A Windward Oahu facility that houses hundreds of often violent mentally ill patients has had to answer to lawmakers lately.
The Hawaii State Hospital has been on the hot seat at the center of legislative hearings, facing allegations of nepotism, sick leave and overtime abuse, and even bigger issues of worker safety.
Emelinda Yarte, a former worker who was badly injured when a patient with a mixed martial arts fighting background lashed out, testified at a recent hearing.
“I got pushed on the wall. He pushed me on the wall (and I) hit my head,” she said. “We were on the ground. All I could see was blood on the floor, and I just closed my eyes.”
“There are a lot of concerns about safety obviously and whether or not the patients are properly staffed,” said Sen. Clayton Hee, who has been heading up the legislative hearings, “because the demography of the patients are MMA, drug-induced, psychotic.”
But KHON2 has learned not all of the hospital’s problems are happening on the inside.
It’s not a prison so the facility doesn’t call them inmates, but every one of Hawaii State Hospital’s 200 patients was sent there by a court after getting into trouble that often includes extreme violence.
“We understand that the community is anxious about having patients from the Hawaii State Hospital be back in the community, because all of them came in legally encumbered in some way,” said Dr. William Sheehan, medical director for Hawaii State Hospital.
When they first arrive, patients are kept under lock and key. But over time, patients gain enough stability to be considered for approved excursions, like court or doctor appointments and sometimes even outings like the beach, the library or the nearby mall, all at a ratio of up to four patients per staff.
“Part of the point of that is to help our people learn how to have clean and sober fun in the community and not have to violate the law or not have to be high or intoxicated,” Sheehan explained. “We get a list every day of people leaving the campus and we know when they’re going. There’s always a risk.”
The risk includes elopement, the hospital’s term for escape. While elopements are down from the double digits about a decade ago, just about every recent walkaway happened when the patient was already off-property on an approved outing.
“Obviously, the policies need to be reviewed, because we haven’t yet gotten into the number of elopements other than the one that occurred where (David) True Seal killed somebody on the Big Island after being gone. He’s the longest escapee,” Sen. Hee said
The facility now requires a lot of review and sometimes triple approval levels before an outing.
“We know the risk isn’t probably going to go to zero, but we want to manage the chances that something adverse happens as best we can,” Sheehan said.
Just outside the hospital wings, residential care homes are rented by recently discharged patients on conditional release. They have much more freedom to come and go, including a well-worn path from the non-smoking hospital grounds to one of Windward Community College’s designated smoking areas.
“I raped my mother and I shot somebody,” one patient openly admitted to KHON2.
He described the kinds of care he’s still getting at the outpatient home: “Taking medication and go to my sex offender treatment.”
KHON2 asked Windward Community College students when they see the kinds of people who come in and out of there, do they have any concerns for safety?
“I do, because we do hold nighttime classes, which is really dark on campus and it’s really dangerous to be walking from our buildings to the parking lots,” said student Michelle Muromachi.
“Knowing that they did these crimes, I’m actually a lot more aware that they commit crimes and are not just mentally ill,” said student Amber Maze. “They actually are capable of doing something harmful.”
When asked if they think any more should be done in terms of security between the two properties, student Inez Reid said, “Definitely, I think that having a separate hangout area might be better than connecting it with the college.”
College officials said they are thinking about making the whole place smoke-free anyway, telling KHON2 in a statement: “Windward Community College currently is in the process of considering a transition to a smoke-free campus with the projected goal of removing all Designated Smoking Areas on our campus.”
Meanwhile, back up the hill, the hospital continues to grapple with how to serve court-assigned patients in a place that never intended to be a prison for those with mental illness, or what’s called a forensic prison.
Sheehan said having a forensic facility would markedly change elopement problems, because “it will have security built into it and proper physical structures built into it to do both, take care of people and maintain safety and security at the same time.”
Hospital officials have the money and approval to tear down an old building near the top and start designing a forensic prison that could cost about $200 million.
“To get funding, design and build a new building (will take) I’m told five to seven years fast-track,” Sheehan said. “Better than nothing. I’ll take it at this point. I’ll take it because we have to do something. We can’t keep doing what we’re doing now. This is a squeeze on everybody.”