Monday, July 21, 2008

July 21 Meeting: Hawaii Transformation Grant and adult mental health issues

Rupert Goetz and Marya Grambs

Click here to listen.

Rupert Goetz and Marya Grambs

Dr. Rupert Goetz: Mental Health Transformation Grant: Hawaii is one of 9 states at received $10.95 million over 5 years to transform our mental health system to focus on prevention, effective intervention and recovery, provide coordinated culturally sensitive services, to ensure sustainability and be consumer driven. Hawaii’s system is fragmented and uncoordinated because it grew up piecemeal.

After one year in operation the program has completed a Comprehensive Mental Health Plan and Needs Assessment and a Resource Inventory. Six task groups are working on educating the public, systems integration, consumer and professional development and training, research, evaluation and dissemination, financing, sustainability and criminal justice. This year plans will be prioritized. Year 3 will be implementing data collecting, Year 4, evaluating and realigning and year 5 integrating.

Marya Grambs: Mental Health America: Mental Health problems in older adults are usually overlooked – they are underreported and under-treated, even by the health professionals who care for them. This has a dramatic impact on the quality of the lives of older people and the lives of those around them. One in four older adults have a significant mental disorder (26%), including depression, anxiety, psychosis and dementia. In the next 25 years, the number of older adults with major psychiatric illnesses is expected to more than double from 7 to 15 million individuals as the Baby Boom generation ages.

What is the impact of mental illness in older adults if it’s not treated? People get sicker. They have lowered quality of life -- greater disability and impairment. There’s impact on family and on caregivers and greater use of health care system, poor health outcomes and premature death due to other medical conditions and suicide.

The issue is that older adults do not get adequate treatment for mental health problems. Depression is a major problem. In Hawaii, up to 8 % of older adults not in nursing homes suffer from depression, and yet 70-90% receive no treatment for it, data indicate that 70% of people in nursing homes have depression. But it’s treatable: up to 90% will show significant improvement with treatment.

Why is there such a low treatment rate for depression among older adults? First, family, caregivers, or healthcare professionals do generally not recognize depression symptoms: “Because you are old, alone, sick and there’s nothing to be done. It’s just a normal part of aging.” THIS IS NOT TRUE. Depression is not normal, it’s an illness, and just because you’re old does not mean you have to be depressed.

Handouts for Dr. Goets' talk are:
MHT SIG Overview slides

Department of Health press release on the first annual Transformation State Incentive Grant meeting:

HONOLULU - To celebrate its first year and report back to the public on progress, the Mental Health Transformation State Incentive Grant (MHT SIG)working group will hold its annual meeting on Wednesday, July 23, 2008 from 8:30 a.m. to 3 p.m. at the Pearl City Cultural Center located near the top of Waimano Home Road. The meeting is open to the public and registration is required by contacting MHT SIG at or by calling (808) 453-6649.

One year ago on July 11, 2007, Hawai'i's effort to transform mental health services through a federally funded MHT SIG was launched at a meeting at the State Capitol. Dubbed by Governor Linda Lingle as a "once-in-a generation opportunity" to transform mental health services, this $11 million five-year grant allows Hawai'i to plan and implement changes to improve the state's the system of care.

Lt. Governor James R. "Duke" Aiona, Jr. and Health Director Chiyome Fukino, MD will open the first annual meeting. SAMHSA Project Officer, Commander David Morrissette will follow with a discussion of transformation efforts being made nationally. The Keynote address on "Trauma and Recovery" will feature Tonier Cain, a consumer advocate. A panel of local experts will follow her presentation with a discussion on the role of "trauma" across the lifespan.

Understanding how many lives, both individually and over generations, have been touched by traumatic events relating to mental health supports closer collaboration between transformation participants who all bring their personal perspectives. In the afternoon, attendees will be able to meet with members of the Task Groups to discuss what priorities are being addressed first.

While this meeting is open to the public at no cost, advance reservations for the Annual Meeting are required. Reservations can be made by contacting MHT SIG via e-mail at or by calling (808) 453-6649.

Friday, July 04, 2008

July 21 Program: What happens to vulnerable youth as they “age out” of foster care, child/adolescent mental health, special education or drop out of h

Please note change of date for this meeting only:

MONDAY, July 21, 2008

11:30 a.m. to 1:00 p.m.
Miyama Main Hall, Harris United Methodist Church
Nuuanu Ave. and South Vineyard Blvd.
Ample parking - driveway off Nuuanu Ave.


11:30 Luncheon: Hawaiian Stew, Brown Rice, Salad, Dessert, $5.00 Donation

11:45 Welcome, Introductions and Remarks, Larry Geller, President

12:00 Program

Panel: “What happens to vulnerable youth as they “age out” of foster care, child/adolescent mental health, special education or drop out of high school?”

Rupert Goetz, M.D., Director, Hawaii Transformation Grant, “Integrating an Uncoordinated Mental Health System,” (can this serve as a model for other state social services?), and
Marya Grambs, Executive Director, Mental Health America of Hawaii

12:45 Questions and Answers

1: 00 Adjourn

About the Program

Marya Grambs, Executive Director of Mental Health America of Hawaii
has been working for Hawaii’s mental health for 67 years, dedicated to reducing the stigma of mental illness and improving care, treatment for children, adults and seniors. Grambs’ talk will focus on vulnerable young adults as they age out of services.

Rupert R. Goetz, M.D., Director of the Hawaii Transformation Grant completed a Psychiatric Residency at the Oregon Health and Sciences University (OHSU) in 1988.  Professionally, he first served in 1988 as Director of the Psychiatric Emergency Services, then as the Director of Managed Care for the Department of Psychiatry at the OHSU. In 1995, Dr. Goetz became Medical Director of the Office of Mental Health Services for the State of Oregon. In 2003 he assumed the position of Medical Director for the Hawaii State Hospital, where he served until accepting his current, joint position in 2007. At the John A. Burns School of Medicine in Hawaii, he serves as an Associate Clinical Professor in the Department of Psychiatry. In 2001, he was elected a Distinguished Fellow of the American Psychiatric Association. Dr. Goetz' practice is in administrative and community psychiatry, with particular attention to primary

Some announcements

August 12, 5-7 p.m., Waikiki Yacht Club, Hawaii Women’s Political Caucus, 2008 Candidates’ Reception, $40, information: Faye 732-4987, Carolyn 524-0968.

September 15-16, Hawaii Pacific Gerontology Conference, fee includes 2 year membership, breakfast and lunch. Iinformation at

September 16–19, 2008 Asia Pacific Volunteer Leadership Conference, Hawai`i Convention Center, for information, telephone (808) 236-9201.

Every Saturday 4-5 p.m., KHVH AM 830 Talk Radio, a weekly series for seniors and their families.

Thursday, July 03, 2008

New Online Resource About the Needs of Grandparents Raising Grandchildren

Casey Family Programs, the ABA Center on Children and the Law and Generations United have partnered to create the Grandfamilies State Law and Policy Resource Center, at The website educates caregivers, legislators, advocates, policymakers and attorneys about state laws and legislation in support of grandfamilies. The site’s easy-to-use database allows for a search of laws and legislation that address common legal questions surrounding kinship care. Analysis, illustrative stories, and related resources accompany each topic.