Your (Unofficial) Guide to State-Sponsored Therapy in Hawaii
There’s a way to get affordable mental health care that you might not know about. That’s Hawaii’s mental health system.
If you qualify, you can get mental health care at your local community mental health center for a small co-pay or a low sliding-scale fee. But even if you don’t qualify for services at a state-funded provider, Hawaii’s system can still give you information, local referrals to affordable providers, and other essential help for free.
If you’re in a hurry and want to get the most essential information about what’s available at your local program and who it’s for, you can read our quick start guide below.
Quick Start Guide
Quick facts about Hawaii’s mental health system:
- Both public and private providers in Hawaii are straining to meet demand as there is a statewide shortage of mental health professionals.
- All Hawaii community mental health centers accept Hawaii Med-QUEST and offer low sliding-scale fees to people without insurance coverage.
What services are available?
- Hawaii’s mental health system offers specialty and intensive mental health services that can be hard to find anywhere else, like case management, day treatment, and wraparound care.
- Outpatient mental health services including psychiatric evaluation, medication management, and group and individual therapy are also available in most community mental health centers.
Who’s eligible?
- Some services, such as Hawaii’s mental health crisis and information hotline, are available to any Hawaii resident without exception.
- Most Hawaii CMHCs do not have income eligibility requirements, though they focus on serving uninsured individuals and people with Med-QUEST.
- Some services are only available to people with severe conditions like major depression or schizophrenia. However, more people have one of these conditions than realize it! In fact, 1 in 10 Americans experience major depression each year.
Where can you get started?
- You can reach local mental health crisis and information services from anywhere in Hawaii by dialing 988.
- You can find location and contact information for your local community mental health center by scrolling to the directory below.
To learn more about public mental health services in Hawaii, keep reading. We’ve done the research to uncover essential facts about who’s eligible, what services you can get, when to go, where to call, and how it works so you can decide if Hawaii’s mental health system might be right for you.
Who Is Eligible?
You should consider going to a community mental health center if you (or a loved one) are having a mental health crisis, have a severe mental health condition, have Med-QUEST, or don’t have insurance.
Everyone in Hawaii can use the state-funded mental health emergency response system. If you or someone you love is in crisis, you can call the Hawaii crisis line to get the help you need, quickly.
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Use the State System When You're in Crisis
Public mental health services are usually the best option if you’re having a mental health crisis and need help right away.
State mental health programs are required to provide mental health crisis response services and are one of the fastest ways to get care when you’re having a mental health emergency.
The people who answer the Hawaii crisis line can provide caring attention and support as they help you determine the best response to a crisis, whether it’s inpatient treatment or an appointment with a counselor.
Even if you’re not in crisis, you can call the Hawaii mental health hotline for information about affordable mental health services in your area. When you call, you can find out whether you might qualify for state-funded mental health services, schedule an assessment or intake appointment, or get free information about other affordable local providers.
Other parts of the system have stricter eligibility requirements. You need to have a serious mental health condition (a diagnosable condition that affects your daily functioning) to qualify for many state-funded mental health services in Hawaii. However, more people have a qualifying condition than realize it. Don’t assume you’re not eligible!
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Fast Facts About Eligibility in Hawaii
Consider using the Hawaii state mental health system if you:
- Are having a mental health emergency
- Have Med-QUEST or don’t have insurance
- Live in an area with limited mental health resources
- Need to get information about affordable providers in your area
- Have a serious mental health condition like major depression, bipolar disorder, or schizophrenia
- Need specialty mental health care like day treatment, case management, wrap-around care, or home-based services
Eligibility criteria depend on the service you want and current funding, so it’s worth calling to confirm. To get started, you can call the Hawaii mental health hotline or reach out to your local community mental health center, which is listed in the directory below.
One of the most important requirements you need to meet to get services at a Hawaii community mental health center is to be a resident of the area it serves.
It’s a great option if you’re a local resident with Med-QUEST. All community mental health centers in Hawaii accept it, and it can be hard to find other providers who do.
You can also qualify if you have no insurance and have a limited income. Community mental health centers in Hawaii focus on serving the uninsured and underinsured. If you qualify, you can usually get services for the cost of a low sliding-scale fee.
You can also qualify if you have a severe mental health condition that affects your functioning or safety on a day-to-day basis. You may also qualify for services if you belong to a special eligibility group.
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Special Eligibility Groups
The basic eligibility requirements for state-funded mental health services in Hawaii are that you need to be a resident of the area the program serves and:
- Have Med-QUEST or lack insurance or
- Have a serious mental health condition.
Even if you don’t meet other eligibility requirements, you may still qualify for services if you:
- Have been a victim of a natural disaster or terrorism
- Are or were recently homeless (or at risk of homelessness)
- Have recently been discharged from an inpatient psychiatric facility
- Are involved in the criminal justice system or are on probation or parole
This doesn’t mean you can’t get services at a community mental health center if you’re not a member of one of these groups. Eligibility can change based on funding and state policy, so it’s a good idea to call before you assume you’re not eligible.
In general, community mental health programs aren’t the best place to go if you have mild mental health issues and are covered by a private insurance plan.
However, if you’ve recently been hospitalized or incarcerated for mental health reasons or are at risk of hospitalization or incarceration due to mental illness, you should reach out to your local community mental health center in Hawaii.
Their specialized services are designed to help you address these challenges and get the support you need to regain stability while living at home in your local community.
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Check Out the State System If You Need Specialized Services
Community mental health centers in Hawaii are great places to find specialized and intensive mental health services like case management and day treatment that can be hard to find anywhere else. These specialty programs can give you extra help when you’re dealing with severe symptoms.
You can also usually find affordable therapy and other basic outpatient mental health services like medication management at Hawaii’s community mental health centers. Whether you need to have a severe mental health condition or to meet other requirements to get these services depends on current Hawaii mental health funding and policy.
You can find the number for your local community mental health center in the directory below. We encourage you to call even if you think you might not be eligible. Even if you’re not eligible, or if the program doesn’t offer the service you want, they can probably still help you.
People who work at community mental health centers are knowledgeable about local resources and will often give you free information or even referrals to other affordable providers nearby, including local non-profits that provide free or low-cost counseling.
Where Do You Call to Get Started?
The easiest way to learn more about state mental healthcare in Hawaii is to call the Hawaii mental health hotline or your local community mental health center.
The Hawaii 988 CARES line serves as both a crisis hotline and general information line you can call to learn more about mental health resources in Hawaii.
To reach the CARES line, call 988. To find the location and number of your local CMHC, scroll to the directory below.
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Important Numbers in Hawaii
The statewide Hawaii CARES crisis and information hotline is 988.
The Crisis Text Line for the state of Hawaii is 741741. Text ALOHA to get started.
You can reach the United Self-Help peer-to-peer warmline at (808) 947-5558 on Oahu and at 1-866-866-HELP (4357) from the Neighbor Islands.
You can reach the Hawaii National Alliance on Mental Illness (NAMI) Helpline by calling (808) 591-1297.
The number for the Adult Mental Health Division of the Hawaii Behavioral Health Services Administration is (808) 586-4686. You can reach their eligibility hotline at (808) 643-2643.
Public mental health services in Hawaii are managed on the state level by the Adult Mental Health Division of the Hawaii Behavioral Health Services Administration For general information about Hawaii’s system, you can contact them at (808) 586-4686.
However, you’ll probably get the best results by calling the Hawaii mental health hotline at 988 or contacting your local community mental health center directly. You can find the number for your local community mental health center in the directory below.
Hawaii CMHC Directory
State-funded outpatient mental health clinics in Hawaii are called community mental health centers (CMHCs).
You can call the CMHC where you’d like to receive services to find out more about what they offer and whether you might be eligible. You can also check their website for updated information. We’ve listed the numbers and websites for all of the Hawaii CMHCs below.
Hawaii Community Mental Health Centers
- Oahu Community Mental Health Center:
- Oahu Community Mental Health Center (Honolulu): (808) 832-5770
- Central-Leeward Oahu Treatment Services (Pearl City): (808) 453-5950
- Wahiawa Unit (Waihawa): (808) 621-8425
- Mahaka Unit (Waianae): (808) 354-9123
- East Honolulu Treatment Services (Honolulu): (808) 733-9260
- West Honolulu Treatment Services (Honolulu): (808) 832-5800
- Windward Oahu Treatment Services (Kaneohe): (808) 233-3775
- Central-Leeward Oahu Treatment Services (Pearl City): (808) 453-5950
- Oahu Community Mental Health Center (Honolulu): (808) 832-5770
- Kauai District Community Mental Health Center:
- Kauai Community Mental Health Center (Lihue): (808) 274-3190
- Hawaii District Community Mental Health Center:
- Hawaii County Community Mental Health Center (Hilo): (808) 933-0409
- East Hawaii Mental Health Clinic Section (Hilo): (808) 974-4300
- Honokaa Clinic (Honokaa): (808) 775-8835
- Pahoa Clinic (Pahoa): (808) 965-2240
- Waimea Clinic (Kamuela): (808) 885-1220
- West Hawaii Mental Health Clinic Section (Kealakekua): (808) 322-4818
- Ka’u Clinic (Naalehu): (808) 939-2406
- East Hawaii Mental Health Clinic Section (Hilo): (808) 974-4300
- Hawaii County Community Mental Health Center (Hilo): (808) 933-0409
- Maui District Community Mental Health Center:
- Maui Community Mental Health Center (Wailuku): (808) 984-2150
- Lanai Services (Lanai City): (808) 565-6189
- Molokai Services (Kaunakakai): (808) 553-7889
- Maui Community Mental Health Center (Wailuku): (808) 984-2150
The Hawaii Adult Mental Health Division also has an eligibility hotline you can reach Monday through Friday at (808) 643-2643. You can leave a voicemail if no one answers.
You can also can walk in to your nearest CMHC or mental health clinic during regular weekday hours to ask for information or for an eligibility assessment.
Also Consider: Federally Qualified Health Centers
Federally qualified health centers (FQHCs) are another great way to get affordable publicly-funded mental health services in Hawaii.
These federally-funded programs provide cutting-edge care in places where good primary healthcare was once hard to find. Most provide integrated care, meaning you can get primary medical and mental health services at the same location.
Each FQHC accepts Medicaid and Medicare and offers low sliding-scale fees if you don’t have insurance. Their eligibility requirements are generally less strict than the requirements for the state-funded system.
You can search for FQHCs near you by using the online search tool on the U.S. Health Resources and Services Administration website.
Troubleshooting Guide
The state mental health system is complicated and can be confusing to navigate. If you’re having any issues, we’re here to help. Here are some of our solutions to common problems you might experience.
Problems and Solutions
1. You can’t get through to someone on the phone.
Except in extremely rare circumstances, someone should answer the Hawaii crisis line any time you call. But if you’re not in crisis, the person you talked to gave you another number to call, and you’re having a hard time getting through, you can try going to a walk-in clinic instead.
Most CMHCs in Hawaii run walk-in centers where you can be seen during regular business hours on Monday through Friday. Some let you walk in and wait without an appointment. You can often be seen the same day. If the wait is long or they don’t have availability, you can schedule an appointment and come back.
We recommend checking your county program’s website for clinic locations and hours.
2. There’s a long waiting list.
State-funded services are often in high demand. Hawaii is working to shorten waiting times and make sure you can get seen for essential services right away. However, if you’re not in crisis, you may still have to wait before you can be seen by a therapist or other mental health provider.
Sometimes, it’s worth it to wait if you’ve found a good therapist or service. You can read our article on what to do before your first therapy session for tips on how to maintain your mental health while you wait.
If your symptoms are getting worse and you’re worried you can’t wait, you should call a crisis line. The caring people who answer can help you figure out if you need help right away and tell you where and how to get the level of care you need.
If you’re not in crisis but don’t want to wait, you can call a local hotline, an intake worker, the main number, or your contact person at the agency to ask if there are other options. There may be another affordable local program they could tell you about that could meet your needs but has a shorter waiting list.
3. You’re not eligible for state-funded services.
If you’re not eligible for state mental health services in Hawaii, the people at your local CMHC should still be able to help you.
Intake workers usually keep lists of affordable local mental health resources for people who aren’t eligible or would prefer to go somewhere else. Ask for information, resources, or even a direct referral to another provider.
4. Your state system doesn’t offer the service you want.
State mental health programs sometimes have to change or limit the services they offer based on their current funding. If you’re admitted to a community mental health center but it doesn’t offer the service you need, you have two options.
One is to try an alternative service that they do offer. The other is to ask if they can recommend an affordable alternative provider who does offer that service.
If they do offer the service you want, but it’s limited, stand up for yourself if they try to get you to do something else. Don’t accept getting pushed into something you don’t want just because it’s easier for them or because they can get you in faster.
If you’re willing and able to wait, tell them you would prefer to wait for the service you want, whether that’s therapy, medication, or something else.
5. You don’t like your therapist.
You should never accept bad therapy—or bad mental healthcare of any kind—for any reason. This is just as true in the public system as it is anywhere else. If you have a bad therapist, ask for a new one. Tell your main contact person at the agency, an intake worker, or a manager that you want to try a different therapist.
If you’re not sure whether you have a bad therapist, you can read our articles on how to spot an unethical therapist and how to do a background check on a therapist. If you don’t like your therapist but wonder if it the problem might be fixable, you can read our articles, “What If I Don’t Like My Therapist?” and “How to Fix Problems with Your Therapist.”
If you don’t like the first therapist you’re assigned, ask someone at the agency if they have a webpage or list of therapists you can review. You can read their bios and see if you think one might be a better match. Not all agencies do this, but it doesn’t hurt to ask. You can read our article on how to choose a therapist for information on what to look for.
If you’ve run into a problem that we haven’t addressed, don’t give up. Call someone at the CMHC (or the Hawaii information line) and tell them what’s going on.
You’re much more likely to get the help you need when you advocate for yourself and are persistent. Tell the person you talk to what you need or what problem you’re having.
If they don’t help the first time, call them back and tell them. If you keep calling and keep calm and focused, you should eventually get through to someone who can help you.
Deep Dive: How Does the System Work?
To understand Hawaii’s mental health system, it helps to understand how it started and how it’s changed since then.
Public mental health services have been around for a surprisingly long time. But for over a hundred years in America, the only way to get them was in a psychiatric hospital.
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For More Information
To learn more about what the public mental health system was like in the early days—and how psychiatric inpatient care has evolved since then—you can read our article “Do Insane Asylums Still Exist? The Surprising Past and Present.”
To learn more about what inpatient mental health treatment is like now, and the differences between how it works in general hospitals and specialized psychiatric facilities, you can read our article “How Inpatient Mental Health Treatment Works.”
In the 1960s, Americans started thinking differently about mental health care. Conditions in psychiatric hospitals were getting worse and new medications made it possible to provide mental health treatment on an outpatient basis.
In response, new laws were passed that required state and local governments to establish community mental health programs as alternatives to institutionalization for people with serious mental illness. The most important was the Community Mental Health Act, which President John F. Kennedy signed into law in 1963.
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What Is the Focus of the Hawaii Mental Heath System?
The Hawaii mental health system developed out of the need to provide services for people with severe mental health conditions and people experiencing mental health crises.
It prioritizes clients who have limited incomes and are in need of more intensive services. The Hawaii Adult Mental Health Division states that it generally serves people who are:
- Uninsured or underinsured;
- Court-ordered to treatment;
- Diagnosed with a serious mental illness (SMI);
- Victims of natural disasters and terrorism; and/or
- In a state of crisis and in need of help “for a short time.”
Mental health conditions that typically qualify as SMI include schizophrenia, other psychotic disorders, bipolar disorder, and major depressive disorder, though definitions for SMI vary from state to state. The Hawaii state websites do not list criteria or definitions for SMI.
Given how broad these categories are and that it’s not clear whether there are exceptions, we recommend calling to ask if you’re eligible for mental health services at a local Hawaii CMHC.
Many state mental health programs trace their origins back to the 1960s when these important changes started to happen. Hawaii is no exception.
Hawaii started opening community mental health clinics in the early 1960s. The first CMHCs in Hawaii were located on Maui and the Island of Hawaii. When President John F. Kennedy signed the Community Mental Health Act in 1963, the state was able to open additional CMHCs. Hawaii now has CMHCs on Oahu, Kauai, Maui, and the Big Island.
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The Mental Health Professional Shortage in Hawaii
Unfortunately, while Hawaii has been recognized for its pioneering health insurance laws and high-quality health system, it has fallen behind other states in the quality of its mental health system. In 2018, it ranked lowest of all American states for access to mental health care among adults.
Hawaii suffers from a shortage of psychiatrists and other mental health care practitioners. It does not have enough community mental health services or inpatient treatment beds to meet the demand. This has put pressure on primary care doctors, emergency departments, and the police to address the needs of people with mental health conditions.
In the past, Hawaii incarcerated people with mental illness, and it’s happening again: There are now more people with mental illness in Hawaii jails than there are in its state psychiatric hospital. Hawaii’s prison system has been sued by the Department of Justice for failing to provide proper care to inmates with mental health conditions.
Fortunately, Hawaii is working to improve its mental health system. In recent years, it has passed mental health reform bills, implemented diversion programs, and expanded the capacity of the state hospital.
Public mental health services in Hawaii are managed on the state level by the Behavioral Health Services Administration (BHSA) within the Hawaii Department of Health.
The Adult Mental Health Division within the BHSA oversees the state’s psychiatric hospital as well as its community mental health centers.
To learn more, you can call your local CMHC or the Hawaii 988 CARES hotline. They know how the system works and will help you get where you need to go.
Conclusion
According to the Substance Abuse and Mental Health Services Administration, only 34 percent of people in Hawaii who have mental health conditions get treatment for them. Many of them qualify for public mental health services but don’t know about them.
You can make a difference by reaching out and connecting with local mental health resources to get the care you need. If you’re not sure whether you qualify for Hawaii state mental health services, call 988 or your local CMHC. You may find out you can get mental health services at a community mental health center or that there’s another affordable option nearby.
The most important thing is to get started—the help you need may be only a call or click away.