Weeks after Hawaii began quietly sending some of its most challenging psychiatric patients to mainland facilities to ease overcrowding, one of those early transfers has ended in tragedy. A 34-year-old man who was moved off-island died last month at a South Carolina psychiatric center, and family members plus lawmakers say the state now owes them a full accounting of how the transfer was handled. The case has quickly become a high-profile test of the state's plan to relieve pressure at the Hawaii State Hospital.
Payton Nathaniel Hough, 34, was among the first patients transferred from the Hawaii State Hospital and died by suicide in November at Columbia Regional Care Center, according to Hawaii News Now. The outlet reported the Department of Health had not confirmed the incident and that Hough’s family learned of his death on Nov. 25 from his sister’s Instagram post. Lawmakers were notified only after reporters asked the department about the transfer, HNN said.
Long Record Of Illness And Violence
Hough had a long history of serious mental illness and had been in and out of the Hawaii State Hospital for about a decade. In 2019 he was jailed at the Oahu Community Correctional Center after a violent attack that left another inmate dead, Civil Beat reported. A judge later found Hough not criminally responsible by reason of insanity and ordered him committed to the Department of Health for treatment, as per Civil Beat. That history has often been cited in coverage of the mounting strain on Hawaii’s forensic and hospital systems.
Why Officials Backed Mainland Transfers
At an October briefing on hospital overcrowding, Hawaii State Hospital administrator Mark Linscott told lawmakers the hospital planned to send the first four patients to a mainland facility as a targeted step to “decompress” the campus, as reported by Hawaii News Now. Hough’s attorney said he was unaware his client had left the islands, and Hough’s family said it would have opposed the move. State Rep. Della Au Belatti called a death among the early transfers a “red flag” and demanded a comprehensive review of Hough’s intake and observation period at the South Carolina facility.
Staff Warnings At A Strained Hospital
The offshore transfer program comes as the Hawaii State Hospital struggles with long-standing overcrowding and workplace-safety concerns. Staff have filed complaints alleging rising assaults and understaffing, Civil Beat reported in June. That reporting and other coverage describe a “revolving door” of people cycling through short stays and frequent readmissions, complicating efforts to secure long-term treatment. Advocates and staff say any plan to send patients out of state must include stronger monitoring, better family notification and clearer oversight.
Lawmakers Push For Answers
Lawmakers have asked the Department of Health and the State Hospital for answers and are pressing for a review of transfer protocols and notification policies. Officials with oversight roles say they want clear standards for who is eligible to leave the islands and how facilities report incidents so families and legislators are informed promptly. In the coming days, they are expected to pursue hearings and follow-up requests for records that could determine whether Hawaii’s controversial mainland transfers continue or get a hard second look.
