A Broken Cycle


This project is a requirement of the GOA Abnormal Psychology Course. Using the process of design thinking, a challenge in the world of mental health was identified, interviews and research were undertaken, and a solution prototype was developed. Below you will find information about the identified area of concern and my proposed solution. Please feel free to provide feedback on this prototype, using questions such as “How might we…”, “What if….?”, “I wonder….”, “I like…”, and “I wish.” Keep the comments positive, please. For more information on the process of Design Thinking, click here.


My name is Izzy Horio, I’m 17, and I go to Punahou School in Honolulu, Hawaii. For this project we had to think about something that would affect our local community. One of the most prevalent issues in Hawaii is our homeless problem. We have a large homeless population, partly because of the climate and because the cost of living here is extremely high. It’s really hard when I’m driving around and see families, elderly people, and even kids, who don’t have any real place to spend the night. It’s even worse to think that some of these people suffer from mental illness and are unable to get the care they need. Homeless have a higher rate of mental illness and that aggravates their medical problems. This problem is something I wanted to spread awareness on and encourage people to do whatever they can to help.


This “broken cycle” I’m going to talk about has to with the homeless people who suffer from mental illness. To get started on this project, I interview Vinnesha Bertola. She works for IHS’s (Institute for Human Services) outreach program. They go out onto the streets and provide minimal care for the homeless who suffer from mental illnesses. A big challenge the outreach program in IHS has to deal with is the gaps in the system. If they take someone to the hospital, they usually just get discharged within 24 hours and then there are some who get arrested and go through the jail system. But, in the jail system the mentally ill don’t get the care they need so it’s really hard for IHS to provide services with their limited funds and resources and with the jail and hospital systems the way they are, IHS can’t count on any help from them either. In 2016, over $16 million dollars was used by Queen’s Medical Center to help homeless suffering from mental illnesses. Insurance covers some of this cost, but the hospital has to cover most of it.

  With limited resources, IHS can only do so much.

The first step to any treatment is getting your “patient” to trust you. Mrs. Bertola has to make sure they understand she’s there to help them, not hurt them. It’s also important for them to understand she’s not forcing them into anything; she’s providing them with solutions. You have to create a platform, which can take time, before you are able to provide the homeless with actual medication.


When people get arrested and aren’t stable for court, they can be sent to treatment centers. Oahu uses the state hospital, but these days it’s so full of people. It’s extremely difficult to keep track of everyone and often times people are overlooked. A lot of defendants prefer to spend the few days in jail than go through a long mental evaluation to figure out if they’re unfit for court. These people then spend a short period in jail, are released, and probably get arrested again and go through the same cycle. This is why the outreach programs are so important. If outreach workers are able to provide treatment, they may be able to intervene and prevent illegal behavior.  




As I said before, the outreach program IHS has helps the homeless who suffer from mental illness. Their goal is to have one psychiatrist working with an outreach team in the four Oahu regions. One problem they face is money. To expand their street team islandwide, it would take around four million dollars a year. To make this work, IHS needs the cooperation of other service providers and the community.

Above, I have included a survey for you to take about homelessness in your community.


I have volunteered at IHS before, and I wouldn’t say they have the best facilities so reaching 4 million dollars is going to be difficult. Although this is a big goal, it’s doable if we work together as a community. Volunteering at IHS or donating money to them. Call (808) 447-2827 to do your part and donate.


Blair, Allyson. “Law exists to help mentally ill get treatment, but few resources available to do so.” Hawaii News Now, 24 Mar. 2017, Accessed 13 Apr. 2018.

Blair, Allyson. “PART III: Team has seen results with hardest homeless cases. Now, they want to expand.” Hawaii News Now, 12 Oct. 2017, Accessed 19 Apr.2018.

Defrees, Robert. “IHS Outreach Could be Better.” Blogspot, 20 Nov. 2012, Accessed 19 Apr. 2018.

Nagourney, Adam. “Aloha and Welcome to Paradise. Unless You’re Homeless.” The New York Times, 3 June 2016, Accessed 19Apr. 2018.

Stewart, Colin M. “Homeless population soars.” Hawaii Tribune Herald, 19 June 2015, Accessed 19 Apr. 2018.

Withy, Kelly M., et al. “Health Care Needs of the Homeless of O’ahu.” NCBI, 9 June 2009, Accessed 13 Apr. 2018.

Share this project
  1. April 28, 2018 by Sondra Nachbar

    I wish there were more that we could do for the homeless especially the mentally ill. What suggestions are made by the politicians and health professionals in Hawaii?

    Your report was heartbreaking — you have certainly achieved your goal of making people more aware.

    • April 29, 2018 by izzy horio

      some politicians have a plan to make housing for the homeless, but we have so many homeless that it’s going to be really hard to do this.

  2. April 30, 2018 by leilani.ahina

    I love that you were interested and inspired to pursue this very challenging topic…and it seems clear that the solutions will also be complex. It seems like a meaningful solution will need to involve a merging of multiple issues – legal, mental health, and economic, for starters.

Sorry, the comment form is closed at this time.

Sorry, the comment form is closed at this time.