FAMILY MINISTRIES CENTER
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Mission Statement
Our mission is to strengthen individuals, couples, families, psychologically and relationally so that they may be able to fully realize their potential. Family Ministries Center also seeks to provide teaching, research, curriculum and consultation to organizations to strengthen their ability to enrich individuals, couples and families under their care. We seek to serve first those in Hawaii and secondarily those outside the State.
About This Cause
FMC Molokai Behavioral Health Project The warmth and depth of aloha once a living expression of our State can be seen alive and well on the Friendly Isle (Molokai). This close-knit population of 7,000 has long been protected from the over-commercialization and overt westernization of the larger four. Molokai’s family bonds extends broadly throughout the community by lineage, marriage, culture or by the constancy of neighborly interactions. Yet this very strength and essence of community-sense has been greatly challenged by the behavioral health fallout from the precarious straddling of old Hawaii and demands of our western culture. Recent discussions with some of the island’s stakeholders (i.e., community leaders, former Molokai High School Principal Stanford Hao and his staff, two meetings of over 20 faith-based leaders, phone calls and meetings with three key non-profit executives of Molokai Child Abuse Prevention Pathways, Elizabeth Fujii, Na Pu’uwai, Native Hawaiian Health Care Systems, Kamahanahokulani Farrar and Helene "Lani" Ozaki, Lili'uokalani Trust - Kipuka Moloka'i) have overwhelmingly concurred that culturally-sensitive, effective, consistent and reliable behavioral health assistance is needed. While empirical data is wanting (due to the small population), these leaders have agreed that problems are probably worse now than identified by the Molokai General Hospital Community Health Needs Assessment (March 29, 2013). This survey indicates: “The death rate due to suicides was over twice as high in Molokai in 2001‐2005 (20.4 deaths/100,000 population) compared to the state (9.8); among men, the suicide death rate was 36.1 deaths/100,000 males. (p.37) A lack of services for mental health is a contributing factor to Molokai’s poor outcomes. The Health Resources and Services Administration designated Molokai as a mental health professional shortage area.” (p.37) Note their summary statement: “Those interviewed for this topic suggest integrating physical and mental health care and utilizing creative solutions such as tele‐access to bring mental health services to hard‐to‐ reach populations.” (p.38). (emboldened areas are this author’s). This author recently obtained non-public information for this grant application. In 2017 there were 13 attempted and/or completed suicides (breakdown of this data upon request due to confidentiality of source). Also, all stakeholders universally concurred that domestic violence (both sexual and physical) on Molokai has not been adequately addressed. When the stakeholders listed above were variously questioned, they raised four consistent issues: 1) lack of established, on-island, professional behavioral health providers; 2) cost accessibility of providers in financially-challenged island; 3) concern that providers would not be conversant in the local culture (i.e., rural small-town Hawaii, native Hawaiian values), and that, 4) “everyone knows your business and talk (i.e., lack of assurance of confidentiality).“ While a cursory online search for behavioral health providers indicate that there should be sufficient numbers of providers for the limited population of the Island, stakeholders believed that there may be only two full-time, on-island, practicing, behavioral health providers (one with doctorate-level training). One stakeholder who is acutely aware of the state of Molokai’s behavioral health said “They (providers) sit in their office flipping their smartphones waiting for people to come, who never show up. I told them maybe you got to go to their homes. . . . I may have to rethink the western view of service delivery.” What is strikingly clear, if behavioral health care on Molokai is to be meaningful it needs to not only have: 1) providers with the requisite understanding and skills in diagnosing and treating behavioral disorders within the context of local cultural norms; 2) counselors personally conversant in the local culture; 3) appreciate the sine qua non of confidentiality, in delivering behavioral health care in a small, tight-knit, community; 4) but above all, a commitment to providing sustainable, effective, long-term care. The multi-pronged approach of MOLOKAI BEHAVIORAL HEALTH PROJECT is an attempt to address these crucial and necessary aspects of providing behavioral health. The initial phase of the project will be to: 1) establish relationships with natural caregivers in the community (school principals and counselors, faith-based leaders, community non-profit directors by identifying the behavioral health needs of their organizations, 2) offer workshops for both staff and population served, (being sensitive that large groups activities are unlikely); 3) raise community awareness of tele-behavioral health services; 4) secure “innocuous” counseling sites. The estimated time frame for this initial phase is one year. Understanding that sustainability of the project necessitates the continued development and maintenance of these four key components of effective behavioral health delivery (second phase). Family Ministries Center, Inc. (FMC) has already shown that it can deliver on a project of this magnitude. Five year ago, as a part of the strategic plan to meet the behavioral health needs of the underserved populations outside of Oahu, FMC targeted Kauai (Dr. Akamine’s home island) to eventually expand its care. FMC sponsored well-known family psychologist, John Rosemond (columns in Star Advertiser) to put on a parenting seminar targeting high-risk families. FMC obtained private donations to underwrite Rosemond’s fees, as well as, pay for advertisement on the local radio stations, airfare, hotel accommodations, and secured a Kauai County grant to host it at the Kauai Convention Center. FMC met and advertised this seminar to family-oriented organizations: various private, social service agencies, nonprofits (e.g., Hale Opio, Kauai). Soon after and for the next year, FMC through Dr. Akamine led numerous parenting workshops. Given the nascent stage of tele-behavioral health in Hawaii at that time, FMC was only able to start providing tele-behavioral health care in 2017 to families on the north side of Kauai (native Hawaiian families). All three of Family Ministries Center, Inc. licensed, professional, providers are born and raised in Hawaii, coming from rural areas; one provider being part-Hawaiian. Family Ministries Center, Inc. thus has the requisite qualifications and the willingness to commit long-term to the behavioral health of the Molokai community. FMC understands that not in every case will potential clients be able to have internet-accessed care (i.e., lack of internet service at home/community, smartphones with inexpensive data plans, etc.). The securing of “innocuous” sites (mostly churches) with internet access and laptops (for portability and storage) is deemed as crucial in minimizing confidentiality issues (i.e., less conspicuous to go to a church where one can access tele-behavioral health services in a largely faith-based accepting community like Molokai). FMC expects to have a provider on island at least one day per month for intake, counseling, workshops, seminars, and securing relationships with stakeholders. Family Ministries Center, Inc. is estimating that it will take three to five years before this island community is mostly aware of the range of services that we can provide. By the end of year five, Family Ministries Center, Inc. expects to reach a significant level of self-sustainability by being contracted by non-profits (including faith-based organizations) and business to provide workshops or seminars (given it a presence in the community). Family Ministries Center, Inc. also expects to receive sustainable income from health insurers who provide or can provided tele-behavioral health care to the residents of Molokai. We expect satisfied recipients of our tele-behavioral health services as well as those who receive on-island care (either in-office or through groups/workshops) would be willing to encourage their insurance companies to supplement care by allowing tele-behavioral health access.