Dr. Tom Vendetti New Maui Mental Health Center Chief
volume 2 issue 9
Dr. Tom Vendetti
New Maui Mental Health Center Chief
he Adult Mental Health Division is pleased to announce Dr. Tom Vendetti as the new
Maui Mental Health Clinic Chief (MMHC). Dr. Vendetti comes to us with a record of exemplary service in both the private and
public mental health sectors. The beginnings of Dr. Vendetti’s record of service in mental health may be traced to his initial position as
a psychiatric aid at Shepard Pratt Hospital in Towson, Maryland, some 32 years ago. Dr. Vendetti was awarded a MSW degree in Clinical
Social Work in 1978, and subsequently relocated to Flagstaff, Arizona, where he assumed a position at The Guidance Center, Inc. In his
new position, Dr. Vendetti played an instrumental role in developing the first community
based treatment facility for Seriously Mentally Ill (SMI) consumers in Northern Arizona.
In 1989, Dr. Vendetti was awarded a Ph.D. in Psychology, and promoted to Clinical
Director of The Guidance Center, Inc. As Clinical Director, Dr. Vendetti oversaw the
building and development of a state of the art acute care unit as part of the continuum
of care for treating the SMI population. That acute care unit became a model for
Northern Arizona and resulted in four other units being built throughout Coconino
In 1994, Dr. Vendetti moved to Maui, where he was initially hired by Maui Kokua
Services as Residential Program Director and later became the Executive Director. In
his capacity as Executive Director, Dr. Vendetti recognized that there was a scarcity of
community housing for SMI consumers. To rectify this situation, he supported an
initiative to merge Maui Kokua Services with Mental Help Hawai‘i, which is one of
Tom Vendetti, PhD.
several non-profit organization in the state that provided housing services for adults
with SMI. Dr. Vendetti’s efforts were a success, as the merger was completed on January 1, 2001.
When asked for his thoughts regarding the current status of mental health services on Maui, including needs and wants, Dr. Vendetti
shared the following:
Maui County was noted for lacking community resources for the Seriously Mentally Ill consumers. This year, however, it appears that a
significant change is going to occur. Mental Health Kokua is planning to open several housing projects, a psychosocial rehabilitation day program,
increase staffing for the crisis mobile outreach program and will continue to provide host family and intensive case management services. Aloha
House has started a residential and day treatment program for the dually diagnosed clients in our community. These services were terribly needed
and will help fill the gap in the continuum of care for the consumers. This will result in fewer psychiatric hospitalizations and a higher standard
of care being provided for the consumers.
The most apparent need at the Maui Community Mental Health Center is to fill the large number of vacant or unfilled positions. The most
obvious example is the Clubhouse. The Clubhouse property is a perfect facility to provide either a Clubhouse model or Day Program model
(PSR) and give the consumers a place to meet and become the “House of Success” (as it is named). Currently, approximately twenty or more
consumers “drop in” and occupy the facility daily. The program needs to be adequately staffed.
Maui County also needs a jail diversion program. Too many SMI consumers are jailed primarily as a result of exhibiting dysfunctional
behavior related to their illness or disability and need treatment, not jail time. It is my hope to work closely with AMHD, the police, and the
judiciary to create an effective program on Maui.
Maui Mental Health Clinic is actively providing services to Hana that are greatly needed and appreciated. Hana is a difficult area to service
because it is not like L āna‘i where ninety-nine percent of the people live in close proximity. The population in Hana is spread out and often
inaccessible. Even with this barrier it appears that the center is having a positive impact on the community.
Page 2 of 8
When asked about his goals and plans, as well as the improvements he would like to
see as the new Chief of Maui CMHC, Dr. Vendetti answered:
My first goal is to get orientated to the job and assess the current situation. I have worked over
the years with the majority of the employees at the center and respect their work and roles as
professionals. I think there may be some misconceptions in the community regarding the center’s
function. A major goal is to educate the community about the types of services provided and
consumers served by the system. I would like to make a video addressing these issues and air it on
Public Access Television. I believe that this program would have a positive impact on the center and
our community. Making a video is very feasible, because I am a filmmaker. I made a film recently
that was presented at the Consumers Conference on Maui and at the National NAMI Conference
in Washington DC. The film was titled “Haleakala Miracle Trek.” It is an educational program
dispelling the myths of mental illness, featuring ten (10) consumers trekking from the top of the
volcano to sea level. I also made the award-winning documentary “Journey Inside Tibet” that was
aired nationally on PBS.
I also see my role as working closely with the non-profit sector, the Mental Health Association
and Maui Service Area Board on Mental Health and Substance Abuse with the goal of promoting
quality care and programs for our consumers.
Jean McDaniel, Sandi Alvestad, Deborah Shoup,
Debra Kae Sutton, Tom Vendetti
Social & Independent Living Skills (SILS) Training
at Hawai‘i State Hospital (HSH)
ver sixty Hawai‘i State Hospital employees and community mental health providers
attended a one-day training on Social & Independent Living Skills (SILS) at HSH on
July 9th. The training was presented by HSH SILS coordinator Daniel Gutkind, Ph.D., state
hospital clinicians, and SILS consultants from the University of California, Los Angeles and
the Seattle, Washington VA Medical Center.
The Social & Independent Living Skills (SILS) program is designed to teach seriously
mentally ill individuals illness-management and core living skills that are needed to function
successfully in the community. “Health care professionals go to school for many years to
learn how to effectively treat mental illness,” says Dr. Gutkind. “But mental health care
consumers don’t just automatically know how to lead an effective life with mental illness.
The SILS program helps consumers learn how to actively manage their own illness, how to
communicate more successfully, and how to handle both everyday hassles as well as problems
that may be specific to mental illness.”
Social skills training is listed in the American Psychiatric Association Clinical Practice
Guidelines as an indicated evidence-based treatment for SPMI individuals. The therapy is
highly interactive and uses structured treatment manuals to guide participants through “learning
activities” which include group discussions, videotaped educational material, peer support,
and learning and practicing of skills through role-playing and rehearsal. Group participants
share personal examples from their own lives to illustrate the success of using these skills or
the need to improve skills. Members are encouraged to assist each other and provide helpful
SILS groups are “modulized,” whereby similar methods are used to teach information
and skills in a variety of topics. Consumers may participate in one or more groups, depending
on their needs.
Several hospital patients have reported being able to negotiate with their doctors and other
hospital staff more successfully after participating in SILS groups, and feel more confident
that they “know what to do” should their symptoms worsen.
“It was really gratifying to see such an interest in this training, especially from the community
providers,” said Dr. Gutkind. “Any kind of skill someone learns works best if there are
consistent opportunities to practice and get feedback from many different people in a variety
of settings. The more we can get consumers, the hospital, community providers, care home
operators, family members, self-help groups and peers all speaking the same language, the
better the quality of life consumers will have.”
The Psychosocial Rehabilitation Therapists
Ten SILS Group Topics:
Basic Conversation Skills
6. Recreation Benefits
7. Interpersonal Problem
8. Friendship & Intimacy
9. Employment Preparedness
10. Conflict Management
Page 3 of 8
The AMHD Quality Management Team Is Growing
wo new QM Specialists have been hired to to help in the implementation of quality control
for the provision of services to consumers. the provision of services to consumers. The
Team will work in accordance with the State Plan for Mental Health, Fiscal Years 2002 – 2003.
The two new members of the Team are Sue Goodman, RN, LSW, and Kelly Snavely, RN. Both
hold the positions of QM Specialist and will be joining Christie Gibson, LSW, who has been
with the Adult Mental Health Division for several years, and started as the QM Coordinator in
Ms. Goodman was born in Connecticut, raised in both Connecticut and California, and
completed her education at the University of Southern California in Los Angeles, Metropolitan
State College in Denver, and the University of Hawai‘i at Manoa. Ms. Goodman has been a
social worker for over 12 years, and a nurse for over 30 years. She has also served as a U.S. Peace
Corps volunteer (family planning and public health) in the rural Philippines, a health/medical
cross-cultural educator for newly arriving volunteers, and as a consultant for the United Nations
maternal/child health project in the Philippines.
Ms. Snavely was born in Key West, Florida, and spent much of her childhood moving up the
southern east coast, ultimately settling in Chicago. She received a Bachelor of Arts degree in
Psychology from Wheaton College in Wheaton, Illinois, and a Bachelor of Science in Nursing
from the University of Cincinnati in Cincinnati, Ohio. Ms. Snavely has worked on the Child,
Adolescent and Adult inpatient Psychiatric units at Children’s Hospital Medical Center in
Cincinnati, Ohio, and at Rush-Presbyterian-St. Luke’s Medical Center in Chicago, Illinois.
Moreover, following the move to Hawai‘i, Ms. Snavely worked for Hawai‘i Biodyne as a Mental
Health Benefits Manager for HMSA, where she was involved in case and utilization management
for HMSA’s commercial and Quest health insurance plans. Some personal interests of Ms. Snavely
include running marathons (which she has done in each of the last 3 years), reading novels,
shopping, and scuba diving.
The responsibilities of the newly formed QM team are diverse, but nevertheless guided by
the unified goal of working to ensure that the AMHD provides quality treatment for consumers.
Some of the activities of the Team include on-site monitoring of AMHD providers and programs,
review of provider organization’s practices and consumer records, risk management activities,
and certification of AMHD providers, programs, and services. Moreover, the Team is committed
to the promotion of evidence-based best practices, and the rapid dissemination and
implementation of needed practices and procedures through the process of ongoing quality
nnette Crisanti, PhD, who has been accepted to give a presentation at the American Public
Health Association Meeting in Philadelphia in November. Dr Crisanti is an epidemiologist
for Adult Mental Health Division located on the Big Island and Oahu . The title of her presentation
is “Perceptions of safety regarding current living arrangements among persons treated at Hawai‘i
Community Mental Health Centers.”
lizabeth Lam, research assistant with the Services Research and Evaluation Unit of the
AMHD who was selected to present a paper titled, “Housing Needs of Mental Health
Consumers in Hawai‘i” at the Annual meeting of the American Public Health Association
Conference. The meeting will be held in Philadelphia, PA in November, 2002. Liz is a graduate
student in clinical psychology at the University of Hawai‘i. Her interests include cross-cultural
psychology, the empowerment of disenfranchised individuals, psychosocial rehabilitation, and
working with adults diagnosed with severe mental illness.
Christie Gibson, LSW, Sue Goodman, RN,LSW
Kelly Snavely, RN
More Kudos To…
Waianae Coast Community
Mental Health Center’s Hale
Na‘au Pono (House of Inner
Balance) who was one of
three programs featured and
given recognition in the
N a t i o n a l Te c h n i c a l
Assistance Center’s (NTAC)
report as having an
exemplary program for
services to Asians and
The clinical programs of
Hale Na‘au Pono are
uniquely influenced by
cultural practices that
emphasize the relationships
of the individual, the family,
the community, and the
natural environment in the
context of a broader spiritual
In Native Hawaiian culture,
the focus is on this system of
relationships rather than on
Page 4 of 8
Nancy Wright Slain
Ms. Nancy Slain is currently the First Vice President of the State Council, and has held this
position for three years. Nancy has been a member of the State Council for the past six years.
During her tenure, one of Nancy’s continuing priorities is exploring ways in which the Council
can work together with CAMHD and AMHD. She is pleased with the inroads that have been
made in the last few years in the creation of a more trusting and productive partnership. When
speaking about the nature and treatment of mental health, Nancy shared the following insights:
Mental health is something we often take for granted. Within my immediate family I have lived
with bipolar disorder, alcoholism, depression, suicide, ADHD, Tourette’s Syndrome, and all the
accompanying disorders and occasional victories associated with these. To me substance abuse
and mental health and joblessness and homelessness and on and on form an inseparable chain
that will shackle a person unless the chain is broken. Receiving appropriate services early is the
hope we can offer.
Nancy Wright Slain
In addition, Nancy related her thoughts regarding continuity of treatment:
Mental health is ageless—it is a carefully woven thread that can unravel at any point in a
person’s life. When we pigeonhole services that only apply to a very narrow and specific population,
we run the risk of leaving many outside the safety net. Although I fully realize the population
that Adult Mental Health is charged to serve, the transition from Child and Adolescent Mental
Health services to Adult Mental Health is a dramatic and dangerous narrowing of that net.
Nancy has a background in teaching and education, first having taught at Iolani School
some 30 years ago. In 1989, her interests and training in teaching and education led her to teach
personal growth courses in Melbourne, Australia, and later in Houston, Texas. While in Houston,
Nancy worked with a women’s shelter. Since returning to Hawai‘i in 1996, Nancy has been a
small business owner, corporate trainer, and prior to her current post, Executive Director of
the Kailua Chamber of Commerce. Her current hobbies include swimming, biking, cooking,
reading, sailing, writing, and video production. Nancy is married and has a 20 year-old son in
the Army at Fort Lee, Virginia.
Five Participants to Attend
Alternatives Conference, 2002
E llen Awai, Randy Hack, Charlene Ryerson,
Kaanoi Kaapana and Rita Gorospe were chosen
by a panel of judges to attend the Alternatives 2002
Conference in Atlanta, Georgia. The Adult Mental
Health Division is sponsoring the five participants
(left to right) Rita Gorospe, Ellen Awai, Randy Hack,
to attend the conference on September 18-22,
Charlene Ryerson, Kaanoi Kaapana
2002. There were 29 excellent applicants. The
selection criteria was based on previous participation in mental health, presentation skills and
what the participants intended to share with other consumers on their return. A luncheon
was held at the Kau Kau Cafe on August 8, 2002 for all applicants. The judges selection was
announced at that time. Everyone received a prize and a had good time. Thank you all for
Provider Fair in October at
Hawai‘i State Hospital
AMHD will be working with
HSH to sponsor a Provider Fair
on October 10, 2002 as part of
Mental Health Awareness Week
2002. Community providers will
showcase their services to HSH
staff, consumers and each other.
It will also be open to consumers
residing in the community, case
managers, and any other
There will be a brief Quarterly
Provider Meeting following the
For more details contact:
Eva Kishimoto at 539-3944
Page 5 of 8
Nationally Acclaimed Forensic Psychiatrist Spearheads
UH Forensic Psychiatry Residency Program
r. Daryl Mathews, Director of the Forensic Psychiatry Residency Program at the University
of Hawai‘i, is credited for spearheading the first forensic training for psychiatrists in
Hawai‘i. Dr. Matthews is a nationally recognized forensic psychiatrist who is also a long-time
resident of Hawai‘i. In discussing the status of forensic psychiatry training in Hawai‘i, Dr.
Mathews related that the State is “behind the times in this area.” As a response to this lag in
training, the Forensic Residency Program will enable the training of board-certified forensic
psychiatrists to provide court-ordered forensic evaluations for individuals with severe mental
illnesses who are also involved in the criminal justice system, including individuals at OCCC,
HSH, and those residing in the community.
The curriculum of the Forensic Psychiatry Program was created by integrating the best
features of other programs throughout the U.S., and is a DOH-UH Collaboration Project,
operated by the Department of Psychiatry, John A. Burns School of Medicine, with funding
provided by the AMHD. A significant goal of the Program is to train psychiatrists to become
experts in conducting psychiatric evaluations for the legal system. The Program sponsors special
seminars and case conferences directed to the training needs of forensic residents, along with
other ongoing and developing forensic training experiences which are of more general interest.
The one year Program, which started July 1, 2002, is currently training two psychiatry residents.
Each of the participating residents is a fully trained board-eligible psychiatrist who, over the
course of the year, will study and work at the interface of psychiatry and the legal system. At
the conclusion of the Program, graduates will be eligible to sit for the certification examination
in forensic psychiatry given by the American Board of Psychiatry and Neurology. The program
is expected to receive provisional accreditation this year by the Accreditation Council on Graduate
Darryl Mathews, M.D.
(back row) Jonathan Briskin, M.D., Daryl Mathews, M.D.
Sharon Tisza, M.D., Lena Osher, M.D.
Age and Gender of Consumers Served by the AMHD
January 1, 2001 – December 31, 2001
Number of Consumers Served
he figure on the right shows the number of male and female
consumers served by the AMHD at HSH and at State operated
CMHCs during calendar year 2001 broken down into different age
groups. The figure illustrates a higher prevalence of males in the
younger population and a higher prevalence of females in the older
population. This pattern is consistent with typical epidemiological
data on age and gender of individuals with severe and persistent
mental illness. It is not clear why this pattern emerges in this population and a number of theories have been suggested. Among them
are (a) males come to the attention of mental health systems sooner
because of aggressive acts; (b) females are nurtured by family members longer and come into contact with the mental health system
only later in life; (c) hormonal factors in women are protective for a
period of time; and, (d) the pattern represents two distinct illnesses
18-24 25-34 35-44 45-54 55-64
in men and women. It is also apparent from the figure that the majority of the population served by the AMHD are adults in middle
adulthood (ages 35-54) which account for 62% of the population
served. Very few individuals receiving services from the AMHD fall into the 18-24 or 65 and over age groups (i.e., 13.9% of the population
Page 6 of 8
Consumers Gain Literacy Skills in Pilot Program
n what was once a barbershop, located in a quiet area on the periphery of a courtyard, a man
sits across from a woman who is speaking slowly and articulately. He does not understand
what she is saying but he listens and watches with a deep yearning for more. Without taking her
eyes off him, she says a word and points to a picture. He is excited as he responds to her
encouragement. He repeats the word she has just said and points to the same picture. He cannot
remember a time when anyone looked into his eyes and believed that he could learn anything. He
does not speak or understand English and he does not read or write. He is fifty-three years of
age, has a mental illness, and is being taught to read and write English for the first time in his life.
The above description is a scenario in the life of a non-English speaking student receiving oneon-one instruction In the Adult Literacy Program at Hawaii State Hospital.
The Adult Literacy Program is an important part of accomplishing a mission to improve the
quality of life and recovery for persons who have a severe and persistent mental illness. Those
who lack the ability to read and write fluently are encouraged to take advantage of the literacy
skills offered in the program in order to become as independent as possible.
In the fall of 2000 Dr. Kim Meyer suggested the Morningside Model of Generative Instruction
be considered when the Adult Literacy Program was initiated. In January of 2001 Roshani
Samarasinghe, whose expertise is in the field of Special Education, developed the Adult Literacy
Program. This curriculum has a history of success in helping minority and underprivileged students
improve their reading, writing and math skills. With the collaborative efforts of Dr. Meyer and
other staff members, the program is run with a zest and passion that is infectious to be around.
Enthusiasm, fun and laughter permeate the classroom with an atmosphere where morale is high
and hope is born.
Students are referred to the program by treatment teams at the Hawaii State Hospital. After an
assessment is performed to understand the individual’s needs and goals, an individualized
curriculum is designed for each student.
When students begin the program, they are encouraged to set attainable goals for themselves
at the beginning of each class. At the end of the session their improvement is shown to them on
a graph. This feedback is instrumental to instill confidence and motivation so the students can
see they are capable of learning new skills. Under the best of circumstances it is hard for people
to admit that they cannot read. This may be even more difficult for individuals with a mental
illness. One of the remarkable parts of the Literacy Program is the confidence it instills in its
participants. Ms. Samarasinghe sees the feedback the students receive as a vitally important tool
and points out that the consumers are much more likely to ask for more classes than to ask for
less instruction time. Students report liking the class very much. This is supported by observations
that suggest students are on-task about 80% of the time (most teachers in schools would be
thrilled with these percentages!).
The Adult Literacy Program provides services for students at all levels, ranging from nonreaders
to students wishing to complete their GEDs. Of the 30 consumers who have participated in the
program, about fifty percent of them have demonstrated gains after six months using standardized
educational tests. So far, students have made more consistent gains in the math curriculum
compared to the reading curriculum. Although the program is still investigating why this occurs,
it may be because of the number of students who have language impairments resulting from
English being their second language.
Some students have made very impressive gains. For example, one math student went from a
fifth grade level to an eighth grade level. The most outstanding gains made by an individual to
date was a person who started the program reading at sixth grade level and reached GED level
before being discharged from the hospital. Another student who was once a delivery person
admitted he could not read the forms needed for his job. After three months of being in the
program, he was able to read by himself.
Pat Spencer, Kim Meyer, Roshani Samarasinghe
Pat Spencer working with student
Chart of Instructors
In addition to standardized tests, timing charts are used to show short-term gains within
and across daily sessions. For example one student improved from reading twenty-three
words per minute to fifty words per minute within one week. It is also quite common to
see students show 30-50% increases in the numbers of problems completed correctly per
minute when working on basic math problems. One of the surprising things about the
curriculum is that students are often timed while doing their work. This is because the
curriculum requires that students be accurate and fast. Speed is essential because it shows
that the student has mastered a particular skill.
The Adult Literacy Program also has three book clubs run by Ms. Samarasinghe, Amanda
Stewart (another teacher who joined the staff in January of 2002) and Winter Hamada (a
graduate student in the Department of Psychology at the University of Hawai‘i who has
been with the program since its inception). The book clubs emphasize student participation
through reading, prediction of stories and retelling of information. Hawaiian culture is
now also included in the program with the assistance of outside speakers and hospital
consumers whose knowledge of Hawaiian history has provided meaning and a feeling of
connectedness during the learning process. Stories of Hawaiian mythology enrich the
curriculum with the depth and knowledge of ancient Hawaiian history and culture. Ms.
Samarasinghe’s plans are to continue developing different themes to enrich the curriculum
and to meet student preferences.
Hopefully, the success of this hospital program will soon be seen in other settings
throughout the state. The AMHD has been soliciting input on a draft Vocational
Psychosocial Rehabilitation Plan. One related element in this plan is the further development
of literacy training and supported education programs.
Page 7 of 8
Supplies and Goal Charts
Map developed with students
Progress and Goal Charts
IAPSRS Officers Elected For New Hawai‘i Charter Chapter
t’s official! Hawai‘i now has its own IAPSRS chapter.
Congratulations to the new officers of Hawai‘i IAPSRS Charter Chapter. The chapter
officers are: Eva Kishimoto (President), Dr. Dan Gutkind (President Elect), Ellen Awai
(Consumer Representative), Eve Okumura (Chair Newsletter Committee), Dr. Philippe
Gross (Chair Conference Committee), Randy Hack (Chair Social Committee).
Come join us at the next meeting on October 23, 2002 at 5:30 pm. The meeting will be
held at the Queen’s Hospital new outpatient mental health clinic on the corner of Vineyard
Eva Kishimoto, President and Dan Gutkind, President-Elect
Page 8 of 8
he following (RFPs) that were issued June, 2002 are presently being reviewed. AMHD plans to
send out notices of awards September, 2002:
• Supported Housing
• Specialized Residential (24 hour rehabilitaiton and 24 hour dual diagnosis
Day Treatment for Persons with Dual Diagnosis
Consumer Support and Warm Lines
Outpatient Treatment/Targeted Case Management
• Supported Case Management/Case Coordination
If you are not on the RFP notification list and wish to be placed on the list, please call Vivian
or Enid at 586-4688.
Department of Health
1250 Punchbowl Street
Honolulu, Hawai‘i 96813
E-Mail for Newsletter:
• Waipahu Aloha Clubhouse reports 125 active members. 17 members were employed (14%).
Of those, all 17 were employed part-time in positions that were less than 20 hours per week.
• Ko‘olau Clubhouse reports 92 active members 21 members were employed (23%). Of those,
all 21 were employed part-time in positions that were less than 20 hours per week.
• Honolulu Clubhouse reports 169 active members. 23 members were employed (14%). Of
those 23, one worked full time (i.e., 40 hours per week); one worked 28 hours per week; the
remaining 21 members worked part-time in positions that were less than 20 hours per week.
• Friendship House reports 68 active members and 29 members were employed (43%). Of
those 29, six worked full time. (i.e., 40 hours per week). Eight additional members worked
20 or more hours per week. The remaining 15 members worked part-time in positions that
were less than 20 hours per week.
• Hui Hana Pono Waianae reports 74 active members. 14 members were employed (19%) Of
those 14, one worked full time (i.e., 40 hours per week). 13 members worked in part- time
positions that were less than 20 hours per week.
Supported Employment Program
• Good news! We now have 171 consumer job placements, compared to 162 last month,
with a 53% retention rate.
• As of August 1st, at State Operated Community Mental Health Centers, 2,178 consumers
completed a quality of life interview within the previous 7 months. Of these, 366 (17%)
reported being employed (140 full-time and 226 part-time employment)
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