Q. Prior to your arrival three years ago, Kahi Mohala went from a private, for-profit operation that ended up in bankruptcy to new ownership and non-profit status where the operation is now turning a profit.

A. I'm very proud and very happy to be a part of Kahi Mohala. We are in the black. Our philosophy is providing the best behavioral healthcare, but making a difference in people's lives is at the heart of our philosophy.

Q. May is Mental Health Awareness Month. As the immediate past president of the Hawai'i Psychiatric Medical Association, what do you think is important for average people to know about mental health?

A. Mental health is a treatable illness, just like pneumonia and diabetes and cancer. There is a stigma but if you need help, help is available.

Q. Speaking of stigmas, you are one of only three doctors in Hawai'i who administers electroconvulsive therapy. What kind of stigmas are attached to a treatment that had been known as electroschock therapy?

A. The stigma comes from the celebrated case of One Flew Over The Cuckoo's Nest. With the latest technology, we know that it is safe and can be life-saving. Even our colleagues and the community feel we're still in the Middle Ages, but there are advances with anesthesia and muscle relaxation and our monitoring.

Q. How does ECT work and what conditions is it used to treat?

A. We use 50 Joules, where a defibrillator gives up to 200 Joules and then you go up to 400 — without anesthesia. We are treating psychotic depression, or major depression with psychotic features. In spite of advances in technology and newer medications, it still takes time before antidepressants and antipsychotics kick in. It can be weeks. In certain cases — where patients stop eating or are highly suicidal or become mute and non-communicative — they can die and time is of the essence.

Q. ECT induces a controlled seizure that releases the body's natural chemicals?

A. It's like having fireworks going off in the brain in which neuro-transmitters are released all at once. You can have remarkable results.

Q. You will soon launch tele-psychiatry service with Hilo Medical Center. Why?

A. We want to have it going as soon as possible because the need is there. When a child or adolescent is brought to the emergency room, you need a consultation with a child psychiatrist to make a disposition whether the patient will come to an in-patient psychiatric unit and, of course, there are only two places in the whole state of Hawai'i who have in-patient child and adolescent facilities, Queen's and Kahi Mohala. A lot of times, without the consultation, patients have to wait in the emergency room for days and days waiting. There is a need on all islands.

Q. In January, Kahi Mohala became a no-smoking facility. How does that affect the treatment of patients who are already dealing with mental health issues?

A. We're a hospital and we want to get people well. We know about the risks of smoking. There have been studies in institutions to see if it makes a difference between being smoke free and behavioral care — whether there's increased agitation and restraint. From the studies, there was no relation. So we're monitoring that to see if there's a connection at Kahi. We want to look at that data.

Q. You went to the Philippines in January with Gov. Linda Lingle as part of Hawai'i's centennial celebration of Filipino immigration to the Islands. How was that experience?

A. It was truly a journey of the heart. I was born and raised in the Philippines, but a lot of my life was spent on the Mainland. So it was a journey of coming back. The hospitality and genuine sincerity was wonderful.

Reach Dan Nakaso at dnakaso@honoluluadvertiser.com.