New Energy for Mental Health Services in Madison

Yesterday, Strategic Behavioral Health (SBH) announced plans for a psychiatric hospital in the Madison area to open by late summer 2019.  It would provide 72 beds, cost $15 to 20 million, and offer inpatient and outpatient services.

According to county officials, the hospital would meet the long-established need for an alternative to a trip to Winnebago State Hospital for persons suffering from a psychotic episode and the police who accompany them.  It would also provide many of the services offered by a crisis restoration center.  Click here to read David Wahlberg’s article in the Wisconsin State Journal.

SBH has an entrepreneurial and ambitious approach to mental health services.  Its website offers this invitation:

“We are currently seeking opportunities to bring services to areas where there is an identified need. We are looking for places where Strategic Behavioral Health can be a good provider and also a good community citizen. Please email our home office to discuss opportunities.”

Since 2006, Strategic Behavioral Health has opened centers in 11 cities, primarily in the south and west.  Willow Creek Behavioral Health Center in Green Bay, which opened in January 2017, was the first site in the mid-west.  According to SBH’s website, the company offers a full range of mental health and substance abuse services to just about any kind of client in need.

Funding mechanisms–the perpetual issue for mental health service providers–are less clear.  SBH offers this guidance on its website.

“With payments often times being the last item patients and their families want to address, we make it a point to keep all involved parties informed while keeping the focus on treatment and recovery. Strategic Behavioral Health works with most major insurance companies and is able to work with each individual to determine the best approach for covering the cost of treatment.”

Private insurance will not cover costs for many of the people who might need a crisis restoration center or other mental health services.  It is likely SBH will be competing with existing service providers for state and county funds.   Let’s hope it is a “good provider and good community citizen” and that competition turns out to be a good thing.

 

 

 

 

Shortage of Mental Health Care Providers has Lasting Consequences for Wisconsin Youth

Almost all of us lament the criminalization of the mentally ill.  For more than a decade, prisons have become a more damaging place for adults with mental illness than the coercive psychiatric hospitals they replaced.

A recent article in the Milwaukee State Journal  shows that the link between mental illness and the criminal justice system can start at a young age.  Reporter Rory Linnane  quotes Peg Rauschenberger, a registered nurse at Milwaukee County’s youth detention center.

“It’s almost like they have to get into some sort of trouble before they get into [mental health] services,” she said.  “They end up being incarcerated for really what is a health issue and it shouldn’t have gotten that far.”

A stay at the youth detention center might begin the journey to the Lincoln Hills School for Boys or Copper Lake School for Girls.  About 75 % of male inmates and 85% of female inmates at the complex meet the criteria for at least one mental health disorder, according to Wisconsin state figures.

The facilities are under judicial order because of inhumane and ineffective treatment of the young inmates.  More to the point, the American Psychological Association has threatened to remove its accreditation as an intern site because of excessive mental health caseloads, inconsistent intern supervision, ethical lapses by staff, transparency failures and other issues.

Read Linnane’s article Shortage of Mental Health Providers Hits Crisis Point for a good analysis of some underlying reasons why many young people end up at the detention center and ultimately the failed juvenile complex.  Largely because of inadequate funding and low reimbursement rates,  Wisconsin does a worse job than most states in providing access to all types of mental health professionals.

UPDATE: The APA has placed the mental health program on probation.  Click here to read a story with more details about the failures of mental health services at Lincoln Hills.

Derail the Jail: What’s the Argument?

Advocates are campaigning to defeat the budget proposal for jail renovation.  They argue that the money could be better spent on affordable housing, mental health services, and other programs that would help keep people out of jail.

Click here  for their website.  You will find information on the remaining opportunities to register your opinion about budget proposals.  Organizers polled country board supervisors about how they will vote on the jail renovation proposal and report their findings.

Click here for an article in Cap Times about a short-term training for employees of the correctional system and others in how to keep people with mental illness out of jail..

Click here for an article in Isthmus in which county and correctional officials respond to arguments from derail the jail advocates.

New Funding for Jail Diversion and Violence Reduction Stimulates Creative Responses

Nearly a year ago, Madison’s City Council approved $400,000 to fund the first steps of a violence reduction plan developed by the Focused Interruption Coalition.   Three agencies responded to the RFPs issued by the city with proposals that offer both new and  time-tested approaches to reducing recidivism, violence, and the trauma associated with it.

Below are the highlights of the proposals as reported by Abigail Becker in Cap Times. Click here to read “Three Agencies in the Running for Madison’s Long-term Peer Support Program.”

According to the proposal from Nehemiah Community Development Corporation , “Participants would receive peer counseling and case management in addition to help with housing, transportation, access to AODA and mental health services and priority entry into job skills training and placement programs.”

“The program would operate a 24/7 hotline with two dispatchers on call to respond to situations. Each peer support specialist would maintain a caseload of 10 to 15 participants, and services would be provided for no less than six months.”

Madison Urban Ministry (MUM)  would provide participants ” access to community engagement opportunities, peer support and mentoring, employment and housing opportunities and mental health and AODA support.”

MUM’s proposal is particularly strong in terms of job training and opportunities.  An  “innovative element to MUM’s proposal is the urban agriculture employment and vocational training program through the FAIR Initiative. The program would train up to five program participants in literacy and cultural competency skills and local food systems in addition to urban agriculture and entrepreneurial training. Participants would earn $13.01 per hour for the training.

Other employment learning opportunities could be available through FoodShare Employment Training, the Employment and Training Association and MUM’s Just Bakery vocational training program.”   In addition, MUM has a long and successful history offering programs that reduce recidivism.

“Zion City International Church Ministries proposed a program called Renewal After Prison, which is meant to teach skills to make the transition from incarceration successful and to stabilize an individual’s life through support services.”

“Under the program, participants would meet in one of four groups, three time per week for one year and will meet with a case manager until stable. The four groups serve as phases and include the initial transition, integration, family reunification and implementation. After a year, participants who are interested can become a peer support specialist.Under the program, participants would meet in one of four groups, three time per week for one year and will meet with a case manager until stable. The four groups serve as phases and include the initial transition, integration, family reunification and implementation. After a year, participants who are interested can become a peer support specialist.”

UPDATE:  Four city council members are proposing a cut of $250,000 in the $400,000 allocated for this effort.  Click here to read the story.

UPDATE: Nehemiah Community Development Corporation and Madison Urban Ministry were recommended by Madison’s Finance Committee to receive funding.  Click here to read the article.  (The cut of $250,000 was not approved.)

UPDATE:  Dane County DA’s office shows a poor response to the opportunities for diversion through restorative justice.  Click here to read an article in Cap Times.

Parisi Responds to Pressure from Jail Diversion Advocates: Sheriff’s Department Benefits

MOSES and other organizations have fought persistently for the right of people with mental illness to be treated in the community instead of being incarcerated.

County Executive Parisi seems to have heard the words.  He includes a focus on jail alternatives and re-entry services in his most recent budget proposals concerning the Dane County Jail.   But, the meaning remains elusive.  Most of the new funding would go to the criminal justice system.

Here are some of the highlights from Parisi’s proposal, as reported in the Wisconsin State Journal (10/1).   Click here to read the article.

His budget proposal would reduce the total number of beds by 91 which, according to him, “illustrates our commitment to alternatives and services to avoid re-incarceration.”

The new jail would have 64 mental health beds.  It currently has none, resulting in solitary confinement for inmates with mental health problems.  According to Sheriff Mahoney, the proposed space “will allow us to virtually eliminate solitary confinement.”

The budget includes $110,000 for re-entry case management services that would provide peer support counselors to help inmates transition back into the community and offer  help finding housing, mental health or substance abuse treatment services.

The budget also contains $68,000 to hire someone to  coordinate the Dane County Re-Entry Team, which is made up of staff from the Sheriff’s Office and Dane County Human Services.

Sheriff Mahoney’s budget includes $1.1 million for re-entry and diversion staff and programming. That staff would work with the team in the community (budgeted at $110,000) to provide a “seamless handoff” as inmates leave jail.

The budget also provides: $100,000 for a comprehensive review of local mental health resources to identify gaps in services and barriers to access; $100,000 to keep  Safe Haven open, and $15,000 to NAMI-Dane to expand its crisis intervention training course for police, public safety and medical personnel.

The math does not compute for anyone who wants more community treatment and less jail time for people with mental illness.  Sheriff Mahoney gains more than $1 million for diversion and programming.  An unspecified community team is budgeted at about 1/10 that amount for re-entry case management services.  That team is responsible for assisting inmates find mental health services and other help.  Those services receive a zero increase.

ANOTHER LOOK AT THE BUDGET: Here is hopeful language from Parisi’s budget statement concerning the crisis restoration center.

” Recently, there’s been discussion about the feasibility of a Mental Health Crisis Restoration Facility to further our community’s response to mental illness. Done in the context of a more thorough examination of available mental health resources in our community, this concept is worth exploring. A comprehensive review of existing mental health services and potential gaps in services would identify how such a facility could be operated in partnership with health care providers and community organizations. It could also shed appropriate focus on the need for all entities – including our health care providers – to reexamine how current mental health services are accessed and administered. There is room to do better. My budget includes $100,000 for a comprehensive review of existing mental health services in our community. This work will both identify potential gaps while evaluating how a potential Crisis Restoration Center or similar community run facility could help improve care and outcomes.”

 

 

 

 

Grants Available to Help “High Users” of the Jail and Social Services

MOSES published a position paper describing the problems associated with people who are “high users” of the Dane County jail and various social service systems.  “Many of these individuals experience complex chronic health conditions including histories of trauma, substance abuse disorders, mental health and chronic homelessness.”  They are expensive for society and lead painful lives.  Click here to read the paper.

Funds are available from the Laura and John Arnold Foundation for grants to test interventions for these frequent users of multiple systems.  Deadline is October 1.

Here is an excerpt from the solicitation description:

“Funding will be distributed to help city, county, and state governments use data from randomized controlled trials to identify individuals who frequently utilize hospitals, jails, and housing assistance services with the goal of connecting them to appropriate evidence-based interventions. Proposals should target interventions that address some or all of the following outcomes of interest: reduction in arrest and recidivism rates; reduction in the use of medical services, such as emergency room visits and hospitalizations; improved health outcomes; housing stability; and economic well-being.”

Click here for more information.

 

 

 

Four Alders Support a Crisis/Restoration Center

Alds. Cheeks, Phair, Eskrich and Clear announced interest in a crisis/restoration center at a press conference on Monday.  Click here to read Dean Mosiman’s account in the Wisconsin State Journal.

Here is the excerpt from the article:

“[Madison]  should work with Dane County and others to explore a Restoration Center, which would be an alternative for individuals who otherwise would be arrested or taken to the hospital because of behavior, intoxication and/or mental health problems.

The latter effort, based on a facility in San Antonio, could be funded by local governments, Medicaid, health insurers, private sponsors and other sources, Phair said.”

MOSES, an interfaith organization, has advocated for a crisis center for more than two years.  The League of Women Voters of Dane County testified in favor of such a center at a recent committee meeting of the Dane County Board of Supervisors.

Read “Funding Mental Health Services Can Pay off for the Taxpayers, as well as the Beneficiaries” on this blog for more information about how a center would operate and be funded.

Cheeks and Phair scheduled budget listening sessions in their districts for Wednesday, Sept. 6, 5:30 to 7:30 p.m. at the Meadowridge Library, 5726 Raymond Rd; and Saturday, Sept. 9, 10 to 12 a.m. at the Sequoya Library, 4340 Tokay Blvd.

Click here to read an article from Cap Times about the press conference.