State university collaboration to transform practice in public sector psychiatric nursing

In 1986 and again in 1988, Hawaii was ranked by the Torrey report as being 51st in the nation in caring for its persistent and seriously mentally ill. After several years of being ranked last in the nation, and with the threat of a consent decree from the U.S. Department of Justice, the state of Hawaii made a commitment to improve the psychiatric mental health care of its citizens. The state's Department of Health, in September 1990, contracted with the University of Hawaii's School of Nursing to provide joint appointment faculty to consult with the nursing staff and to provide the department's chief of nursing. Working together with the joint appointment faculty, the permanent staff began the journey toward creating a state-of-the-art facility. The article discusses how change of such magnitude has been created.