A coalition of law enforcement agencies, hospitals, medical professionals, county and state health services and mental health advocates released recommendations Thursday to reform Wisconsin’s mental health crisis response.
Emergency detentions occur when law enforcement takes a person into custody because they are experiencing a crisis episode as a result of mental illness or other conditions and pose a risk to themself or others, according to the DOJ.
“Overhauling our emergency detention system can lead to better support for Wisconsinites experiencing mental health crises, less time spent by law enforcement officers outside of the communities they serve and more efficient and impactful use of tax dollars,” Attorney General Josh Kaul said. “This broad coalition has come together to provide a roadmap for reform of this complex system.”
Along with the Department of Justice, members of the coalition include the National Alliance on Mental Illness (NAMI) Wisconsin, the Wisconsin Chiefs of Police Association, the Wisconsin Department of Health Services and the Wisconsin Medical Society.
The coalition recommended investments that promote diverting cases away from emergency detention centers, which can be “excessive, costly, potentially counterproductive and not necessary to public safety” for people experiencing behavioral health issues, according to the coalition. The coalition recommended focusing on a “continuum of crisis care.”
"I am in 100% agreement that we must divert cases away from emergency detentions along with improving the entire process & capacity for those that do need emergency detentions. As a peer who has experienced the trauma of multiple emergency detentions in Sheboygan County and was held on a few 72 holds while being a Douglas County resident, I can say that change is needed," said Chrissy Barnard, chair of the NAMI Wisconsin Peer Leadership Council.
One recommendation that some localities are already looking into is additional funding into mental health mobile crisis teams similar to the CAHOOTS model in Eugene, Oregon. The City of Madison is planning to roll out such an effort in a pilot CAHOOTS program next year. On the UW-Madison campus, the student council has passed legislation towards establishing a mental health crisis response team.
“It is believed that there is sufficient demand to justify an expansion of this program, but the limited funding and matching requirement have prevented this program from reaching its full potential,” the coalition wrote.
The coalition also asked for legislative action in distributing more inpatient psychiatric beds across the state instead of at the state facility in Oshkosh, which was created in an “era of mental health institutionalization” and is not suited for short-term stays.
“We know that people in crisis are best served in the least restrictive environment and close to home, support systems and consistent resources. We look forward to continuing to partner with counties, medical providers, law enforcement and other organizations within this coalition to expand the breadth of community-based services locally and reduce the need for higher levels of care,” DHS Interim Secretary Karen Timberlake said.
While some of the proposals require action from the legislature, others — like improvements to tracking inpatient bed data and expanding telemedicine — do not.
Some of the recommendations are included in Gov. Tony Evers upcoming budget, which he will present to the legislature on Tuesday. Evers announced last week that his proposed budget invests more than $150 million into mental health care in Wisconsin.
Over $25 million over two years would go to crisis intervention and emergency detention reforms, including funding to regional crisis centers and the Milwaukee County Crisis Mobile and Trauma Response Teams.
The governor also recognized the impact the COVID-19 pandemic has had on mental health.
“The COVID-19 pandemic has only further exacerbated the need for and underscored the urgency of making sure we have affordable, accessible services available to folks when they need it most, and that’s why it’s a top priority in our budget,” Evers said.
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