Hawaii's Department of Corrections and Rehabilitation (DCR) is confronting what officials, staff, and independent experts have described as a mental health crisis inside its prisons. In 2024, there were five suspected or confirmed suicides in Hawaii state correctional facilities -- the highest total since 2016. Licensed psychologists have been leaving at an alarming rate: as of early 2025, 20 of DCR's 23 psychologist positions were vacant, and one of the three filled positions was held by a provider who had not yet passed the psychologist licensing examination.
These are not allegations from outside critics. DCR Director Tommy Johnson acknowledged the shortcomings publicly. His department, then called the Department of Public Safety, has been under federal scrutiny for its mental health care since 2019 -- when a class-action lawsuit was filed by attorney Eric Seitz on behalf of prisoners who had experienced extreme isolation with little or no mental health treatment, after a series of suicides.
In April 2025, DCR settled the class certification phase of that lawsuit -- Opulento v. Hawaii Department of Public Safety -- by agreeing to an independent expert inspection of OCCC and Halawa Correctional Facility. Two national expert panelists conducted that inspection in June 2025. Their September 2025 report described conditions at the Halawa mental health infirmary as "dismal" and called conditions at OCCC's Module 1 (housing the most seriously mentally ill prisoners) a decrepit, overcrowded environment where restricted out-of-cell time actively exacerbates prisoners' mental illnesses.
Hawaii also sends approximately 1,400 prisoners to a contracted facility in Arizona due to overcrowding -- a geographic barrier that isolates prisoners from their families and from Hawaii's community mental health system.
What Hawaii Prisoners Are Entitled To
Under Estelle v. Gamble (1976), DCR Policy No. COR.10.1G.04 (which defines Serious Mental Illness and Serious and Persistent Mental Illness for DCR purposes), and NCCHC accreditation standards that DCR health care clinics are held to:
- Mental health screening at intake.
- Classification as having a Serious Mental Illness (SMI) or Serious and Persistent Mental Illness (SPMI) when warranted.
- Mental health treatment appropriate to that classification.
- Housing in the Halawa special needs facility for prisoners with severe or chronic mental illness who cannot be placed in general population.
- Crisis stabilization care.
- Medically necessary care consistent with community standards and NCCHC standards.
The DCR Health Care Division
DCR's Health Care Division (HCD) provides medical, mental, and dental health services through staff of physicians, psychiatrists, psychologists, nurses, social workers, dental, and other direct patient care providers at all DCR facilities. HCD operates 24-hour, seven-day-a-week health care services with skilled nursing level infirmary services at Halawa Correctional Facility and at the Oahu Community Correctional Center (OCCC) and Women's Community Correctional Center (WCCC).
All HCD health care clinics operate under NCCHC accreditation standards. Medically necessary care is rendered consistent with community standards of care, the United States Constitution, Hawaii Revised Statutes, NCCHC standards, and DCR policies.
The staffing crisis means that despite these formal standards, the clinical capacity to meet them has been severely compromised. A mental health system with 87% of its psychologist positions vacant cannot function at its designed capacity.
The Facilities
Hawaii DCR operates six correctional facilities on four islands:
Halawa Correctional Facility (HCF) -- Oahu: Two separate facilities. The special needs facility (opened 1962 as a county jail, transferred to state in 1977) houses maximum and closed custody inmates, inmates with severe and chronic mental illness who cannot be placed in general population, and inmates requiring protective custody. The medium security facility (opened 1987, the newest and largest prison in Hawaii) houses male sentenced felons. About 1,400 male inmates from HCF are housed in a contracted facility in Arizona due to overcrowding.
Oahu Community Correctional Center (OCCC) -- Oahu: The primary pretrial detention facility. OCCC houses pretrial detainees and short-term sentenced prisoners. Module 1 at OCCC houses the most seriously mentally ill prisoners. The 2025 expert panelist report described Module 1 as a decrepit, overcrowded environment where restricted out-of-cell time exacerbates mental illness.
Women's Community Correctional Center (WCCC) -- Oahu: The state's women's facility.
Hawaii Community Correctional Center (HCCC) -- Hilo, Big Island: Serves the Big Island population.
Maui Community Correctional Center (MCCC) -- Wailuku, Maui: Serves the Maui County population.
Kauai Community Correctional Center (KCCC) -- Lihue, Kauai: Serves the Kauai population.
The Opulento Lawsuit
Opulento v. Hawaii Department of Public Safety (D. Haw.) was filed in 2019 by attorney Eric Seitz on behalf of families of prisoners who had died by suicide. The complaint alleged that corrections officials "subject people with serious mental illnesses to extreme isolation with little or no mental health treatment."
The class was certified by the District Court on June 30, 2022, covering all persons incarcerated in Hawaii prisons and jails with a Serious Mental Illness or Serious and Persistent Mental Illness as defined by DCR Policy No. COR.10.1G.04.
In April 2025, the parties reached a settlement agreement under which:
- DCR agreed to a preliminary inspection of OCCC and Halawa by two national expert panelists.
- The inspection took place in June 2025.
- The panelists' recommendations are to be adopted by DCR subject to legislative funding.
- The panelists reviewed all policies pertaining to mental health inmates, including assessments, diagnoses, treatment plans, referral criteria, and follow-up care.
- DCR paid $100,000 in attorney's fees.
Financial aspects of the broader case were not yet resolved as of the April 2025 agreement. The litigation is ongoing -- verify current status at publish.
The September 2025 Expert Report
The two national expert panelists who inspected OCCC and Halawa in June 2025 released their report in September 2025. Key findings:
Halawa mental health infirmary: "The physical plant within the mental health infirmary was dismal. The conditions of confinement were equally dismal." A new infirmary for Halawa has been funded, but construction will not be complete for approximately two years from the time of the report.
OCCC Module 1: The report described Module 1 for the most seriously mentally ill as a space where "the decrepit physical plant, overcrowding and restricted out-of-cell time exacerbates many of the inmates' mental illnesses."
The DCR Director acknowledged the shortcomings. The expert panelists' recommendations are to be adopted by DCR subject to legislative funding.
The Staffing Crisis
As of early 2025, DCR's mental health staffing situation was:
- 20 of 23 psychologist positions: vacant.
- 1 of the 3 filled positions: held by a provider who had not yet passed the psychologist licensing examination.
- Licensed psychologists leaving correctional facilities at an alarming rate.
- The mental health system unable to function at designed capacity.
A clinical psychologist who had worked across multiple Hawaii facilities described it this way: "It's just that the facilities and the system are so unequipped to deal with this, and at some point it's too much to put on any individual or group of people to be in charge of this much risk, liability, this many lives."
This context is critical for families: the rights and standards that exist on paper for Hawaii prisoners with mental illness are not being met in practice, and the staffing gap is the primary reason.
The Out-of-State Transfer Problem
About 1,400 male prisoners from Halawa Correctional Facility are housed in a contracted facility in Arizona due to overcrowding. For prisoners with serious mental illness who are transferred to Arizona:
- They are separated from their families by thousands of miles, effectively ending most in-person contact.
- They are removed from Hawaii's community mental health system and any transition planning networks.
- The Arizona facility is not under Hawaii DCR's direct operational control.
- Families face major practical and financial barriers to maintaining contact and advocating for care.
If your person has been transferred to Arizona, contact DCR to confirm the facility name, the contract terms governing mental health care for Hawaii prisoners there, and what oversight DCR maintains over those conditions.
What Families Can Do
If your person is in Hawaii DCR custody and has a mental illness:
Provide psychiatric history at intake. Supply documentation of prior hospitalizations, diagnoses, and active medications. Hawaii's HCD screening at intake is the entry point for mental health classification and care.
Know DCR Policy No. COR.10.1G.04. This policy defines Serious Mental Illness (SMI) and Serious and Persistent Mental Illness (SPMI) for DCR purposes -- the definitions that determine whether your person is in the Opulento class and what care standards apply. Ask the facility whether your person has been classified under this policy.
Know the staffing reality. With 20 of 23 psychologist positions vacant, the frequency of clinical contact your person receives may fall far below what policy requires. Document missed appointments and inadequate contact. These documentation records are essential if you need to escalate.
Know the Halawa special needs unit. If your person has severe or chronic mental illness and is at Halawa, ask whether they are housed in the special needs facility (which houses the SMI population) rather than general population. This placement matters for the level of mental health programming available.
Know the OCCC Module 1 situation. If your person is at OCCC with serious mental illness, the expert panel has documented Module 1's conditions as actively worsening mental illness. Document conditions and file grievances for inadequate out-of-cell time and inadequate treatment access.
If your person has been transferred to Arizona. Contact DCR's main office for information about the contracted Arizona facility, visiting rules, and what mental health care is being provided. Document any gaps in care and communicate them to DCR in writing.
File a grievance. DCR has an administrative grievance process. File formal grievances for: failure to classify as SMI or SPMI, inadequate frequency of clinical contact, medication interruption, and conditions that fall below NCCHC standards.
Contact Disability Rights Hawaii. Disability Rights Hawaii (disabilityrightshawaii.org) is the federally mandated Protection and Advocacy organization for Hawaii and monitors conditions for people with mental illness and disabilities in DCR facilities.
Contact the Opulento lawsuit team. Attorney Eric Seitz filed and is litigating the Opulento class action. Contact his office for information about the class and what legal options may be available.
Seek legal help. If your person has serious mental illness and is not receiving adequate care, is in OCCC Module 1 conditions the expert panel described as harmful, or has been transferred to Arizona without appropriate mental health continuity, consult a prisoner rights attorney with experience in Hawaii's federal courts (District of Hawaii).
Frequently asked questions
How does Hawaii screen prisoners for mental illness?
DCR's Health Care Division (HCD) screens all inmates at intake, including mental health assessments. The classification determines whether a prisoner meets the definition of Serious Mental Illness (SMI) or Serious and Persistent Mental Illness (SPMI) under DCR Policy No. COR.10.1G.04. Provide psychiatric documentation at intake -- prior hospitalizations, diagnoses, and active medications. Given the current staffing crisis (20 of 23 psychologist positions vacant), screening quality may vary by facility and timing.
What mental health facilities does Hawaii DCR operate?
DCR operates six correctional facilities statewide: Halawa Correctional Facility (HCF, Oahu) with a special needs unit for severe/chronic mental illness; OCCC (Oahu, pretrial); Women's Community Correctional Center (WCCC, Oahu); Hawaii Community Correctional Center (HCCC, Hilo, Big Island); Maui Community Correctional Center (MCCC, Maui); and Kauai Community Correctional Center (KCCC, Kauai). Each facility has an NCCHC-accredited health care clinic. About 1,400 prisoners from Halawa are housed in a contracted Arizona facility due to overcrowding.
What is the Halawa special needs facility?
The Halawa Correctional Facility's special needs facility (originally built 1962) houses maximum and closed custody inmates, inmates with severe and chronic mental illness who cannot be placed in general population, and inmates requiring protective custody. It is the primary housing unit in Hawaii for the most seriously mentally ill prisoners. The September 2025 expert panelist report described conditions in the mental health infirmary as "dismal" -- physical plant and conditions of confinement both. A new infirmary has been funded but was approximately two years from completion as of the report.
What is OCCC Module 1 in Hawaii?
Module 1 at the Oahu Community Correctional Center (OCCC) is the housing unit for the most seriously mentally ill pretrial detainees and sentenced prisoners at OCCC. The September 2025 expert panelist report described it as a space where "the decrepit physical plant, overcrowding and restricted out-of-cell time exacerbates many of the inmates' mental illnesses." Restricted out-of-cell time and poor physical conditions were identified as actively worsening the mental illness of the people housed there.
What is the Opulento v. Hawaii lawsuit about?
Opulento v. Hawaii Department of Public Safety (D. Haw., filed 2019) is a federal class action challenging the mental health care provided to prisoners with Serious Mental Illness and Serious and Persistent Mental Illness in Hawaii's correctional facilities. It was filed after a series of suicides and alleges that prisoners with SMI were subjected to extreme isolation with little or no mental health treatment. The class was certified in June 2022. In April 2025, DCR agreed to an independent expert inspection of OCCC and Halawa as part of a partial settlement. Financial aspects of the case remain unresolved.
What did the 2025 expert panel find about Hawaii prisons?
Two national expert panelists inspected OCCC and Halawa in June 2025 as part of the Opulento settlement and released their report in September 2025. Key findings: Halawa's mental health infirmary had "dismal" physical plant and conditions of confinement; a new infirmary was funded but approximately two years from completion. OCCC Module 1 -- the unit for the most seriously mentally ill -- had a "decrepit physical plant, overcrowding and restricted out-of-cell time" that actively exacerbates inmates' mental illnesses. DCR Director Tommy Johnson acknowledged the shortcomings. The panelists' recommendations are to be adopted by DCR subject to legislative funding.
How bad is the mental health staffing crisis in Hawaii?
As of early 2025, 20 of DCR's 23 psychologist positions were vacant, and one of the three filled positions was held by a provider who had not yet passed the licensing examination -- meaning DCR had effectively two licensed psychologists for its entire correctional system. Licensed psychologists have been leaving at an alarming rate. A clinician who had worked across multiple Hawaii facilities described the situation as beyond what any individual or group can be expected to manage. Five prisoners died by suspected or confirmed suicide in 2024 -- the highest annual total since 2016.
Are Hawaii prisoners sent out of state for mental health?
About 1,400 male prisoners from Halawa Correctional Facility are housed in a contracted facility in Arizona due to overcrowding -- not specifically for mental health reasons, but the transfer affects any prisoner with mental illness. Out-of-state transfer separates prisoners from family, Hawaii's community mental health system, and transition planning networks. For prisoners with mental illness transferred to Arizona, contact DCR to confirm the facility, the mental health care provisions in the contract, and what oversight DCR maintains. Families should document any gaps in mental health care for transferred prisoners in writing to DCR.
What can families do if mental health care is denied in HI?
Provide psychiatric history at intake. Ask whether your person has been classified under DCR Policy No. COR.10.1G.04 (SMI or SPMI). Know the staffing reality and document missed clinical contacts. If your person is at OCCC Module 1, document the conditions. If they've been transferred to Arizona, communicate with DCR in writing. File DCR grievances for classification failures, inadequate clinical contact, medication interruptions, and conditions violations. Contact Disability Rights Hawaii (disabilityrightshawaii.org) for legal advocacy. Contact the Opulento lawsuit team (attorney Eric Seitz) for class action information.
Who oversees mental health care in Hawaii prisons?
DCR's Health Care Division (HCD) manages mental health care internally, operating NCCHC-accredited clinics at all six facilities. Disability Rights Hawaii (disabilityrightshawaii.org) is the federally mandated Protection and Advocacy organization for Hawaii and monitors conditions for people with mental illness and disabilities in DCR. The Opulento federal class action (D. Haw.) maintains ongoing judicial oversight through the April 2025 settlement's expert inspection process, with panelists' recommendations adopted subject to legislative funding. The case remains active. ---