Hawaii to open prisons and jails for inspection of mental health services
Hawaiʻi has agreed to open its prisons and jails for inspection by two national experts who will assess the state’s troubled inmate mental health services.
The agreement was reached as part of ongoing efforts to resolve a federal lawsuit filed in 2019 over prisoner suicides. There is no agreement yet on financial aspects of the case.
The experts will produce a plan to improve the state’s correctional mental health system, which has been falling far short of filling critical positions such as psychologists, psychiatrists and advanced practice registered nurses.
Twenty of the department’s 23 psychologist positions are vacant, and one of the three filled positions is held by a provider who has not yet passed the psychologist licensing examination, legislators were told recently by Tommy Johnson, director of the Department of Corrections and Rehabilitation.
There were five suspected or confirmed suicides by Hawaiʻi inmates in 2024 — four men and one woman — the largest number since corrections officials reported five confirmed suicides in 2016, data compiled by Civil Beat shows.
Nationally, 41% of federal and state prisoners have a history of mental health problems, according to the Bureau of Justice Statistics.
Attorney Eric Seitz filed the 2019 class-action lawsuit against the state, alleging corrections officials “subject people with serious mental illnesses to extreme isolation with little or no mental health treatment.” The suit was originally filed on behalf of the family of an inmate who killed herself while in a state correctional facility two years earlier, and another who was rendered a paraplegic in a suicide attempt.
Seitz said Thursday the suit followed a rash of suicides inside Hawaiʻi prisons and jails nearly a decade ago. In it, he claimed the state failed to provide adequate mental health care, including basic measures to prevent suicide and self-harm.
“They’re understaffed, the facilities are not conducive to providing the care that they need, they can’t transfer out people who need to be in hospitals because the (state) hospital is overpopulated at this point, so it’s kind of desperate,” Seitz said.
The five apparent suicides last year look to be ongoing symptoms of those problems, he said.
“It’s going to be a big challenge for the state to be able provide adequate services for people with mental health needs,” Seitz said, “but it’s something we have to do, we have to figure out a way to do.”
Experts Will Have ʻUnfettered Accessʻ
Johnson said the inspection agreement does not mean the state admits it is failing to meet national standards for correctional mental health care.
“I don’t think the state is stipulating that we don’t meet it, I think we’re trying to settle the lawsuit and at the same time address the concerns that Eric and his clients have,” Johnson said.
The experts are not being hired to evaluate the state correctional system to determine if it meets correctional mental health standards, he said.
Instead, Johnson said their job will be to look at the system “with unbiased eyes” and describe what is needed in a variety of areas such as intake screening for mental illnesses, appropriate housing for mentally ill prisoners, staffing levels, and frequency and duration of mental health care.
Corrections officials will provide them with “unfettered access” to facilities, staff and records, he said.
Seitz said the outside experts will be forensic psychiatrists Dr. Bhushan S. Agharkar of Atlanta, and Dr. Jeffrey Metzner of Denver, both of whom are expected to arrive in Hawaiʻi in June.
They are “essentially going to design a mental health system for the prisons that will basically then be taken by joint agreement to the Legislature to be approved and funded next year,” he said.
“What we anticipate is they’re going to recommend staffing levels,” Seitz said. “They’re going to recommend perhaps staffing pay increases. They’re going to recommend certain facilities that need to be provided, which is also relevant when we’re talking about building new prisons.”
Also up for discussion will be protocols to prevent suicides, he said, including deploying trained observers who can diagnose and assess mental risks.
“It will be very costly, unquestionably, but I don’t know what those costs are going to be,” Seitz said.
Johnson confirmed that “Eric and I agreed that we would speak with one voice to the Legislature and the governor next legislative session to seek the resources that we do not have that are identified by the two experts.”
“Every loss of life is tragic. Whatever we can do to improve the system, working with the experts and then with Eric and the Legislature, it’s a win-win for everyone,” Johnson said. “We have to do a better job, and we have to get the resources needed to do that better job.”
He said he and Seitz have not discussed a financial payment regarding the suit, nor have they agreed on any payment to Seitz. No final settlement has been filed with the court, but the two sides have scheduled a telephone conference for Thursday before Magistrate Judge Rom Trader.
The Feds Sued First
The state has been sued before for failing to meet minimum standards for inmates’ mental health treatment.
The U.S. Department of Justice sued in 2008, alleging “deliberate indifference” to the mental health needs of prisoners at the Oahu Community Correctional Center – the state’s largest jail with nearly 1,100 inmates.
A settlement in that case required reforms in dozens of areas, including increasing staffing levels, providing programs for the mentally ill and improving screening at intake. DOJ supervision of the correctional center ended in 2015, and former employees have said staffing levels soon declined again.
Christin Johnson, oversight coordinator for the Hawaiʻi Correctional System Oversight Commission, said she is “extremely concerned” about the mental health staffing shortages. The state needs to focus on both recruitment and retention, she said.
“I think it’s extremely important to get this resolved because at the end of the day, if you don’t have adequate mental health care across the board, in every facility, then people will die,” Johnson said.
“Jails and prisons are very traumatic spaces for people, particularly people who have a history of depression, anxiety,” she said. “So, it’s important that those people are monitored and tracked and watched to make sure that they’re doing OK in these spaces.”
Michael O’Malley, whose son, Joey O’Malley, hanged himself in Hālawa Correctional Facility in 2017, said the effort to overhaul mental health services in the correctional system is “long overdue.”
“They need to provide the space, they need to do it right, and it’s critical,” O’Malley said. “The level of mental illness in the prisons is way beyond what should happen in a civilized society, and we need to address it, so I’m glad that they’re doing something.”
“Yeah, it’s going to cost money, but you know what? In the end it’s going to be a lot cheaper than putting a bunch of really mentally sick people back out on the street and creating more havoc for everyone,” O’Malley said.
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This story was originally published by Honolulu Civil Beat and distributed through a partnership with The Associated Press.