THE COMMUNITY OF HILO AND MENTAL HEALTH KOKUA

THE COMMUNITY OF HILO AND MENTAL HEALTH KOKUA SW 631 – Michael Makekau Instructor – Theresa Krief

MENTAL HEALTH STATISTICS • As many as 450 million people suffer from a mental or behavioral disorder. • Nearly 1 million people commit suicide every year. • Four of the six leading causes of years lived with disability are due to neuropsychiatric disorders (depression, alcohol-use disorders, schizophrenia and bipolar disorder). • One in four families has at least one member with a mental disorder. Family members are often the primary caregivers of people with mental disorders. The extent of the burden of mental disorders on family members is difficult to assess and quantify, and is consequently often ignored. However, it does have a significant impact on the family’s quality of life. • In addition to the health and social costs, those suffering from mental illnesses are also victims of human rights violations, stigma and discrimination, both inside and outside psychiatric institutions.

THE COMMUNITY OF HILO

HAWAII MENTAL HEALTH STATISTICS Total Individuals Served by Adult Mental Health Division Statewide 2003 -2007

Total Individuals Served by Adult Mental Health Division County 2003 -2007

Celebrating 40 Years in Hawaii Mental Health Kokua began in 1973 as a program of the Mental Health Association with one donated house on Sierra Drive in Kaimuki on Oahu. The program was incorporated as a non-profit organization called, “The House”. Since those early days, “The House” expanded services beyond housing to include case management, psychosocial rehabilitation, vocational and outpatient services. With the expanded business scope, in 1994 The House changed is name to “Mental Help Hawaii”. In 2000 the organization merged with Maui Kokua Services to become Mental Health Kokua.

Mission Statement: “We believe that all citizens should have an opportunity to live and participate in and contribute to their communities. Through specially designed services and settings, Mental Health Kokua assists people with mental illness achieve their optimum level of recovery and ability to function in the community. ”

RESIDENTIAL RECOVERY SERVICES CONTINUUM Safe Haven. This facility offers outreach, medical and psychiatric care, case management, 24 -hour residential services, and social rehabilitation activities for persons who are homeless and have mental illness. Mental Health Kokua and Kalihi-Palama Health Center work collaboratively in operating this unique facility in downtown Honolulu which provided housing for 60 people in 2008 with 34 residents graduating and now off the streets in Honolulu living in permanent housing. Therapeutic Living Program (TLP). An immediate, short-term alternative to institutionalization, the Therapeutic Living Program, located on Oahu and in Hilo include community placement, access to clinical care, and linkage to needed community resources. Transitional Residential Resources. A 24 -hour supervised group residential facilities and individualized services in traditional housing settings serving persons with serious mental illnesses. Located on Oahu, Maui, Kauai and East and West Hawaii. Supportive Living Housing Sites. Supportive group housing is provided on a less intense level with consumer support available 8 -16 hours a day on site and on-call. Residences are located in Oahu, Maui, Kauai and East and West Hawaii.

CONSUMER COMMUNITY SUPPORT SERVICES Homeless Outreach services are extended on Maui and Kauai to connect homeless mentally ill persons with mental health and special services including entitlements, and assist them in moving to transitional or permanent housing. Case Management. Community based care management services on provided on Maui to individuals who need support and assistance in community recovery. Comprehensive services include crisis stabilization, treatment planning, recovery plan assessments and implementation, individual and group counseling, medication assessment and monitoring, and self-care education. Psychosocial Rehabilitation. Mental Health Kokua offers a Maui therapeutic day rehabilitative social skill building service which allows individuals with serious mental illness to gain the social and communication skills necessary to allow them to remain in or return to naturally occurring community settings. PEER Coach. The mission of the PEER coach project is to provide persons with mental illness the opportunities to empower themselves by teaching and learning skills necessary for daily living. The PEER coach, by using the empowerment-based model of recovery seeks to provide the consumer with participation in social and community based activities for a limited time per week.

MENTAL HEALTH KOKUA – COMMUNITY HOUSING 2011 Big Island/Hawaii Served 170 people 22, 360 Bed Days (95% occupancy) 90% Improved Independent Living Skills Maui Served 915 people 17, 520 Bed days (87% occupancy) 90% Decreased Homeless Oahu Served 338 people 27, 735 Bed Days (95% occupancy) 95% Increased Quality of Life Kauai Served 26 people 5, 475 Bed Days (85% occupancy) 90% Increased Quality of Life

MENTAL HEALTH KOKUA SAFE HAVEN PROGRAM (Oahu) Served 77 people 9, 125 Bed Days (95% Occupancy) 81% Increased Quality of Life PEER COACH (Statewide) Served 97 People 52 PEER Coaches hired by MHK 97% Increased Skills Note: MHK hires more people with mental illness than any other company in Hawaii.

MENTAL HEALTH KOKUA 2011 DEMOGRAPHICS Statewide Characteristics of Persons Served White 529 Asian/Pacific Islander 363 Multi-cultural 160 African 34 Hispanic 31 Native American 14 Mid Eastern 4 Other 164 Total 1299

MENTAL HEALTH KOKUA STAKEHOLDER SURVEY SCALE 1= Strongly Disagree 5 = Strongly Agree

CARF ACCREDITATION The programs and services provided by MHK are accredited by the Commission on Accreditation Rehabilitation Facilities (CARF). CARF is an independent, nonprofit organization whose mission is to ensure that services meet consumer expectations of quality and outcomes. MHK must comply with business standards set by CARF, which involves leadership, governance, strategic planning, input from stakeholders, legal requirements, health and safety, outcome management, human resources, fiscal management, risk management, technology, and rights of persons served. In 2012, MHK earned a perfect score with CARF for the second consecutive year; only 3% of surveyed organizations earn no recommendations. Only one in a thousand programs surveyed who receive CARF accreditation receives a perfect score. This shows that MHK not only provide excellent care, they are leaders in administering health care services in Hawaii and the nation.

TIMELINE – MENTAL HEALTH KOKUA 1973 - Mental Health Association began a program as “The House” with a $40, 000 annual budget and a few volunteers. 1979 - The House created the Network vocational program. 1983 - The House developed the Duplex, the first non-profit mental health program to develop HUD housing. 1988 - The House created the first clubhouse/psychosocial program in Hawaii. 1991 - The House opened Hilo Hale/HUD in Hilo, HI. 1992 - The House opened the SAIL housing programs opened on Oahu. 1994 - The House became Mental Help Hawaii. 1994 - Safe Haven opened as the first homeless shelter in Hawaii for people with mental illness. 1995 - PATCH Place opened in Hilo 1997 - Mental Help Hawaii became nationally accredited by CARF. 2001 - Mental Help Hawaii and Maui Kokua Services merged to become Mental Health Kokua. 2001 - MHK developed Kealahou transitional housing in Kona; developed the PEER Coach program, and Maui case management. 2002 - Hale Noho transitional housing on Oahu, and the PATH homeless outreach program in Maui and Kauai. 2004 - Hale Koho opened on Oahu and Ho`okahua/ HUD transitional housing opened in Kauai, HI. 2005 - MHK developed Kona Kokua/ HUD transitional housing in Kona, HI. 2006 - Hale Amau/ HUD transitional housing opened in Hilo, HI. 2008 - Developed Maui Case Management; Market Street transitional housing opened on Maui. 2009 - Waipio Gentry/ HUD transitional housing opened in Leeward Oahu; Mill Street opened in Maui; Kokua Counseling Centers opened in Oahu, and MHK received perfect score with CARF international accreditation. 2010 - MHK with USDA acquisition opened MHK Maui Market St admin/ program office. 2011 - Fort Weaver/ HUD transitional housing opened in Leeward Oahu 2012 - MHK developed Oahu Case Management; 2 nd consecutive perfect score with CARF international accreditation; MHK has more than 200 employees on 4 islands, 26 locations, and 1400 persons served annually.

Outcomes Outputs Inputs Activities Participation Short Staff Board of Directors County Advisory Board Administrative Management Volunteers Committees Facility/Site Locations Kauai Oahu East Hawaii West Hawaii Maui Form and strengthen public health partnerships with mental health programs. Integrate mental health into public health program efforts. Develop mental health communication messages for target audiences Safe Haven Therapeutic Living Program Transitional Residential Resources Supportive Living Housing Sites Homeless Outreach Case Management Psychosocial Rehabilitation PEER Coaching Funding Aloha United Way Hawaii Community Foundation Kaiser Permanente Harry & Jeanette Weinberg Foundation Foodland Define mental health research gaps and agenda. Identify opportunities for programs. Generate understanding that addressing mental health issues is fundamental for establishing physical health. Serve the needs of the community with respect to the specific target population of the mentally ill. Medium COMMUNITY Identify mental health implementation and integration barriers in systems, communities, and families. Collaboratively work towards improvement of community conditions and establishing roles in the community. Mental health strategies are integrated into targeted efforts to improve the health of individuals and populations. Communities are more supportive and healthy. INDIVIDUAL Treat, refer, and encourage selfmanagement of mental and physical health issues. Increase in knowledge, attitudes, and beliefs. Have increased sense of empowerment. Initiate and sustain regimens of healthy behaviors. To realize of recovery and vocation/personal goals. To maintain consumer engagement in treatment. In-Kind Donations LOGIC MODEL - MENTAL HEALTH KOKUA Long Individuals are more resilient— adaptable, able to cope with stress. Quality of life improves. Optimal mental and physical health are achieved. Disparities in qualities of life are reduced. Public, mental, and physical health systems are integrated at all levels, sectors, and settings. Achieve optimum level of recovery and ability to function in the community.

Problem, Issue or Concern Being Addressed Geographic Area the Organization Serves/could serve Assisting individuals with mental illness to address mental health issues and work towards recovery and independent ways of living. Resources needed/ resources under utilized Individuals (with talents, skills, gifts who are connected to the organization) Citizens connected to the Org w/ associations in the Community Institutions in the Community which currently partner with the org. Institutions in the Community which the org should partner in the future Currently Serves: Contributions, gifts, grants, and similar Kauai amounts received Oahu Maui Direct public Hawaii support Resources originating outside the neighborhood Residents Churches Vocational Rehabilitation Alumni – Mentorship Military (Hickam AFB) US Dept. of Housing and Urban Development (HUD) Higher education institutions Staff HPD Could Serve: Churches PEER Coaches Investment developments Residential Assistants Public information Students Businesses Volunteers Land Home-based enterprises Molokai Lanai Other Rural Areas Assets (resources) Indirect public support Government contributions (grants) Program service revenue Other income Media Institutions – Residential Homes Newspaper, Radio, Social Networks (Own) Information Hospitals State and County Institutions/Programs Other mental health institutions Public Schools The Food Basket Civic clubs Libraries Bank of Hawaii Cultural Programs Parks First Hawn Bank Social Service Agencies Radio/TV Stations Organizations that provide activities for individuals with mental illness Kona Neighborhood Service Clubs Interest on savings Employment partnerships and temporary cash investments Banks Technology Federal Gov’t. More businesses to provide workplace employment Welfare Expenditures Individual businesses Athletic Clubs Vacations Hawaii KOKUA Counseling Centers Boy/Girl Scouts of America Government Officials Communities Aloha United Way Capital Improvement Expenditures American Psychiatric Assoc. Aloha United Way Salvation Army Kaiser Permanente Foodland Hawaii ARC Being able to survive w/o gov’t funding during cutbacks Organizational Asset Inventory

RECOMMENDATIONS

$9, 000 FINANCIAL STATEMENT 2011 - MHK 2003 2011 2004 2005 2006 Revenue = Purple Expenses = Yellow Assets = Green Amount of income in 2011: $7, 939, 022 Mental Health Kokua Other organizations performing similar types of work $7, 939, 022 $313, 496 Assets in 2011: $8, 767, 535 Mental Health Kokua Other organizations performing similar types of work $8, 767, 535 $128, 300 2007 2008 2010

Donate online: www. mhkhawaii. org Monetary Donations - Corporations & Foundations: Aloha United Way Combined Federal Campaign Foodland Give. Aloha Harry & Jeanette Weinberg Fdn. , Inc. Hawaii Community Foundation Hawaii Island United Way Honolulu Friends Meeting Kaiser Permanente Katherine Grosscup Kauai United Way Maui United Way Rotary Club of Kahului The Movie Museum Winifred Mann Trust Western Union Hawaii Hotel Associations In-Kind Donations - Corporations & Foundations: Elena’s, Home of Filipino Food Diverse Mortgage Kaloko Furniture Let Them Eat Cupcakes Sts. Peter and Paul Church COSTCO Roy’s Waikoloa Bar & Grill Big Island Candies KTA Stores Blue Hawaiian Helicopters Legal Aid Society Sts. Peter and Paul Church

2013 Board of Directors Uson Ewart, Chair Sean Tadaki, Vice Chair Peter Wolff, Jr. , Vice Chair Greg Tatsuguchi, Vice Chair Cindy Mc. Millan, Secretary Ronald Gregorio, Treasurer John Breinich Patrick Duarte Alan Tamanaha Anthony Guerrero, MD Joanne Nakashima Pat Duarte Elaine Waldow Terrence Watanabe Hawaii County Advisory Board Angela Gannon Irene Solloway Maui County Advisory Board Glenn Kunitake Charles Maalea Elaine Waldow Kauai County Advisory Board Joanne Nakashima Administrative Management Staff Greg Payton -Chief Executive Officer Dennis Koo - Chief Operations Officer Summer Such - Chief Financial Officer Keisha Bolden - Chief Human Resources Officer Jim Carter - Director of Programs Frank Cummings - Maui County Services Director Gary Michell - Hawaii County Services Director Les Gusman - Oahu County Services Director Pamela Menter - Safe Haven Services Director Jessieann Yokoyama - Consumer & Senior Services Director Merrily Worrell - Kauai Program Services Manager Melby Albano-Housing Division Manager Shelilah Peters-Development/Office Manager

References Hilo, Hawaii Island. Retrieved March 17, 2013, from http: //www. gohawaii. com/big-island/regions-neighborhoods/hilo. Mc. Knight, John & Kretzmann, John. (1996). Mapping Community Capacity. Evanston, IL: Institute for Policy Research, Northwestern University. Retrieved from http: //www. northwestern. edu/ipr/publications/papers/mcc. pdf. Mental Health Kokua (2013). Retrieved March 17, 2013 from http: //www. mentalhealthkokua. org/. MHK Outcomes and Stakeholder Survey FY 2011 (2011). Retrieved March 17, 2013, from http: //www. mentalhealthkokua. org/publications/MHK_Outcomes 2. pdf. U. S. Census (2010). State and County Quick Facts. Retrieved March 17, 2013 from http: //quickfacts. census. gov/qfd/states/15/1514650. html.