Last year, Hawaiʻi adopted and expanded the 988 CARES crisis helpline so callers can directly reach mental health and substance use resources.
"They're able to take those calls and handle them if a crisis is occurring," Amy Curtis, the chief administrator of the adult mental health division within the state’s Department of Health, said.
"They'll see what they can do by phone, but if they need to, they can send out crisis small mobile outreach units and those had been able to then send someone to a licensed crisis residential shelter," she said.
Curtis said licensed crisis residential shelters can be found on Maui, Oʻahu and Hawaiʻi Island. A request for proposal has been put out for one on Kauaʻi, but a workforce shortage has hindered movement.
"One of the things that occurred during COVID was the identification that we needed to have more of those sites that individuals need to go to if they're having a crisis, as well as really expand that crisis line," Curtis said.
Another piece to this continuum of care could be stronger crisis intervention and connecting those in need with the appropriate mental health resources.
The concept was introduced through Senate Bill 1594 this past legislative session, which would have offered funding for a center on Oʻahu and a neighbor island with 24-hour beds for those to be assessed. It also focused on getting crisis intervention training for law enforcement across the state.
"You're talking about services for people who are suffering mental crisis issues right now, in real time," House Homeless and Human Services Chair Representative Della Au Bellati of Oʻahu said earlier this summer. "We have a system that deals with some of this when police pick people up and they take them to the hospitals where they get treated, but there may be a way to be able to assess them quickly."
She said the cycle of bringing people to emergency rooms or to jail is unproductive and not cost-effective.
Sen. Sharon Moriwaki introduced SB 1594, she said it's "critical" for law enforcement to be trained in crisis intervention and de-escalation. This would have expanded on the training done with local police departments.
That bill went to conference committee with the support of subject matter chairs but eventually died without funding.
"Crisis is definitely a concern that we're seeing now, and that's coming from both family members, consumers and providers of mental health services, that in Hawaiʻi, that that's a big concern," Katherine Aumer, chair of the state Council on Mental Health, said.
Aumer called SB 1594 a "great opportunity" to begin addressing a need. "But regrettably, that bill, as well as many other bills that the council as well as the DOH did not get the funding that we were hoping to see. We are hoping that next legislature, there'll be more opportunity, or at least, as much if not more support for those bills."
In separate interviews, bill advocates said there was general consensus on the legislation, and that they were even able to get a $30 million initial estimate of the program down to $19 million. However, Finance Chair Rep. Kyle Yamashita of Maui said that wasn't the case. He declined an interview but provided a seven-page written statement.
"We need to be mindful of not just direct funding of programs and positions, but the impacts to agencies that are sometimes not obvious," Yamashita wrote. "Statutory mandates require funding above all other programs a department may have. There may be unanticipated workload or procedural change that may impact existing budgets. There may be additional costs to the public."
Of the mental health bills introduced in the 2023 session, 12 went into conference committee, and two came out and were adopted. One was funded in the state budget.
Yamashita wrote that the DOH could expand an existing program to include what was in SB 1594. He also noted that the Adult Mental Health Program earned general fund increases in the current and upcoming fiscal years.
One passed bill, Act 89, establishes a two-year child and adolescent crisis mobile outreach team through a pilot program on Oʻahu and neighbor islands. It is supposed to expand existing crisis response services.
"This might sound cliché, but the youth really are our future and we need to ensure that they have all the resources they need to thrive to, to do well in our society," Amur said.
