Even in the best of circumstances, troubled youths who need specialized treatment for serious problems, including severe mental illness, substance abuse or behavioral issues, face unique challenges.
But if the young person is poor, or in trouble with the law, and the appropriate services are not available in Hawaii, a future that could be saved may easily be lost. Every effort should be made to avoid such an outcome.
While relatively few Hawaii youths face this dilemma, their number has grown. As the Star-Advertiser’s Sophie Cocke reported recently, state agencies are exploring ways to address this problem, including the critically important need to expand available services in Hawaii so vulnerable kids can remain within reach of their families.
Establishing a modern, secure, 24/7 residential treatment center in Hawaii should be a firm priority, even if budget constraints prevent immediate action.
In the meantime, the state does provide a safety net of sorts. For the 2016 fiscal year, the state has contracts with 47 mainland residential treatment facilities, from states including Utah, North Carolina, Texas, Michigan, Minnesota, Arizona, Tennessee, Indiana, Montana, Oregon, Arkansas, Illinois and Pennsylvania.
At-risk youth can reach these treatment centers voluntarily through Medicaid, through the courts or the Office of Youth Services.
In the 2015 fiscal year, the state sent 35 youths to mainland residential treatment facilities; in 2013, the number was just 5. Ideally, the number should be 0.
For the state, sending youths to the mainland is a last resort, according to Daniel Ulrich, medical director of the Child and Adolescent Mental Health Division. It should be. The best solution is to have the young people treated at home.
“Families are an integral part of the treatment and healing process and mainland placements obviously leave them out of the loop,” said David Hipp, a former executive director of the Office of Youth Services.
This is especially crucial for local youth who may feel out of place on the mainland.
“Our Hawaiian and Pacific Islander kids struggle when they are so far from the islands,” Hipp noted.
One solution that’s been proffered is to build a secure facility on the same property where one already exists — the Hawaii Youth Correctional Facility in Kailua. The facility could serve those mentally disturbed youth who require a safe place to live and 24/7 care. It certainly would be more expensive than sending youth to the mainland, which now costs an average of $350 per person per day.
Nonetheless, lower costs may not be such a bargain, especially if a critical part of the youth’s treatment — family support — is absent, and the youth relapses upon returning home.
Furthermore, the state must monitor carefully the mainland facilities to ensure that appropriate services are provided. It cannot be a formality.
A 2007 report from the Government Accountability Office found “thousands of allegations of abuse, some of which involved death, at residential treatment facilities around the country.” The report also noted that information about these facilities is sporadic. Oversight varies by state, and the GAO could not locate a single entity that collects comprehensive nationwide data on these facilities.
For most troubled youth in Hawaii, good mental-health treatment can be found here at home. The same opportunity should be provided to those kids who, through no fault of their own, need more.
