The state's release of Tittleman Fauatea from its medical and court systems despite his history of mental illness and assessments indicating the need for continued treatment is an example of a system gone wrong, says attorney Eric Seitz.

Seitz said the problem is widespread. He said he has had cases where people were found mentally incompetent to proceed and were left sitting in jail getting worse instead of being transferred to a hospital. In other cases people were released when they were unfit, unsafe and not monitored.

"It's not an isolated situation at all," he said. "There are hundreds of people wandering around on the streets who are in the same position as this guy."

Fauatea, 25, has been indicted in the Feb. 27 stabbing death of Asa Yamashita. Fauatea will be arraigned today and enter a plea on a charge of second-degree murder.

Yamashita's killing came some three months after Fauatea was taken from the Hawai'i State Hospital in Kane'ohe to serve a six-day sentence at O'ahu Community Correctional Center. He was freed from OCCC on Nov. 29.

Seitz has represented people in other situations where there were serious consequences for the mentally ill or for people who ended up hurt by them, such as the 2005 case of a man who stabbed his mother, nearly killing her, while on release from the Hawai'i State Hospital.

In the court system, the accused may spend months waiting in jail for their cases to be heard when they should be getting treatment, Seitz said. When they are conditionally released they may or may not be monitored, he said, adding that probation officers, who are overworked and understaffed, aren't able to keep track of everyone in their care.

This kind of problem was unheard of in Hawai'i until a couple of years ago, Seitz said.

"Now you see people who are very obviously very seriously ill walking around ... which is an indication that those two systems are not working, do not have adequate resources and are not working well in conjunction with one another," he said.

Both the state Judiciary and Department of Health had Fauatea in their systems by mid-August, court documents indicate. Court proceedings on misdemeanor charges against Fauatea were halted while he was ordered to the state hospital for evaluation of his fitness to stand trial.

He was diagnosed as schizophrenic in a series of assessments, all of which concluded that Fauatea posed a mild or moderate risk to himself or others.

However, the "probability of dangerous behaviors increases to moderate or high if he is not under the current level of supervision," states an Oct. 15 psychiatric evaluation written when Fauatea was still a patient at the hospital in Kane'ohe.

Further, a December report noted that Fauatea stated he would probably stop taking his medication when he was released.

The assessments detailed Fauatea's history of mental illness, referring to three psychiatric hospitalizations in California and one at Kahi Mohala as well as how he threatened to kill his sister's children in 2003, and attacked three patients while at the state hospital.

Fauatea was taken from the hospital in November to go to jail for an 'Ewa harassment conviction and released into the community after serving his time. But there apparently were expectations that he should have returned to the state hospital until a Kane'ohe trespass charge was heard in mid-December, court records and a recording of a Dec. 19 Kane'ohe District Court hearing showed.

FEDERAL OVERSIGHT

The state's ability to care for mental health patients has been called into question before. After a 1991 lawsuit was filed by the U.S. Justice Department's civil rights branch, the state entered into a consent decree that launched 15 years of federal oversight over its delivery of mental health services and treatment.

In 2001, a scathing report criticized management of the state hospital, and Judge Kevin Chang was appointed "special master" to oversee the hospital's effort to improve conditions and services for the mentally ill.

It took five more years for the state to satisfy the requirements of the decree. Federal oversight ended in 2006.

Today, budget cuts are reducing the mental health services that can be offered.

Last year the state initiated a series of cuts that decreased the number of hours of service available through its private providers from 24 to 3.5 a month, including services for the most needy, said Tina McLaughlin, with Care Hawaii, a mental healthcare provider.

McLaughlin said adjusting to the changes has been difficult and she, like others, said she expects to see more mental health problems as a result.

"I believe there will be an increase in adverse outcomes such as suicides, homicides, hospitalization and incarceration," she said.

The adjustment was a way to meet a budget deficit, said Janice Okubo, spokeswoman for the state Department of Health, which oversees mental health programs and the Hawai'i State Hospital.

"There's been overspending of the budget so we're trying to bring things under control," Okubo said. "We were estimating that if we did not implement that strategy that we would have run out of money in April and there would be no service after that."

The Health Department would not comment on the Fauatea case anew. But Okubo has said that the hospital had a court order to release Fauatea.

Michelle Hill, deputy director for Behavioral Health and acting division chief for Adult Mental Health, did say that patients with serious and persistent mental problems typically continue to get care after leaving the hospital.

It is unclear whether such care was ordered for Fauatea.