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July 19, 2019

6/6/2019 7:29:00 AM
Advocacy groups, law enforcement call for regional mental health crisis centers
Hartman: Wait times, location for mental-health beds strain resources

Richard Moore
Investigative Reporter


A coalition of mental health advocates, providers, and law enforcement organizations have rallied around a proposal to improve Wisconsin's mental health crisis system, specifically, a proposal to allocate $2.5 million in the upcoming state budget for regional crisis centers for adults.

More than 55 groups signed a letter asking legislators to fully fund the proposal to establish a network of regional crisis centers, which they believe would provide better outcomes for people experiencing mental health crises and make better use of law enforcement resources.

Among the groups signing the letter were the National Alliance on Mental Illness (NAMI), Disability Rights Wisconsin, Autism Society of Greater Wisconsin, Badger State Sheriffs' Association, Kids Forward, Lakeland Care, Survival Coalition of Wisconsin Disability Organizations, The Arc Wisconsin, and the Wisconsin Sheriffs and Deputy Sheriffs Association.

The Legislature's Joint Finance Committee was to take up consideration of the proposal this week.

The groups say Wisconsin's mental health crisis system is lacking local resources. In 2018, they observed, more than over 3,000 people experiencing a mental health crisis were transported from their community to Winnebago Mental Health Institute, for many far away from their support networks and mental health providers.

Oneida County had 38 transports to Winnebago during 2018; Vilas, 24.

"Individuals experiencing a mental health crisis deserve to receive prompt treatment and care in their own communities where their families reside," Crystal Hester, public policy and advocacy director for NAMI (National Alliance on Mental Illness) Wisconsin, said. "In addition, long transports to Winnebago put financial and resource strains on law enforcement, taking them out of their communities for hours at a time. We need a better system for all involved."

Hester said law enforcement backs the need to develop local crisis resources, and Oneida County sheriff Grady Hartman said there is in fact a problem.

"The key problem for us is the wait times for the beds," Hartman told The Lakeland Times. "A few years ago, the medical clearance and the location of the mental health bed took about three hours. Now, it's not uncommon to have to wait eight-plus hours after medical clearance for a bed somewhere in the state."

After the department finds a location, Hartman said, they still have the transport to do, which he said often takes eight hours.

"We have discussed this issue among the other state sheriffs and this is a common issue for everyone," he said. "I think the answer is to create more beds within the state. If that can be done within the budget, then I'm all for it."

Grant County sheriff Nate Dreckman also said the current emergency detention process was very time-consuming for law enforcement.

"Depending on their location, officers are spending multiple hours, sometimes an entire day, transporting an individual to Winnebago," Dreckman said. "These lost hours increase the workload for other on-duty officers and impact the public safety of Wisconsin residents. Building more regional capacity for emergency detention is the long-term solution to addressing this crisis for more emergency detention beds."

Barbara Beckert, the Milwaukee office director of Disability Rights Wisconsin, said the success of regional crisis centers would depend on engaging stakeholders in the planning and implementation process.

"Our organizations endorse the proposal and the need for a stakeholder advisory group, including people who have experience with the crisis system, advocates, counties, mental health providers, and law enforcement," Beckert said.



LRB analysis

The groups called for the regional crisis center funding after a paper prepared by the Legislative Reference Bureau listed it as a proposed option.

That option, which would allocate $2.5 million in 2020-21 for a new grant program to fund the centers, would require the Department of Health Services (DHS) to establish criteria for stabilization facilities for adults and to award grants under the program, as well as create an annual, sum certain appropriation for the program.

The groups signing the letter to the JFC said there was ample justification for the regional crisis centers.

"When an adult has a mental health crisis, many communities do not have local resources available to evaluate and support the person in crisis," they wrote. "Because of the lack of local resources, law enforcement often must transport an individual experiencing a mental health crisis across the state to Winnebago Mental Health Institute, far from their family and support system."

That's not only traumatizing for the person in crisis and costly, but is a major drain on law enforcement resources, they argued.

"In 2018, over 3,000 people experiencing a mental health crisis were transported from their community to Winnebago Mental Health Institute," the letter stated.

Establishing a network of regional crisis centers would allow a person in crisis to be assessed and supported closer to home and to natural supports, resulting in better outcomes for those in crisis and reducing the time commitment for law enforcement to respond to psychiatric crises, but there are other benefits, too, the groups argued.

"Crisis stabilization centers serve as a diversionary alternative to inpatient treatment units," the letter stated. "In general, evidence reviewed by the SAMHSA (Substance Abuse and Mental Health Services Administration) suggests a high proportion of people in crisis who are evaluated for hospitalization can safely be cared for in a crisis facility. The same evidence suggests the outcomes for these individuals are at least as good as hospital care, and the cost of crisis care is substantially less than the cost of inpatient care."

Strong stakeholder involvement will be important to ensure that this model is successful, the groups stated.

"Our organizations endorse the proposal and the need for a stakeholder advisory group, and are ready and willing to assist with the planning and implementation process," the letter concluded.

Richard Moore is the author of the forthcoming "Storyfinding: From the Journey to the Story" and can be reached at richardmoorebooks.com.





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