Some legislators openly expressed their frustrations at state mental health experts for their lack of data and specifics on how to best deal with mentally ill criminal defendants and keep them out of Hawaii’s jails and prisons during a briefing Monday at the state Capitol.
Dr. Michael Champion, Gov. Josh Green’s senior adviser for mental health, told a joint hearing of the Senate Committee on Health and Human Services and House Committee on Health and Homelessness that 17% of Hawaii’s jail and prison inmates have serious mental illnesses.
“When you expand it to any mental illness or any behavioral health conditions, the numbers are much, much, much bigger,” he said.
Champion said that a Behavioral Health Crisis Center represents the best practice model to deflect criminals away from the judicial system and provide them with services. The Iwilei Resource Center, a medical respite center that opened in June, includes a pilot program.
A well-rounded and integrated treatment plan would include education, support groups, supportive employment and housing and counseling, Champion said.
“I’m disappointed because it’s theory,” said state Sen. Joy San Buenaventura (D, Puna), who chairs the Senate Committee on Health and Human Services. “I wanted to hear reality.
“What is the need?” she asked. “What are the programs? What is the capacity? What are the governor’s plans to meet that capacity?”
Champion referred to the state Department of Health and state Department of Public Safety to provide data and answer questions for Buenaventura.
DOH officials later told the Honolulu Star-Advertiser that plans are underway for a second Behavioral Health Crisis Center somewhere on Oahu or on a neighbor island to help identify needs.
State Rep. Della Au Belatti (D, Makiki-Punchbowl) chairs the House Committee on Health and Homelessness and said she wants more data.
“What’s been frustrating is that the Department of Health is not acting with the kind of speed with which the mental health crisis we’re facing on the streets seem to demand,” Belatti told the Star-Advertiser after Monday’s briefing.
Dr. Courtenay Matsu — representing DOH as medical director and acting administrator for the adult mental health division — said defendants whose crimes are the result of mental illnesses such as psychosis, anxiety and trauma would be directed to the Hawaii State Hospital.
However, she said, those who have existing mental and behavioral issues such as violent behavior, antisocial personality and difficulty with authority and committed a crime unrelated to their mental illness will be directed to jails and prison.
Upon arrest, defendants are briefly assessed during their intake process and could be referred to a jail diversion program if they qualify, Matsu said.
Matsu said DOH officials since April have examined 758 defendants for potential jail diversion.
Of them, only 1% were accepted.
According to Matsu, out of the rest, 294 defendants were unable to be interviewed due to staff shortages or showed aggression or did not cooperate; 288 refused to participate in their evaluations; 164 were ineligible due to a legal history of violence or didn’t have severe persistent mental illness.
According to Tommy Johnson, director of the state Department of Corrections and Rehabilitation, 476 inmates were transferred to the Hawaii State Hospital under court order in 2023, representing an increase of 196 inmates from the previous year.
Dr. Kenneth Luke, administrator of the State Hospital, told the Star-Advertiser that almost all committed patients return to society at some point, and 14% return to the State Hospital within 90 days.
“We believe this number will decrease with enhancements to the Behavioral Health continuum of care,” Luke said.
Currently, the DOH provides mental health treatments to those court ordered to the State Hospital, including psychiatric medications, psychotherapy, nursing care and rehabilitative programming. However, not all patients consent to treatment.
Matsu said during her presentation that the DOH is “working to expand capacity for the entire continuum of care.”
Matsu said that the jail diversion program “shouldn’t be expanded until we can really make improvements to increase the effectiveness of this program.”
Belatti said she pressured the Health Department because she wants to determine how to “strategically invest valuable state resources” to best deal with mentally ill defendants.
State Sen. Jarrett Keohokalole (D, Kaneohe-Kailua) also pushed Champion for specifics.
He asked whether Green’s office will take the lead on providing charts that will appropriately address needs including crisis, treatment, supported living and recovery and support, “so that the Legislature has some holistic understanding of what we’re supposed to be funding and where.”
Champion provided “a sequential intercept model program” as a blueprint to promote community-based strategies to reduce the involvement of mentally ill defendants.
Buenaventura said she already knows the concepts and policies and wants to hear the governor’s plans to identify the need.
“I do expect you to do your job and tell us what the programs are,” Buenaventura told Champion.
