Honolulu Star-Advertiser

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Column: Community-care services help mentally ill homeless in Hawaii

DENNIS ODA / APRIL 11

Homeless clients line up at the River Of Live Mission before they are served breakfast.

May is Mental Health Month, a time to raise awareness around mental health issues. For me personally, that means advocating for and supporting the 7,000 homeless individuals living in Hawaii, many of whom suffer from mental illness.

It’s hard to imagine what many homeless individuals go through on a daily basis unless you’ve experienced it, even for one night. I’ve had the privilege of participating in the annual #CEOSleepout organized by the Salvation Army Hawaiian & Pacific Islands. Together, leaders from across the state sleep outside at the state Capitol rotunda to better understand the struggles of Hawaii’s homeless residents.

During one sleepout held last year, the weather was unpredictable, the streets were loud, and needless to say, I only got a few hours of real sleep. For me, the experience puts into sharp focus that many of us are just one or two bad breaks away from being homeless ourselves and experiencing the many issues and illnesses that can go hand-in-hand with the condition — particularly mental illness.

According to Mental Health America of Hawaii, a staggering 60% of Hawaii’s most vulnerable homeless individuals also experience mental illness.

So, how do we address mental illness, particularly among our homeless population?

First, it’s important to overcome the stigma linked with mental health conditions. Societal pressures and misconceptions about mental illness prevent many from seeking the help they need, and all too often, those impacted suffer in silence.

Sadly, 68% of adults living with a mental illness in Hawaii do not receive the treatment they need. We must find better ways to connect those with mental health conditions to the most appropriate therapies — from less intensive outpatient centers, counseling and drug therapies, to more intensive treatments such as inpatient and residential care, when necessary.

And, while great strides have been made in developing better medical treatments, only recently have we begun to recognize the problem can’t be solved by medical interventions alone. Having a home, employment, a strong support system and other social and environmental factors accounts for 90% of a person’s health outcomes.

These are huge systemic issues that can’t be tackled by the health-care community alone. Fortunately, there are models being implemented in the state that are building a bridge between the health-care system and available social services. These programs are showing success in addressing basic human needs and, in turn, producing better health results and lowering costs.

A good example is ‘Ohana Health Plan’s partnership with Hawaii’s Med-QUEST Division to offer the Community Care Services (CCS) program, which addresses behavioral health needs for Medicaid members determined to have serious mental illness (SMI). There are approximately 5,000 members currently enrolled in the program, which coordinates face-to-face case management services, 24/7 crisis assistance and convenient telehealth options.

We also make connections to social support services that are critical to good health such as housing, food or employment. By addressing both our members’ behavioral health and social needs in a holistic manner, we’re working hard to improve health outcomes.

As a result of these programs, inpatient admissions for those with depression and severe mental illness have continued to steadily decline.

While there is no simple solution to eliminate homelessness or treat mental illness in Hawaii, as we observe Mental Health Month, let’s make progress by working together to recognize and address the factors that can affect not only someone’s living situation, but his or her overall health and well-being.


Scott J. Sivik is the state president of ‘Ohana Health Plan.


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