WAILUKU — Maui Memorial Medical Center stands committed to keeping its child psychiatric unit open despite low numbers of patients and a struggle to break even financially, The Maui News reported.

"The service is such an important thing," Maui Memorial Chief Executive Officer Wesley Lo said recently. "We want to keep it open."

Molokini II, the adolescent behavioral health unit at the hospital, was shut down for three years until it reopened in May.

Hospital records show over the first six months of operation an average of nearly three patients per day staying an average of a week in the unit. Nick Hughey, regional director of clinical resources, said patient census was lower than projected for the first six months, but that probably was because of timing and an initial lack of awareness about the availability of the service.

He said more recent census counts show the average patient load has increased to nearly four patients per day. The child psychiatric unit can house up to seven patients a day, and on occasion has operated at capacity.

In the first six months after the unit reopened, there were about eight weeks during the summer when children were at home and psychiatric professionals were less likely to recommend hospital treatment, Hughey said.

During the first six months, Molokini II took in 47 patients from Maui, 13 from the Big Island, two from the Marshall Islands, three from Honolulu and one from Lana'i. Thirty-two patients were girls and 34 were boys.

Molokini II is the only adolescent behavioral health care facility on the Neighbor Islands and one of only three in the state.

Hughey and child psychiatrist Dr. Harold McGuffey, medical director for behavioral health services at Maui Memorial, have made visits around the state to inform professionals and groups about the unit and the services it provides.

"We realize we're going to be more of a regional center, not just for Maui," Hughey said.

"We really appreciate the hospital providing the service for the community," said Colleen O'Shea Wallace, Maui branch director of Mental Health America in Maui. "It's just so important to have this. ... From what we hear from parents and professionals, they are happy that it's there for the children."

Wallace and other advocates of young mental health patients have pushed for the reopening and continual operation of Molokini II. Without it, young mental health patients in crisis are forced to seek care off-island, away from their homes and families.

Retired child psychiatrist Dr. Al Arensdorf, who now serves as a health care adviser to Mayor Charmaine Tavares, said it's often critical that young patients have access to their families while being hospitalized.

"It really goes to the heart of their care," he said.

A majority — 59 of 66 — of the patients seen in the first six months were diagnosed with a variety of mental diseases and disorders. Another five were hospitalized because of injury, poisoning or the toxic effects of drugs. One was listed as having alcohol/drug use issues; and the last had been unclassified, hospital records show.

Prior to its shutdown in 2004, Molokini II recorded up to $1 million a year in deficits. Lo estimated at last year's opening that the revived Molokini II could lose as much as $175,000 a year, although he still has hope it can break even.

"We need time to develop it," he said.

The unit closed in June 2004 because of the hospital's inability to get commitments from child psychiatrists to be on-call to respond to emergencies 24 hours a day, seven days a week. After a little more than two years, Maui Memorial was able to hire two psychiatrists and an advance practice registered nurse to serve as the on-staff primary medical team.

"It's working so far. We haven't had any gaps," McGuffey said.

Just prior to opening Molokini II, the hospital joined forces with Maui Youth and Family Services to start regular monthly meetings with community service providers and other professionals who come in contact with youth who need mental health care.

Since Molokini II reopened, Maui Youth and Family Services has shut down a residential home for adolescent girls, giving doctors at Maui Memorial one less option for further treatment after hospitalization.

"It's a concern. It does take away from the spectrum of services. Hopefully someone else will step forward," McGuffey said.

Executive Director Tim Murphy of Maui Youth and Family Services said the residential facility housing up to eight girls closed in December because of the lack of trained professionals to support the house.

The boys' facility has been closed since 2006, Murphy said, also because of problems with recruiting enough qualified personnel to staff the house and provide "high-end treatment" services.

In the meantime, Murphy said his agency was in the midst of establishing five new foster homes where services for adolescents with substance abuse problems and/or mental health symptoms can be provided.

Arensdorf, McGuffey and Murphy all touted efforts by service providers to meet regularly and work together to help in the treatment of young mental health patients.

Wallace, Maui executive director for Mental Health America, said the loss of services for young mental health patients in the community makes it more important for hospital care and foster homes to be available as treatment options.

Hughey said the group of service providers meeting regularly expects to produce a resource guide for families and professionals who deal with young patients with mental health and/or substance abuse problems.

In addition, the group will produce public service announcements to assist families who need more help.

McGuffey, who has been treating patients here for 11 years, said he's noticed improvements with, in particular, the state departments of Education and Health.

"It really does seem to be improving more. And there's more collaboration," he said.

For more Maui news, visit http://www.mauinews.com/default.aspx">The Maui News.