The Kulia Program: psychiatric rehabilitation in Hawaii

The Kulia Program was a culturally oriented, psychiatric rehabilitation program. It was developed in the only in-patient psychiatric hospital serving the 2 million multi-ethnic residents of the island state of Hawaii. From 1992-1999 the Kulia program was implemented on the only open, 36-bed unit of the Hawaii State Hospital with the mission of facilitating the reintegration of the chronically mentally ill into the community by encouraged its patients "to strive for the highest." Of the 238 patients discharged between 1992 and 1999 only 7% were re-hospitalized. Comparisons with other four treatment units during this period were not appropriate because of the difference in patient populations. These units provided long-term institutionalization of the criminally mentally ill, the behaviorally disoriented, mentally retarded and/or traumatically brain injured, and the behaviorally disoriented demented elderly. Their lengths of stay varied from 8 years to over 20 years in the hospital during this time period.