Coronavirus clouds prospects for Hawaii’s mental health reforms
Among the business Hawaii lawmakers left unfinished when they abruptly suspended the Legislature to help slow the spread of the new coronavirus were proposals to improve psychiatric care for the state’s mentally ill.
Lawmakers had convened with a new sense of urgency on this topic after a Honolulu man shot and killed two police officers, fatally attacked his landlord and burned down several houses in a morning of stunning violence in January. The man’s neighbors had sought restraining orders against him, detailing his erratic, violent behavior in court filings.
Yet just two months later, uncertainty is clouding the bills’ prospects as the number of people testing positive for the coronavirus increases daily. A mandatory 14-day quarantine for all arriving travelers and a statewide stay-at-home order have crippled the state’s tourism industry and are expected to make a large dent in state tax revenue. Lawmakers don’t know when they’ll be able to resume deliberating.
The proposed reforms come as Hawaii tries to shift toward more assertively nudging, or even forcing, people to get care when medical professionals and judges determine it’s necessary.
Ed Mersereau, who leads the state Department of Health’s behavioral health division, noted that historically, the mental health care pendulum in Hawaii and the rest of the U.S. has swung from relatively easily committing people to a hands-off approach.
“These measures are designed to bring us a little bit more of a middle ground,” Mersereau said.
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Some proposals, notably one that would increase the amount of time hospitals may hold a patient against their will in an emergency to three days from two days, have generated objections on civil liberties grounds.
The state public defender said this rule would allow someone to be held five or six days if they were brought in over a weekend or a holiday.
“This exceedingly long detention period based upon a police officer’s opinion and a mental health emergency worker’s over-the-telephone judgment is not justifiable,” the public defender’s office said in written testimony.
Mersereau hopes the state will address the virus and mental health care in tandem because helping the mentally ill is also a way to help limit the pandemic. Many struggling with mental illness are living on the streets and coming into close contact with people with substance abuse disorders and other conditions that put them at risk, he said.
“If it becomes more of an issue and community spread becomes the issue, we’re going to see the mental health and substance abuse populations pretty hard-hit, and those are going to be hotbeds for additional community transmission,” he said.