Some mental health advocates and consumers are raising concerns about the state's decision to do away with a day treatment program that serves about 300 severely mentally ill people annually.

The psychosocial rehabilitation program, which costs the state about $1 million a year, teaches people a wide range of things, from job skills and personal hygiene to how to cook. Advocates say the program is vital to keeping some clients stable. Without it, they say, some severely mentally ill people wouldn't leave their homes.

At the end of the month, many of those in psychosocial rehab programs will be transferred to state-run mental health clubhouses, which also offer day treatment for people statewide with severe mental illness. The biggest difference is that the clubhouses don't offer transportation, which could be a big challenge for rural clients.

Ku'ulei Kiliona, a member of the state Council on Mental Health, said the severely mentally ill people in the psychosocial program need the stability and routine that the day treatment brings.

"It's learning life skills," she said. "Many of them don't know how to shop. They learn nutrition, proper hygiene . They cook meals."

About 60 people turned out for the council's meeting last week to protest the program cut.

"The rug is being pulled out from under their feet," Kiliona said.

Dr. Bill Sheehan, acting chief and medical director of the state Health Department's Adult Mental Health Division, said the cut will be tough for some mentally ill people, but added that the state is trying to make sure clients in psychosocial rehab are transferred to other programs before Nov. 30. The program serves about 100 people at any one time.

The end of the psychosocial rehab program is the latest in a slew of cuts the state has made to the Adult Mental Health Division over the past 12 months to rein in costs and meet new budget restrictions. Some mental health advocates say the cutbacks — taken together — represent significant change to community-based mental health services, which the state has bolstered over the past decade, following a federal lawsuit.

Greg Payton, executive director and chief executive officer of Mental Health Kokua, said the cutbacks are dismantling a system that has taken years of work to build.

"It's a huge change in the system without any public input," said Payton, whose organization offers a state-contracted psychosocial rehabilitation program.