Hawaii Mental Health Services Guide

Few private mental health providers are able to immediately serve people in crisis, while most state mental health programs, including Hawaii’s, have crisis response systems that help people get mental health care quickly in an emergency. This usually makes public mental health services the best option if you’re having a mental health crisis and need help right away. The people who answer crisis lines 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.

Publicly-funded outpatient mental health programs in Hawaii are called community mental health centers (CMHCs). In addition to affordable therapy, CMHCs provide specialized and intensive services that aren’t available anywhere else or that are hard to find in private clinics, like case management, psychosocial rehabilitation, and day treatment. Consider going to a CMHC if you need intensive treatment, live in an area with limited mental health resources, or can’t access mental health care in the private sector due to your diagnosis or financial situation.

Like the public mental health systems in many other states, the public mental health system in Hawaii prioritizes clients who have limited incomes and are in need of more intensive services. Hawaii’s official mental health website states that “as the state mental health authority,” the Adult Mental Health Division (AMHD) “serves adults needing mental health services.” While the state website does not list absolute eligibility requirements, it does clarify that AMHD “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 the uncertainty about whether there are exceptions, we recommend calling to ask if you’re eligible for mental health services at a local Hawaii CMHC. The AMHD 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 clinic hours to ask for an eligibility assessment.

To find out if you can get the services you need at a publicly-funded provider in Hawaii, you can call the Hawaii CARES crisis and access line at (808) 832-3100 or (800) 753-6879. This number functions as both a crisis hotline and general information line about mental health resources in Hawaii. For general information about the Hawaii public mental health system, you can call the Adult Mental Health Division at (808) 586-4686.

You can also call the CMHC where you are interested in receiving services to find out more about what programs they offer and whether you may be eligible. We’ve listed numbers for Hawaii CMHCs below. We got this information from official websites for the Hawaii Department of Health, Behavioral Health Services Administration, and the Adult Mental Health Division.

In the 1960s, Americans started thinking differently about how to treat mental health conditions. New laws required state and local governments to establish community mental health programs as alternatives to institutionalization for people with serious mental illness. Many states’ public mental health programs trace their origins back to this period. Hawaii’s system 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.

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. It ranks lowest of all American states for access to mental health care among adults.

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.

Hawaii suffers from a shortage of psychiatrists and other mental health care practitioners. It also does not have enough community mental health services or inpatient treatment beds to meet the demand. This has put pressure on primary care doctors, hospital emergency departments, and the police to address the needs of people with mental health conditions. Fortunately, Hawaii is working to improve its mental health system. It has recently passed new mental health reform bills, implemented diversion programs, and expanded 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.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), only 32 percent of people in Hawaii who have mental health conditions get treatment for them. One reason for the care gap is that people aren’t aware of their options for affordable mental health care, including the public mental health system. You can help change these statistics by reaching out and using your local mental health resources to get the care you need.