More Bipartisan Support for Regional Mental Health Crisis Centers

An editorial in the Racine Journal  supports legislation that would provide a grant program for mental health crisis restoration centers.  The bills would also allow law officers to take people with acute psychiatric needs to the closest mental health institute in the state.

The authors point out that although access to psychiatric care would be more quickly available in some parts of the state with passage of the bills, residents in the Racine area still would have to travel at least two hours for help.  Therefore, they support the funding of regional crisis centers that would be situated at hospitals.  Click here to read the editorial.  Here is an excerpt.

“So the aspect that has us enthusiastic is the proposed grants for developing regional mental health crisis centers. Given all of the facilities operated by Ascension, Aurora and United Hospital System in the Racine-Kenosha area, we see no reason why one of the area facilities couldn’t obtain a grant and establish itself as a regional center.

We want our law officers on duty within Racine County, not taking 4-plus hours out of a shift to transport someone in need of mental health care to a state-mandated facility. Especially when a facility within 40 miles of the station could be established as a regional destination for such patients.”

The bills (SB 681/AB 815) were introduced by Republican and Democratic legislators and by members from Dane County and the center of the state.  Among its supporters are: the Wisconsin Chiefs of Police Association; the League of Wisconsin Municipalities; the Dane County government; the Dane County Cities and Villages Association, and the League of Women Voters of Wisconsin.

See “Bipartisan Support for Better Access to Mental Health Institutes” on this blog for background on the legislation.

UPDATE:  Local criminal justice and other officials in St. Croix also reported problems because of the lack of crisis restoration centers.  Here is what they told Attorney General Schimel.

“Yehlik and others made clear to Schimel that it does agencies in western Wisconsin no good to open more beds on the other side of the state.

North Hudson Police Chief Mark Richert said funding issues make local hospitals hesitant to establish such facilities in western Wisconsin. That, Schimel said, is because of reimbursement issues.

But, he noted, law enforcement also isn’t getting reimbursed for the cost of transports to the state’s Winnebago Mental Health Institute, which he said can exceed $1,000. St. Croix County Sheriff Scott Knudson said his office performed 47 such transports to Winnebago last year.”

Schimel later called the issue “a gigantic drain on county and local budgets.”

The above comments come from the River Falls Journal.  Click here to read the full article.

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.





New Efforts to Promote Jail Diversion Programs

We are pleased that Paul Rusk, chair of the Public Protection and Judiciary Committee (PP&J), has organized a joint committee meeting with the Health and Human Needs Committee (H&HN) to discuss the availability of mental health and substance abuse services, as they relate to plans for the Dane County jail.

The meeting is at the request of the League of Women Voters of Dane County and other advocates.  The H&HN Committee passed a unanimous resolution, asking for the meeting.  It will take place on June 6 at 5:30 in the City/County Building in room 354.

Chairperson Rusk has asked the county’s Director of Human Services Lynn Green to describe mental health and substance abuse programs offered by the county, with an emphasis on  jail diversion efforts.  Sheriff David Mahoney will talk about difficulties posed by the lack of “special needs” beds and the resulting inappropriate use of solitary confinement.  The county’s corporation counsel will be available to discuss legal issues.

Time will be available for public comment and discussion between the committees.   The LWVDC will testify, as will NAMI-Dane, Journey, and MOSES.  Attendees can register in support of jail diversion programs for people with mental illness.

UPDATE:  Click here for a story from Cap Times about the meeting.  Check back for testimony.

UPDATE:  Click here for a story from the Wisconsin State Journal about the most recent plan to renovate the jail.  It includes comments from mental health advocates at the meeting.

UPDATE: Click here for an article from Cap Times with a comprehensive description of the new plan.

UPDATE: Click here for an article from Isthmus (6/22) entitled “Parisi Still Not Ready to Endorse Jail Proposal. “

Two Steps forward in Efforts to Decriminalize Mental Illness: New York City and Arkansas Set Up Crisis Stabilization Centers

New York City has awarded contracts totaling $90 million to two nonprofit agencies to establish diversion centers providing short-term stays for people with mental illness or substance abuse issues who might otherwise be arrested.   An estimated 2,400 people will be served annually.  (Wall Street Journal: May 11)

The centers will offer counseling, behavioral-health assessments and help with substance abuse.  They will not be available for violent or high-level drug offenders.  As described by a city official in the article, “This is someone who may be exhibiting problems, they may need to talk to somebody, they may be having a particularly bad day.”

Although a welcome effort to help people with mental illness avoid a jail cell and criminal sentence, advocates have identified shortcomings with the approach.  Police officers will be making the decision about eligibility for the centers.  The crisis centers will become a revolving door unless there are long-term supports, said the director of behavioral health at the Council of State Governments Justice Center.

Arkansas’s investment in crisis stabilization centers is much smaller ($5 million), but the centers are part of a major reform effort in the state.  Legislators and officials worked with the Council of State Governments (CSG) staff to address the financial and social problems of a rapidly increasing prison population.  Click here to read the report on Arkansas’s justice reinvestment approach.

Act 423, passed by the state legislature in March 2017 and signed by the governor, limits the period of incarceration for people sanctioned for low-level violations of their parole; requires training for law enforcement officers in how to respond to people with a mental health crisis, and creates local crisis stabilization centers that enable law enforcement officers to divert people with low-level offenses away from county jails to receive mental health treatment in the community.

The legislation is expected to reduce the projected growth in the prison population by nearly 10 percent and avert hundreds of millions of dollars in prison construction and operating costs.

Governor Asa Hutchinson (R) said of Act 423.  “We have neglected the mental health challenges in our nation for too long.  Through the creation of these crisis stabilization units, this bill will provide much-needed assistance to those suffering from mental illnesses and also provide relief to our law enforcement officers who so often have to deal with incidents involving those who need help rather than detention.”

The League of Women Voters of Dane County is encouraging the county board of supervisors to consider crisis stabilization centers and other diversion methods as part of its review of the next version of the Mead & Hunt recommendations about the jail.

Unfortunately, these steps forward are occurring at the same time as a giant retreat in Washington, D.C.   Click here to read a story in the Washington Post (May 13) that describes Attorney General Jeff Sessions’ directive to federal prosecutors to “pursue the most severe penalties possible, including mandatory minimum sentences, in his first step toward a return to the war on drugs of the 1980s and 1990s that resulted in long sentences for many minority defendants and packed U.S. prisons.”



Join Efforts to Provide Treatment instead of Jail Time for People with Mental Illness

At least 40 percent of the inmates at the Dane County jail have a mental illness, according to Sheriff Dave Mahoney.   Several years ago, he described the abysmal conditions under which many of them were housed and pressed for action on a new jail that would include better options for those inmates.

The Dane County Board of Supervisors appointed three task groups to consider problems of racial equity and the prevalence of mental illness among inmates.  The Board issued a report including  30 recommendations in September 2015 and appointed a task group to develop additional recommendations to divert people with mental illness from jail.

Click here to read the initial report.  Click here to read the report of the Diversions Task Force.

Recommendations in both reports include the idea of a crisis restoration center to which people with mental illness could be taken for assessment, short-term treatment, and referral to other community-based treatment.  Crisis restoration centers have been successful in other communities and ultimately have saved taxpayers dollars.

Some recommendations in the reports have been implemented.  However, there has been no movement towards establishing the center.  In fact, the share of county funds directed to mental health services continues to decline in relation to population growth and the share allocated to the criminal justice budget.

The League of Women Voters of Dane County and NAMI-Dane County want further conversation about how effective diversion, mental health, and addiction programs can be supported and established.   An excellent op ed from NAMI-Dane County appears earlier in this blog.

As a good step towards this dialogue, the LWVDC is urging people to contact their county board supervisors to request a joint meeting between the Public Protection and Judiciary (PP&J) and Health and Human Needs (HH&N) Committees before June 15 to discuss formulating a plan that would increase opportunities for diversion.   On June 15, the full board is scheduled to receive the latest version of the Mead & Hunt recommendations concerning the jail.

Members of PP&J include Carousel Bayrd, Dorothy Krause, Maureen McCarville, Michael Willett, and Chair Paul Rusk.   Members of H&HN include Hayley Young, Heidi Wegleitner, Chair Jeremy Levin, Matt Veldran, Nick Zweifel, Richard Kilmer, and Ronn Ferrell.   Click here to access the website for the Dane County Board of Supervisors.

UPDATE:  Advocacy works!   The Health and Human Needs Committee unanimously passed a resolution asking for a joint meeting with the Public Protection and Judiciary Committee to discuss jail diversion programs.

David Wahlberg has an excellent article in the Wisconsin State Journal that finds evidence for the oft-repeated claim that money is being transferred from the Health and Human Services budget to the General Fund, where it plugs holes in the budgets of over-spending departments.  Since 2011, the HH&S department has given up $25 million.

Here is an excerpt from the article:  ” [CEO] Lampert said in an interview that Journey could use additional money to expand treatment sites, boost substance abuse programs, add services for the homeless, serve more teenagers and help keep people out of the jail and Mendota Mental Health Institute.”

Click here to read the article.


Judge Candidate Jill Karofsky Supports Mental Health Law Court…and She Won!

The Wisconsin State Journal endorsed Jill Karofsky in her bid to become Branch 12 District Court Judge.  The editorial board included this language in its endorsement.

“Karofsky will have a shorter learning curve in the job. And her experience provides more insight into how to improve court operations.  For example, [she] cites bias in bail-setting hearings as a key contributor to racial disparities in Dane County courts.  She also speaks with authority on the need for a special court to handle cases involving people with mental illness.”   Click here to read the endorsement.

Karofsky is running against Marilyn Townsend.  Both candidates met with the editorial board of the WSJ and replied to questions submitted by the Dane County League of Women Voters.  In her response to the League’s questions, Karofsky again mentioned her support for mental health law courts.  Here is her reply to a question about the disproportionate rate of incarceration of minorities.

“Judges should support, encourage and help develop alternatives to incarceration such as treatment alternative and diversion programs and specialty courts. These alternatives not only reduce incarceration rates but they have proven to reduce recidivism by addressing alcohol and other drug addiction and mental illness. In addition, at-risk youth in our community must be linked to positive connections and mentors. Judges can be some of those positive role models. Judges must also be a part of the community and take leadership roles in bringing about collaboration among attorneys, residents, advocates, service providers, clergy, and nonprofits.”

Here is Townsend’s response to the same question

“Incarceration of minorities is in part the result of sentencing by Judges but also the result of laws and policies that will require changes by the Legislature. While I know that a Judge must apply the existing law to the facts of each case, to the extent I may have discretion in sentencing, and alternatives to incarceration are available, I would seek to avoid or limit incarceration when an alternative is appropriate. In addition, I believe judges who deal with these cases, and understand the problem, could help by drawing attention to the circumstances that call for legislative changes.”

Click here for Candidates’ Answers.  The election is April 4.  Click here for voting information.

NOTE:  Karofsky again supported establishment of a mental health law court in a WSJ article on March 26.   No mention of support from Townsend in the article.

Long Trip to Oshkosh Harms Those with Mental Illness and Costs the Taxpayers

An article in Cap Times by Abigail Becker describes the interaction between Madison’s police department and people with mental illness.  Click here to read “Crisis Cops.”

Becker describes the emotional and financial costs of the requirement that police take people in need of inpatient care to the Winnebago Mental Institute near Oshkosh.   People in severe mental crisis endure a 2-hour ride in a police car and police are unavailable for other duties.

Moses, an interfaith advocacy organization, has argued for the development of a local restoration center in which people in crisis could receive immediate help.   The idea has been effective in other communities.   Click here to read a case study of its implementation in Bexar County, Texas.

The League of Women Voters of Dane County will host a forum on April 5 from 7:00 to 8:30 at Capitol Lakes, 333 West Main Street on “Jailing the Mentally Ill:  Better Options.”   Click here for more information.

After the March: Act Locally

Madison had the second highest per capita number of marchers in the country.  We might  have been first if so many of us had not marched in Washington, D.C.

How can we harness all that energy and maintain it over four long years?  I made a list to remind myself of all the opportunities close at hand.  They suit my priorities and mostly fit in my “keep at it” category.  But, still, they might offer some new ideas to someone else.

Learn about local government. The League of Women Voters Dane County encouraged its members to attend committee meetings of the city and county governments in the next months.  I’m going to a meeting of the county’s Health and Human Needs Committee on January 25.  We will discuss what we learned at unit meetings in February.

Follow the Money.  A coalition of 18 organizations released an alternative budget showing that nearly $900 million would be available to improve the lives of middle- and low-income people in Wisconsin by closing two tax programs that benefit millionaires and other wealthy people.  The Wisconsin Budget Project posted the budget on its website, along with other reports that help explain how fiscal policies affect our lives.  I learned only a few days ago that Wisconsin’s minimum wage is one of the lowest in the country.

Try to Understand and Explain Medicaid.  Medicaid is the largest source of funds for mental health services.  It is particularly important to poor people and people with serious mental illness.  But, it is a very complicated program that varies from state to state.  Wisconsin’s situation is especially complicated because Governor Walker refused federal funds to expand services, but used state tax dollars to add some people to the rolls.  The various proposals for change likely will end up decreasing services and reducing the number of people who are eligible.  Understanding and explaining how that will happen is hard.

Stay Informed about Efforts to Get People with Mental Illness into Treatment instead of Jail.  Dane County has had lots of activity on the goal of reforming the criminal justice system during the last couple of years.  The County Board produced a report with 30 recommendations.  MOSES continues to meet and offer good ideas.  Dane County sent a team to a Stepping Up Summit to learn from experts and other communities.  But, the necessary expansion of mental health services has not occurred.  We need an economic argument, showing that tax dollars would be saved by treating people before they are sentenced.  The Stepping Up Initiative website offers accounts from communities that have been more successful than we have.  I’ll try to learn from them.

Remember that Money Helps.  When I’m feeling too old, tired, or discouraged to do something about an issue, I’ll try to remind myself that some organization doubtless is working on it and its employees need paychecks.