To Erin McGroarty / Wisconsin Watch
When Chrissy Bernard faced a mental health crisis and needed the care she needed most, law enforcement handcuffed her, put her in the back of a police car, and forced her to become Wisconsin’s only state-owned civilian. I drove 5 hours to a mental health facility for
Bernard remembers that the seats in the police car were cold. She would eventually have her shoes confiscated because she probably couldn’t hang by the leash.
The 330 miles between Bernard’s hometown of Superior, Wisconsin and the Winnebago Mental Health Institute near Oshkosh made it difficult for her loved ones to comfort her directly.
Bernard, who was diagnosed with bipolar disorder, anxiety, post-traumatic stress disorder, and borderline personality disorder, stayed there for several months and only saw his family three times, she says.
Almost 15 years later, after getting the help she needed, Bernard is now a Peer Support Specialist for the National Alliance for Mental Illness in Wisconsin (NAMI). She has called on many lawmakers to overhaul the emergency mental health system, but it hasn’t helped her or many others, she says.
Wisconsin’s mental health crisis services operate county-by-county, creating wide disparities in care. With few exceptions, counties rely heavily on law enforcement to detain people during mental health emergencies and to ensure that patients are seen as a threat to themselves or others and receive treatment. Transfer the patient for
For rural residents, the nearest treatment facility may be hundreds of miles away.
“It’s so traumatic that the whole system needs to change. You’re treated like a criminal from the start,” says Bernard. I have been hospitalized more than 30 times for health problems.
She has allies driving change, including other advocates, mental health professionals and law enforcement officers. , add care options other than long-term hospitalization, and fund teams of mental health professionals to respond to emergencies, removing such burdens from law enforcement.
“Right now, the system for emergency detention in Wisconsin is broken,” said Wisconsin Attorney General Josh Kaul, who convened a solutions-focused summit in 2019. “And we need to find alternatives.” there is.”
Democratic Gov. Tony Evers has proposed more than $17 million for such an overhaul in the 2021-2023 biennium, but the Republican-led Congress has been skeptical of Evers’ other hundreds. declined the offer. Republican lawmakers have expressed support for localizing mental health crisis services, but the $10 million allocated for it remains tied up in the bureaucracy.
Rural Wisconsin has few resources
Wisconsin is one of the few Midwestern states that relies on individual counties to provide emergency mental health services. Iowa, Minnesota, and Missouri have regionalized mental health emergency services to varying extents, while Ohio and Illinois have adopted a hybrid approach, said Milwaukee County Behavioral Health Department of Crisis Services. Dr. Tony Thrasher, medical director and president of the American Emergency Association, said. psychiatry.
“That way, care can be decentralized,” says Thrasher, who advocates a regional approach in Wisconsin that includes making sure each area has mental hospitals and other services. increase.
“Instead of doing this with 72 different counties, turn it into four or five areas that counties can work with,” he says.
Wisconsin is transferring mental health funds to counties. But sparsely populated rural counties lack the funds to build crisis centers and hire professional staff, Thrasher said.
This was the case in Bernard’s hometown of Douglas County, which forced him to travel to Winnebago County. More recently, the situation has become more complicated for some patients in Douglas County who live near the Minnesota border, Barnard said. They may end up in hospitals in Rochester, Minnesota or Fargo, North Dakota and struggle to find transportation home.
In Minnesota, counties with large populations typically run their own emergency mental health services, while rural counties often pool resources to provide community care, according to the Minnesota Department of Health. I have.
Illinois is divided into five regions for emergency mental health services, offering nine state hospitals, more than 30 community hospitals with psychiatric units, and more than 162 community mental health centers and agencies. I’m here.
Mental health calls distract law enforcement
Thrasher says residents need better options than just ‘call the police.’
Relying heavily on law enforcement to respond to mental health emergencies distracts law enforcement from other public safety duties, Kaul told Wisconsin Watch.
Officials seem to agree. Most respondents to his 2019 survey of police chiefs and sheriffs by the Wisconsin Department of Justice said they spent a lot of time in mental health interventions that required detention. Of the 354 respondents, 96% said that adding non-law enforcement mental health facilities and transportation would likely improve the process.
Law enforcement officers are the first responders to mental health crises in most states. However, according to the American Psychological Association, a trained medical professional can almost always alleviate a mental health crisis.
Some of Wisconsin’s more populous communities, including Madison and Milwaukee, have shifted such duties to trained civilians.
According to a report released in November 2022, Madison’s Community Alternative Response Emergency Services (CARES) program responded to 935 calls in its first year of operation and resolved most situations in the field. And only 3% of calls required a transfer to the police.
Seeking short-term options
And for patients who need care following a crisis? Overhaul proponents say they want alternatives to Winnebago County.
Across much of Wisconsin, law enforcement and those responding to mental health crises face a choice between emergency detention or no intervention at all, Kaul said. But investing in short-term inpatient facilities, psychiatric emergency rooms, and reception centers can give responders a useful middle ground.
Madison includes the University Hospital’s 20-bed psychiatric inpatient ward, where patients who do not require long hospital stays can receive care for just a few days.
“Many people in crisis can turn around and make significant improvements in 24 to 48 hours, without the need for lengthy hospital stays,” Thrasher said.
Republicans Reject Evers’ Proposal
In his final budget, Evers proposed funding a range of services supported by mental health advocates and law enforcement representatives. , built up to two regional crisis centers. Each area is equipped with emergency emergency care facilities, a temporary observation center, a 15-bed stabilization facility, and at least two inpatient psychiatric beds.
Evers also proposed $5 million to create five community crisis stabilization facilities for adults who voluntarily seek care. According to his proposal, the center will provide 16 crisis stability beds to “reduce trauma” and provide “community-based care in the least restrictive setting.”
Republicans, who head the Joint Finance Committee, removed each proposal from the budget Evers ultimately signed.
The commission included $10 million in its supplementary budget for “community crisis services or facilities,” but those funds have not yet been released. State law requires that the agency designated to receive such funds request its release and justify its need. In this case it is the health services sector.
To this end, the ministry has requested meetings with the Joint Committee once in January and most recently twice in December. The committee has yet to meet, an Evers spokesperson told Wisconsin Watch on Dec. 19.
Spring Green Republican Senator Howard Marklein, who co-chairs the Joint Finance Committee, declined to comment on the story. Filed a letter with DHS, the Joint Finance Committee accused the agency of failing to detail how the $10 million would be used.
“Instead, we have resorted to requesting information on the use of funds from stakeholder groups because your agency is unwilling to provide basic information,” said Marklein and his co-chair of the Senate. The letter, signed by Rep. Mark Born, R-Beaver Dam, said: .
“Our goal is to use the $10 million in the most efficient way possible to maximize our overall impact,” the letter adds.
The Joint Finance Committee supports a community mental health crisis model that includes Crisis Emergency Care and Observation Centers, the letter said, adding that committee staff will contact DHS to set up a meeting.
Aside from the budget controversy, the Evers administration attempted to help counties transferring Medicaid recipients during emergency detention by requiring federal reimbursements. An Evers spokesperson said the request was denied because it violated social security laws.
Evers plans to announce the next budget on February 15, after a series of public hearings.
“Governor. Evers continues to work on improving its crisis response system, but we don’t have to wait until the next biennial budget is passed,” Evers’ office told Wisconsin Watch. “$10 million of taxpayer money has been wasted in the Republican-controlled budget of the Joint Finance Committee, and it’s time for them to release those funds.”
Mental health healing allows advocates to help others
Looking back on the dark chapters her mental health struggles reigned in, Bernard is grateful for her progress and stability.
“I ended up losing my house, my job, my fiancée,” recalls Bernard. “I basically lost everything, including my pets.”
Bernard now owns his own home in Superior, where he lives with two cats and a dog. She has been with Essentia Health, an integrative health organization serving patients in Minnesota, Wisconsin, and North Dakota, for 12 years. Her recovery made that possible for her term.
Barnard currently sits on the NAMI Wisconsin Board of Directors, which elected her “Peer of the Year” in 2019, and has served on various councils, task forces, and peer support groups related to mental health and recovery. I’m here.
“Wherever I go, I like to advocate for mental illness recovery,” she says. “Because I know from personal experience that recovery is possible.”
If you or someone you know is suffering or in danger, support is available 24/7. To contact 988 Suicide & Crisis Lifeline, call or text 988, or use the chat feature on 988lifeline.org.
Wisconsin Watch (www.WisconsinWatch.org), a non-profit organization, collaborates with WPR, PBS Wisconsin, Milwaukee Neighborhood News Service, other news media, University of Wisconsin-Madison Journalism and Mass Communications. All work created, published, posted or distributed by Wisconsin Watch does not necessarily reflect the views or opinions of his UW-Madison or its affiliates.