A brown smokestack and a single building is all that is seen of Mendota Mental Health Institute from the Memorial Union Terrace. Yet this often overlooked part of the view serves as one of only two major mental health treatment centers in Wisconsin.
MMHI, formally known as the Wisconsin State Hospital for the Insane, houses men who are either waiting for forensic treatment before trial or men who have already pled “not guilty by reason of mental disease or defect” in court — meaning they will spend the duration of their sentence in a mental hospital.
MMHI also has a smaller program for violent juveniles referred by the Wisconsin Department of Corrections who struggle with mental illness.
While MMHI tries to evaluate and serve the population of men entering the justice system with diagnosable mental health problems, there is a large population of people who fall through the cracks of the system. This can happen to those who are not diagnosed initially, or those who have developed a mental illness while in prison.
In the past, MMHI received praise for their quality work, even winning the Gold Achievement Award of the American Psychiatric Association. However, the system MMHI plays a part in is far from perfect, according to UW-Madison law professor Kenneth Streit.
Streit explained that despite the work MMHI does to treat those with mental illnesses, many patients are “getting stuck in jail until their case is adjudicated,” even more than those convicted of crimes. People with mental health issues are picked up by police and often enter the bureaucracy of the justice system, which keeps them from getting prompt, effective treatment.
Streit, who works with the State Public Defender’s Office and currently is sponsoring a man in MMHI, said there are often not enough beds for all those who need to undergo forensic evaluation before standing trial, which means waiting lists for those who desperately need medical treatment.
Data provided by the Department of Health Services showed the MMHI has about 280 beds for forensic patients, 29 beds for the Mendota Juvenile Treatment Center and 20 other beds in their general unit.
Streit said the lack of housing is very frustrating, and that public defenders almost always have their clients waiting in county jails before they are able to get a spot at a facility like MMHI.
This problem then spills over into the state prison system, where more than 40 percent of prisoners in Wisconsin struggle with some type of mental health issue, according to the Wisconsin Justice Initiative.
DHS also operates the Wisconsin Resource Center, which is located next to MMHI’s sister institute, Winnebago Mental Health Institute. It treats prisoners who have mental health problems while incarcerated.
Streit explained that a possible solution to breaking the regressive cycle of mental health in the criminal justice system is to invest in community rehabilitation programs that would help people get care before they are reincarcerated.
“A big reason the state prisons have a lot of people with mental health issues is because a more aggressive, a more dynamic mental health system is not available in their community,” Streit said.
There are, however, dedicated organizations whose missions are to help combat the regressive cycle of mental health in the criminal justice system, like the National Alliance on Mental Illness.
“If you just look statistically, there [are] a lot of people in the prison system who have undiagnosed and untreated mental illness,” Executive Director of NAMI’s Wisconsin branch Jessica Gruneich said.
She explained some of these people end up in institutions like MMHI or Winnebago, but many end up back in the community without receiving adequate health care for their mental illness.
NAMI works with the Wisconsin legislature to provide free support programs for those who are struggling with mental health issues and their families. In addition, they hold police trainings for crisis intervention to give police the tools to support someone who is having a mental health crisis rather than escalating the instance.
Gov. Tony Evers’ Administration allocated some state funds for a 14 bed expansion in the Mendota Juvenile Treatment Center.
DHS Representative Jennifer Miller also said Evers proposed $45 million for behavioral health treatment and access, allocated especially for rural and underserved areas of the state.
Yet the problem, according to NAMI’s Public Policy and Advocacy Director Crystal Hester, comes down to investing in community-based care, since she approximates about 800,000 people across Wisconsin are impacted by serious mental health illnesses.
“While we certainly need more beds, essentially what we need probably even more is to focus on prevention to help folks before they are at that crisis level,” Hester said. “It could be 14 beds; it could be 140. Essentially that is not getting to the root of why folks are not getting the help they need earlier.”
Since the final budget has not passed, there is no guarantee any money will be invested in local mental health treatment.
Miller said although funds would alleviate some strain on the current system, he believes it is an issue that needs more attention than it is currently receiving.
“Sometimes I think mental health advocates don’t always get a seat at the table,” Miller said.
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