HONOLULU (KHON2) — A new Hawaiʻi bill, SB1322, is causing strong debate. It changes how the state gives mental health care, especially to people who are homeless.
Supporters say it will help people get care before ending up in jail or the hospital. However, critics say it removes important protections and could be misused.
The big question is whether the government should force people into treatment. The bill also changes how medical practitioners, social workers and police can act and how hospitals and lawyers handle treatment cases.
The opposition
Maui resident Jim Gottstein said Senate Bill 1322 is dangerous
Jim Gottstein, author of The Zyprexa Papers and president of the Law Project for Psychiatric Rights, spoke out strongly against Senate Bill 1322. He said the bill would make it easier for the state to “lock people up” and “drug them against their will”.
After Gottstein moved back to Alaska following his time at Harvard, he found himself and unable to sleep for days. After jumping form his father’s second-story window, he was hospitalized for 30 days in the Alaska Psychiatric Institute.
After recovering, Gottstein worked to make laws better to protect those dealing with mental crises and won five Alaska Supreme Court cases challenging forced psychiatric treatment. He called SB1322’s foundation “flawed”.
“The idea that involuntary commitment keeps someone from hurting themselves is ludicrous because it dramatically increases suicide,” Gottstein said. “Some studies have shown over a year, more than 100 times more likely to commit suicide after you’ve been psychiatrically imprisoned.”
He also warned against relying on psychiatric drugs. “The current ubiquitous reliance on psychiatric drugs is reducing the recovery rate from 80% to 5%,” he said, adding that such medications can also “reduce the average lifespan by 20 years.”
Gottstein’s biggest concern is about how patients who object to treatment are treated.
Nurse practitioner Dave Fields warns of weak protections
Dave Fields, a psychiatric nurse practitioner and opponent of SB1322, also raised serious concerns. He has worked in multiple settings across Hawaiʻi, including Queen’s Hospital, IHS and Hawaiʻi State Hospital.
“I was the first provider on Maui to successfully petition for community treatment,” Fields said.
Fields said the current process requires a hearing where patients have the right to counsel and evidence is reviewed in court.
But under SB1322, he said, “the whole process gets rid of that three-panel system.” Instead, the decision to medicate someone against their will can be made by just one other doctor. “It even weakens the already weak safeguards,” he said.
He called the changes “ripe for abuse,”. especially in facilities with staffing shortages. Another major issue Fields pointed to is legal representation.
He summed up his stance clearly: “I just see it going very, very wrong.”
The advocates
Senator Joy Buenaventura defends the bill as necessary and compassionate
Senator Joy Buenaventura, chair of the Senate Health and Human Services Committee, supports SB1322. She said it would help community health workers provide outpatient care for mentally ill people, especially those who are homeless.
SB1322, she said, “intends to streamline the process of assisted community treatment.” She explained the bill includes “reporting requirements” for the Department of Health, which would help lawmakers see whether the system is being abused.
“What we want to do is to ensure that those who are mentally ill or homeless are able to get treatment in the least restrictive setting, which is outpatient care,” Sen. Buenaventura said.
She did acknowledge the shortage of care options in Hawaiʻi.
“The need for psychiatric treatment for any mental health or behavioral treatment is huge because the demand is huge, but the service providers are small,” she said.
She also responded to critics who said the bill is just a way to clear homeless people off the streets.
“That’s not true,” she said. “This allows for those who are mentally ill to be able to have the capacity to determine whether or not they have a home,” she explained. “If they are in fact homeless, we will at least have the mental capacity to live in a congregate setting so that they do not endanger the safety of others.”
Sen. Buenaventura said the goal is to help people stabilize and regain control.
Governor’s mental health advisor backs the bill as a proactive solution
Michael K. Champion, M.D., Senior Advisor for Mental Health and the Justice System in the Office of the Governor, expressed strong support for Senate Bill 1322. He described the measure as a tool to address the growing impact of untreated mental illness and substance use across Hawaiʻi.
“Mental health conditions and substance use problems affect people from all walks of life, including many who are homeless or at risk of becoming so,” Dr. Champion said. “Related crises have a profound impact on individuals, their families and communities.”
Champion said the bill would help connect people to care before a crisis becomes worse. “SB1322 enhances pathways to care and supports proactive approaches to engage individuals in behavioral health crises — supporting stabilization, recovery and improved personal and community outcomes.”
His statement aligns closely with the goals laid out by Sen. Buenaventura where she emphasizes that treatment over punishment and early intervention over delayed care.
Conflicting visions for care and control
While Sen. Buenaventura described the bill as a humane way to help people get care in the community, both Gottstein and Fields see it differently. They argue SB1322 removes critical protections and increases the risk of harm.
Gottstein said, “I wrote [a] letter to the governor; and I suggested that he veto the bill and really convene some kind of system to look at how to improve outcomes for people.”
Sen. Buenaventura stood by the need for the bill: “Police officers are disinclined to just arrest people for being crazy, even though they obviously need help.”
You can click here to read the full text of SB1322. You can watch the full interviews and discussions on the SB1322 with Sen. Buenaventura, Gottstein and Fields in the video above.
As SB1322 awaits the governor’s decision, the debate remains clear. One side sees it as a way to bring dignity and support. The other sees it as a dangerous loss of rights.
Both sides agree on one thing: how Hawaiʻi treats mental illness and homelessness is far from solved.