The first "Chief's Roundtable" on Maui in three years was held at the J. Walter Cameron Center on Friday, Feb. 10. State of Hawai'i Department of Health Adult Mental Heath Division (AMHD) Chief William P. Sheehan, M.D., hosted the community meeting.
Sheehan told the more than 100 attendees that the meeting was intended for mental health service consumers to ask questions, advise him, weigh in on what the mental health division is doing, and to talk about concerns and needs not being met.
Audience members embraced the opportunity, sharing their experiences regarding the lack of flexibility in housing regulations for people with mental illness, the need for more peer specialists to work with and advocate on behalf of mental health consumers, and the threats of loss of benefits and housing if they spoke out about gaps in service and abusive treatment.
Addressing fears of benefit or housing losses by those who spoke out about their concerns regarding the mental health system on Maui, State of Hawai‘i Department of Health Adult Mental Health Division Chief William P. Sheehan, M.D., said, “There should be no retaliation for anything that was said in this room today.” Sheehan addressed questions and comments from more than 100 mental health service consumers, providers and advocates at a community meeting held at the J. Walter Cameron Center on Friday, Feb. 10.
Thea Ramsay is 46. She said she was living at home in an abusive relationship and had been looking forward to going to an assisted-living facility.
"It would have been perfect," Ramsay said, "but I could not do it, because I was not 55 or older." She called for more expansive eligibility requirements for assisted living.
"Now I am living in a converted garage with a tiny sink and no oven," she said. "If I have an anxiety attack, then it's just too bad."
Another member of the audience told Sheehan that the one-year time limit for living in a group home is not conducive to patient stability and the previous time limit of two years had been better. But Sheehan said that AMHD had been forced to eliminate $1.2 million from its budget due to funding cutbacks.
"I did not want to cut a line of service, and I had to cut back to one year," Sheehan said. "I admit to you all that I did it. Ultimately, I had to make a decision."
Diane, a cancer survivor and mental health service consumer who asked to be identified only by her first name, challenged Sheehan's decision.
"I am one of the people affected by your decision," Diane said. "I feel like I am cattle in a group home. At the group home, I can't stay the day. There is something sick about it. It's a dysfunctional system that is not well."
"I was a mother," Diane, who is suffering from depression, said during an interview after the meeting. "I was a student. It was not my choice to be in the system. I am living in fear. I have been told that I have to go to a shelter or be on the street. At a shelter you have to work, but I can't work.
"There is no place for me," she continued. "If I was an addict, I could get help."
Susan King questioned the lack of peer specialists for the mentally ill. "Will the state continue to help us as peer specialists? Will ADMH services continue?" she asked Sheehan.
"Right now, the position is abolished," Sheehan said in response. To get it reestablished is a real big deal. We are trying to solve the problem incrementally by putting peer specialist authorization into agency contracts."
One consumer, who asked to only be identified as Steve, told Sheehan that speaking up can lead to threats of benefit cuts.
"It happens behind closed doors," he said. "I have been threatened for asking for my needs. It has happened to several people. It is not reported, because people are afraid of being cut off. There is no equality. You are the mental patient. It is an abuse of power."
Lisa Darcy, former AMHD employee and community advocate, agreed. "People are not being treated with dignity," she said. "You have to understand that this is not OK. It has to change. When I spoke up, I was pushed out. How can I protect those who are vulnerable when I could not protect myself? You are not welcoming peer counselors. There are people in this room willing to work for free. You've got to do something and not just say you don't have funding. I have spoken up in these meetings and it [the current system] is not OK."
Tyson Quick told Sheehan that "people are living in fear." "I have lived in group homes where people are thrown out in 24 hours," he said. "This cannot happen anywhere else. This is a huge fear that everyone has. We should have the same rights as any renters. To pack people up and throw them out in 24 hours is inhumane. I have seen people die as a result of it."
"A lot of people who are mentally ill do not have dual diagnosis," said Garry Simpson, member of the Hale O Lanakila Clubhouse. "The home I was in threw me out because I did not have dual diagnosis, because they made more money off of those with dual diagnosis no substance abuse issue, so they want someone who has mental health and drug or alcohol issues as well. If you don't have dual diagnosis, they don't know what to do with you."
"You need to investigate what they are telling you here today and either confirm or deny it," a member of the audience told Sheehan. "We can't just keep talking about it."
Dr. William P. Sheehan can be contacted via email at email@example.com.