Citizens' groups rank Hawaii 51st in the nation.

This special edition of the Hawaii Medical Journal presents a collection of articles that describe and comment upon the spectrum of health care services for the seriously disabled mentally ill (SDMI) in Hawaii. It is but one of several statewide responses to the publication, "Care of the Seriously Mentally Ill; A Rating of State Programs," by E. Fuller Torrey, MD, Sidney M. Wolfe, MD and Laurie M. Flynn, Second Edition, 1988. Published jointly by the Public Citizen Health Research Group and the National Alliance for the Mentally Ill, first in 1986 and again in 1988; the study sought to compare and rate all states, plus the District of Columbia, using hospital, outpatient, rehabilitation and housing services as indices of care. The published results ranked Hawaii last (51st) in the Nation in its care of the SDMI in both years of the survey. On a scale of 1 to 20, no state ranked higher than a total of 14 points across the four categories of care (Table 1: Summary of State Ratings by Points). Additionally, only 12 states showed significant improvement between 1986 and 1988. Hawaii is included among those states deemed to be "going nowhere."