Ten years ago Cathy Klarin’s son began getting into "trouble" of a kind that later turned out to be early symptoms of schizophrenia.
"It was almost impossible to get the help then, as it is now, to get him properly diagnosed," Klarin said. "There are very few resources if any. It’s taken me this long, and only within the last six months am I actually getting the help I need for him to go forward."
Klarin and about a dozen mental health advocates gathered Tuesday outside the fourth-floor office of Senate Health Chairman Josh Green at the state Capitol to demand that Green hold a hearing on a measure they believe would significantly improve mental health treatment in Hawaii, particularly in rural communities.
House Bill 1072 would allow psychologists who undergo special training to prescribe medications for mentally ill patients, which supporters say would translate into better, more rapid care for people with mental illnesses who don’t have ready access to a psychiatrist.
Psychologists have that prescriptive authority in New Mexico, Louisiana and Illinois but not in Hawaii.
Klarin, a Waikoloa resident, found there were few psychiatrists practicing in her area who could provide the combination of drug therapy and emotional therapy her son needed.
"These are the people that are falling between the cracks and ending up in prison, that are ending up with the homeless tidal wave, that are ending up committing suicide, and I won’t stand for it," Klarin said, her voice breaking with emotion. "I won’t let my son fall through the cracks, and that’s why I’m here. I’m here to help somebody else so they don’t have to go through what my family has been going through."
Marya Grambs, executive director of the Mental Health America of Hawaii, said her organization operates a help line, "and we get calls every day from consumers and family members who cannot find a psychiatrist to prescribe medication, and that means people get hospitalized and people decompensate," she said. She said granting prescriptive authority to specially trained psychologists would help.
Marie Terry-Bivens, a Kauai clinical psychologist and president of the Hawaii Psychological Association, said Hawaii’s rural areas particularly have problems getting care because obtaining proper treatment might require a flight to another island.
Advocates said Maui Memorial Medical Center closed a mental health unit there in October, and Maui children in mental health crisis must now be flown to Oahu for treatment.
The issue of granting prescriptive authority for psychologists has been kicked around at the Hawaii Legislature for 31 years, but proposals have never been passed because "the physicians have a very strong lobby," said Alex Santiago, executive director of the Hawaii Psychological Association.
Santiago served in the Legislature from 1990 to 2000 and is a former chairman of the House Health Committee.
Physicians in rural areas support the bill, including Dr. Lee Evslin, a former chief executive officer of Wilcox Memorial Hospital, but the physicians’ lobby in Honolulu does not, Santiago said.
"They will stop at nothing to stop this bill," he said.
Green (D, Naalehu-Kailua-Kona) is a physician but noted he has sponsored bills before to allow prescriptive authority for psychologists. However, he isn’t ready to do so now.
"Any significant change in prescription patterns requires some collaboration between the primary prescribers, meaning physicians and psychologists," Green said. "They will need to work together, and I have expressed to both sides that I need to see some consensus."
Green said the psychologists will rely on the physicians if a patient has a reaction to the drugs and needs to be hospitalized.
"We’re a small state. It’s going to actually require a partnership, and there still is animosity between psychologists and medical doctors. I’ve simply asked that they work through some of that animosity for the benefit of the patients," he said.
The measure is not currently scheduled for a hearing.
