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The Honolulu Advertiser
Posted on: Wednesday, September 12, 2007

Mental-health patients need a show of aloha

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The conflict over a proposed mental-health treatment facility in Kailua compels us to ask: Who deserves to live in a community?

The answer would seem to be obvious: We all do. As long as people are well enough to live in a home environment without posing a danger to anyone, they should have a place in our neighborhoods.

Pressures on the mental-health system to develop a full range of care, from outpatient treatment to inpatient hospital admissions, has led state Health Department officials to reorder the use of Hawai'i State Hospital facilities.

Lest anyone forget, the overburdening of that Kane'ohe campus is what landed the state system in years of oversight by the federal courts.

Redirecting a total of 16 residents from the hospital grounds to two homes on a single lot within the general community is the intent of the Kailua proposal, one of three submitted to state authorities by the agency CARE Hawai'i. The one in 'Aikahi is the first to undergo scrutiny by the State Health Planning and Development Agency, but two others are in the pipeline, in Salt Lake and in Waipahu.

SHPDA's job is to evaluate not the location but whether the facilities would duplicate services or, instead, are needed within the state's healthcare system. A later health review of all three facilities will gauge staffing and other quality-of-care concerns before the required license is issued.

Neither of these reviews is designed to give weight to community reaction. Nor should they, as long as the patients are appropriately selected so that they are not a threat to themselves or others due to criminal history, drug use or other factors. They also need to be adequately supervised.

Judging by the proposed around-the-clock staffing support, health officials seem aware of this duty; they must be held accountable to it. In the 'Aikahi case, for example, the licensing review must make sure the two homes can accommodate the eight people assigned to each residence.

Beyond that, there seems to be no basis — legal or social — to discriminate against residents who are being prepared for independent living. As long as staff can handle the care and supervision, these are people who should feel at home in the neighborhood.