The Mental Health Crisis System is Broken – We Can Fix It

Mary Kay Battaglia, Executive Director NAMI Wisconsin

Our nation’s healthcare system prides itself on stellar emergency room care for accidents, cardiac events, and medical needs. But for those experiencing a mental health crisis our system fails to care for those most in need and the response is not from a medical perspective. The responsibility involves law enforcement and a patchwork of public mental health services. In a mental health crisis, when lives are on the line, the lack of an effective response can lead to job loss, disconnection from family, poor health, homelessness, an increase rate of imprisonment and mortality. These losses are traumatizing, and the system can be humiliating for the individual and their family, but we all pay the price.

Wisconsin counties are required by Chapter 51, the state mental health statue, to provide crisis services, including telephone counseling, mobile crisis response and psychiatric hospital care. (1) While counties are responsible for providing mental health crisis response, what is available or happens varies widely.

Counties that fail to prioritize local mental health services, crisis response teams, and crisis stabilization beds, end up spending funds on law enforcement to transport citizens to Winnebago Mental Health Institute. Not only is it traumatizing for individuals who are removed from their local communities and agonizing for families, it is also an inefficient use of taxpayer dollars. Law enforcement spends too much time providing medical transportation, which takes them away from their primary responsibility to preserve community safety. The lack of a comprehensive mental health system in the county is also a disservice to the citizens in the county who live with a mental illness. In Wisconsin, approximately 19% of adults aged 18 and older received mental health services during 2019-2020.

(2) NAMI Wisconsin constantly hears stories from people who have experienced the mental health crisis system firsthand, like this account from Chrissy Barnard of Douglas County:

“Signs of my illness started in high school, but I did not seek help for depression until college because I was ashamed and thought my family and friends would not understand. Several times, when it got unbearable, I attempted suicide. Over time this led to 33 hospitalizations and over a dozen encounters with law enforcement which made me feel like I had done something wrong. I was handcuffed all but one time, even though I was usually willing to go voluntarily. Each time I was transported by law enforcement to various hospitals hours away from the people who knew me and cared about me. I felt traumatized. I was handcuffed and crying in the back of a squad car. During this time, not only did I lose a sense of self, I also lost my job, my home, my pets, control of my own finances and the ability to make choices for my own health. I was taken away from my daily life.”

Paula Verrett shared her story at the Wisconsin Attorney General’s Emergency Detention Summit in October of 2019:

“I cannot tell you how many emergency detentions I experienced. The calls to various clinicians, crisis lines, and family members all blur together. What I can tell you is that when the police showed up at my door, I always knew that I had done something wrong, that I was a bad girl and that I deserved to be punished. All my childhood thoughts and feelings rushed back, and I was terrified of what would come next. The last time I was placed on an emergency detention I ended up on a six-month commitment order. I felt like a criminal, even though I had broken no law.”

The public county mental health system plays a pivotal role in serving individuals in a mental health crisis. Over 61 percent of individuals enrolled in county mental health systems have entered care through crisis intervention services. (3) I encourage our state, counties, and local communities to take a more in-depth look at our community mental health system and build a more humane response. Two areas of the state (Milwaukee County and Fox Valley) have done just that. They brought stakeholders together and are working on plans for comprehensive mental health crisis response.

(4) Let’s look at the rare opportunity now before us to rebuild the mental health crisis system throughout Wisconsin. Thanks to bipartisan passage of the National Suicide Hotline Designation Act of 2020, federal funding is available through enhanced Medicaid match and crisis service grants to build crisis response services that will better serve people like Chrissy and Paula. (5) The legislation calls for a three-pronged approach:

“Someone to talk to,” Call 988 for 24/7 Crisis Counseling

As part of the new nationwide call center, Families Services of Northeast Wisconsin now operates the statewide 988 Wisconsin Lifeline. Trained crisis counselors respond to calls, texts and chats, and includes specialized services for veterans, Spanish speakers, and LGBTQ youth.

“Someone to respond,” Mobile Crisis Teams

Wisconsin law requires counties to make mobile crisis response available for the small fraction (2%) of people who need more support than can be offered over the phone. The goal is to establish mobile crisis teams throughout the state staffed by mental health, substance use and medical specialists working closely with law enforcement as co-responders only in high-risk situations.

“Somewhere to go” Crisis Stabilization Facilities

Some people in crisis just need a safe, local place to stabilize for a few days. We need crisis stabilization facilities in each region of the state to maintain safety, identify additional treatment needs, and provide a “warm hand-off” to appropriate follow-up care, whether peer support and outpatient services or hospitalization.

Chrissy and Paula found a path to recovery. Both are now Certified Peer Specialists who advocate for others to receive more humane crisis care and a smoother road to recovery. We can build a better mental health crisis response system utilizing the financial resources currently available through federal grants and Medicaid matching funds. The 1 in 5 people living with a mental illness in our state deserve a better system and now is the time to capitalize on this opportunity. At NAMI Wisconsin, we know that the best idea is for mental illness to be identified early and treated effectively. We also know that it is wise to seize on this opportunity when it is available. The 988-call center is up and operating. We urge county and state policymakers to do what it takes to establish mobile crisis teams and crisis stabilization facilities throughout the state.

A 2021 IPSOS poll found that four in five Americans, want mental health professionals to be the primary first responder to a mental health or suicide crisis.



3. 2017 Wisconsin Mental Health and Substance Use Needs Assessment, Department of Health



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