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 and the Winnebago Institute of Mental Health 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 saw his family only three times, she says.
Almost 15 years later, after getting the help she needed, Barnard is now a Peer Support Specialist for the National Alliance on Mental Illness (NAMI) in Wisconsin. 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 prevent patients from being deemed a threat to themselves or others to receive treatment. transfer the patient to
For rural residents, the nearest treatment facility may be hundreds of miles away.
Except for the Winnebago County Institute, the state operates only one other mental health facility. The Mendota Institute for Mental Health in Madison serves primarily those involved in the criminal justice system.
“The whole system needs to change because it’s so traumatic. You’re treated like a criminal from the start,” said Bernard, who has been hospitalized more than 30 times for mental health issues in Wisconsin and Minnesota. increase.
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.
“The emergency detention system in Wisconsin right now is broken,” said Wisconsin Attorney General Josh Cowl, a Democrat.
Convened a solution-focused summit in 2019.
“And we have to find alternatives.”
Democratic Gov. Tony Evers proposed more than $17 million for such an overhaul in the 2021-2023 biennium budget, but the Republican-led Congress
rejected the offer among hundreds of other offers from Evers
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. say.
“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 says.
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 operate 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
2019 Wisconsin Department of Justice Investigation of Police Chiefs and Sheriffs
He said mental health interventions requiring detention had eaten up too much time.
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. But while trained medical professionals can most often defuse mental health crises, law enforcement can escalate the threat due to lack of training.
According to the American Psychological Association
.
Some of Wisconsin’s more populous communities, including Madison and Milwaukee, have shifted such duties to trained civilians.
Madison’s Community Alternative Response Emergency Services (CARES) program responded to 935 calls in its first year of operation, resolving most situations on-site.
Released in November 2022. CARES provided in-person assistance and transportation in 31% of cases, and only 3% of calls required 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 feel noticeably better in 24 to 48 hours. No long-term hospitalization is required,” Thrasher says.
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 emergency stable 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.
In it, the Joint Finance Committee accused the agency of failing to provide details on 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 ensure that the $10 million is used in the most efficient way possible with the greatest overall impact,” the letter adds.
Joint Finance Committee Supports Community Mental Health
Crisis model including Crisis Emergency Care and Surveillance Center
The letter added that committee staff would 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 will announce its next budget the next day
the next set
.
“Governor Evers remains committed to improving our crisis response system, but we don’t have to wait until the next biennial budget is passed,” the Evers office told Wisconsin Watch. of 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,” Bernard recalls. “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 her term possible.
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.Call or text 988
988 Suicide and Crisis Lifeline
,or
.
The nonprofit Wisconsin Watch (www.WisconsinWatch.org) collaborates with WPR, PBS Wisconsin, Milwaukee Neighborhood News Service, other news media, and the University of Wisconsin-Madison School of Journalism and Mass Communication. All works created, published, posted or distributed by Wisconsin Watch do not necessarily reflect the views or opinions of UW-Madison or its affiliates.
