Hawaii State Hospital’s new $ 160 million psychiatric facility is empty


October 24 — In May, the state Department of Health unveiled a long-awaited $ 160 million psychiatric facility at Hawaii State Hospital to help improve safety and reduce overcrowding.

The sparkling 144-bed building in Kaneohe is equipped with state-of-the-art security as well as hundreds of digital cameras, clear lines of sight, elevators that separate staff and potentially dangerous patients, and padded rooms where unstable patients can be constrained. or confined to prevent self-harm.

The prison atmosphere is tempered by outdoor spaces where patients can relax, sports fields, a games room and an open dining room, all set amidst a stunning landscape that offers stunning views of the bays. from Kaneohe and Kailua.

The new facility took years to develop, but five months after state officials opened the building to media visits, it sits empty as the DOH continues to develop policies to govern its operations and struggle to fill staff positions.

A state health official declined to speculate when he would start accepting patients.

The union representing much of the staff says a fundamental dispute over the vision for the facility has caused months of delays. Rather than a new hospital designed to treat mental illness, the Hawaii Government Employees Association says the state essentially built a prison, and it took time for state health officials to recognize it fully.

“This will truly be a correctional facility for people with mental illness,” said Randy Perreira, CEO of HGEA. “If you started from this premise, you would realize that policies and procedures must be developed to ensure the safety of both patients and staff. “

Perreira said Run Heidelberg, the administrator of the Hawaii State Hospital, erroneously viewed the building as more of a high-security hospital.

“From the outset, the administration of the Hawaii State Hospital simply did not adequately plan how this new building would be staffed and opened,” said Perreira.

He said security at the facility should be similar to that found at the Oahu Community Correctional Center and Halawa Correctional Facility, where there are trained correctional officers.

According to Perreira, planning has since shifted to the Department of Health’s Behavioral Health Services administration and, promisingly, Ted Sakai, former director of the Department of Public Safety, which oversees the prisons and prisons of the State, was appointed consultant.

Sakai confirmed he was helping the project but said he was not free to comment.

The DOH did not respond to requests from the Honolulu Star-Advertiser to interview Heidelberg, who has a master’s degree in psychiatric nursing and a doctorate in nursing practice. He has worked at Hawaii State Hospital since the mid-1990s and took over as an administrator in 2019.

Heidelberg led a media tour of the facility in May, showcasing its new security features and classrooms set up for therapy and anger management sessions with patients. He said the majority of the facility’s patients at any given time are homeless, and more than 90% suffer from substance abuse in addition to their mental health issues.

Many patients also suffer from severe trauma, he said.

At the time, Heidelberg said the new facility was due to start housing patients in August.

Marian Tsuji, deputy director of behavioral health services administration at DOH, did not directly address Perreira’s characterization of past conflicts between the union and hospital administration, but said the department and the HGEA were now “on the same wavelength”.

“I think we are all going in the same direction,” she said. “We are all eager to get into this new facility, but at the same time, we want to do it right.”

Hawaii State Hospital has been plagued by problems for decades, including lax security and hundreds of assaults by patients against staff. In a high-profile example of security failures, Randall Saito, a patient who was sent to hospital in 1981 after being acquitted of the insanity murder, was released from the facility in November 2017, has called a cab, which took him to the airport, boarded a chartered flight to Maui, and then took a commercial flight to San Jose, California.

He was eventually arrested and sentenced to five years in prison for escape.

This year, the hospital made headlines again after Honolulu Police wrongly arrested a homeless man for a crime committed by someone else. Joshua Sprestersbach was locked up in Hawaii State Hospital for more than two years and forced to take psychiatric medication.

State health officials have long pointed out that the new building will greatly assist reform efforts, including improving security and reducing overcrowding. The hospital is licensed for 202 beds, but with waivers, it accommodated up to 238 patients in other buildings on campus and at a contracted facility in Ewa.

As of Friday, there were 220 patients, according to the DOH. Hospital officials said overcrowding reduced classroom space and the ability to focus on therapy.

Almost all of the patients at Hawaii State Hospital, which is the only publicly funded mental hospital, have been court-ordered there. But 69% of current patients have not been convicted of any crime, according to the DOH. Among these patients, 16% were acquitted but interned in hospital by the courts. Many patients have been deemed unfit to continue the trial or are awaiting such a decision.

Patients end up in hospital after being charged with a wide variety of offenses. Between fiscal years 2015 to 2019, 40% of inpatients had been charged with misdemeanor or minor misdemeanor, according to the most recent from Hawaii State Hospital to the legislature.

About 1 in 5 patients were charged with Class A and B crimes and 38% were charged with Class C crimes. The average length of hospital stay in fiscal year 2019 was approximately eight months.

DOH hoped to build a new mental institution as early as 2005, but funding has been slow in coming. Gov. David Ige’s administration was able to secure funding in 2016 and the Legislature subsequently provided funding in fiscal 2021 for 127 new positions.

The state is currently recruiting registered nurses, psychiatric technicians, social workers and telephone operators, and is also assessing the needs for security personnel, a patient rights adviser and kitchen helpers.

But of the 127 funded positions, only 31 were filled in September, according to the health ministry, while 25 other candidates have been selected but have yet to start work.

State health officials say recruiting only began after the statewide hiring freeze was lifted in April, and noted in email responses that “it There have been challenges hiring hospital staff across the country and Hawaii is no exception. “

Tsuji said she was reluctant to provide a timeline for when the new facility will begin accepting patients. She said an internal committee within the DOH meets regularly to develop policies and procedures for the new building, which must also be approved by the department’s office of health care insurance.

She said the COVID-19 pandemic has also complicated matters.

“I’m reluctant to say anything just because we’re still in a pandemic,” Tsuji said. “And I’m really reluctant to commit to a solid schedule in light of that.”

She said when the draft policies and procedures are ready, the Department of Health will provide them to the HGEA for review.