
Better still, they acknowledge the great deal of work that remains. The Health Department must redouble efforts to develop a secured residential facility for people no longer needing expensive, full-scale hospital care but who are unprepared for less supervised living arrangements.
The state has proven its commitment to creating an environment that provides intensive hospital treatment when that's necessary, and now it's time to build out that continuum of care to the mentally ill. And when requests are made for funding in that regard, lawmakers must meet that commitment with ample support.
