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Hawaii ranks last nationally in healthcare services for seriously disabled mentally ill (SDMI) individuals. Despite a statewide response, the state shows no significant improvement in care quality.
Area of Science:
- Public Health
- Mental Healthcare Policy
- Healthcare Services Research
Background:
- A 1988 report rated state programs for the seriously mentally ill.
- Hawaii's healthcare services for the seriously disabled mentally ill (SDMI) were evaluated.
- This special edition addresses the findings of a national study on mental healthcare.
Purpose of the Study:
- To present a collection of articles commenting on Hawaii's healthcare services for the SDMI.
- To respond to the national "Care of the Seriously Mentally Ill; A Rating of State Programs" study.
- To analyze Hawaii's standing in national rankings for mental healthcare services.
Main Methods:
- Comparison of state healthcare services using hospital, outpatient, rehabilitation, and housing indices.
- Rating of all 50 states and the District of Columbia based on care indices.
- Analysis of changes in state rankings between 1986 and 1988.
Main Results:
- Hawaii was ranked last (51st) in the nation for SDMI care in both 1986 and 1988.
- No state achieved a high score, with a maximum of 14 out of 20 points.
- Only 12 states showed significant improvement; Hawaii was not among them, indicating a lack of progress.
Conclusions:
- Hawaii's healthcare system for the seriously disabled mentally ill is critically underperforming.
- The state's approach to mental healthcare services requires substantial and immediate improvement.
- Hawaii is identified as a state with "going nowhere" in addressing the needs of the SDMI population.
Abstract:
This special edition of the Hawaii Medical Journal presents a collection of articles that describe and comment upon the spectrum of health care services for the seriously disabled mentally ill (SDMI) in Hawaii. It is but one of several statewide responses to the publication, "Care of the Seriously Mentally Ill; A Rating of State Programs," by E. Fuller Torrey, MD, Sidney M. Wolfe, MD and Laurie M. Flynn, Second Edition, 1988. Published jointly by the Public Citizen Health Research Group and the National Alliance for the Mentally Ill, first in 1986 and again in 1988; the study sought to compare and rate all states, plus the District of Columbia, using hospital, outpatient, rehabilitation and housing services as indices of care. The published results ranked Hawaii last (51st) in the Nation in its care of the SDMI in both years of the survey. On a scale of 1 to 20, no state ranked higher than a total of 14 points across the four categories of care (Table 1: Summary of State Ratings by Points). Additionally, only 12 states showed significant improvement between 1986 and 1988. Hawaii is included among those states deemed to be "going nowhere."