Broad coalition recommends emergency detention improvements
MADISON, Wis. (AP) — A broad coalition of Wisconsin law enforcement agencies, health care professionals, local governments and others on Thursday recommended bolstering regional services as part of a multi-faceted approach to better handling of emergency mental health detentions.
The recommendations, some of which require approval by the Legislature, represent an attempt to address a longstanding and worsening issue across the state.
“We have a system that needs to be reformed,” Attorney General Josh Kaul, who convened a summit in 2019 to address the issue, said at a news conference announcing the recommendations.
The group’s work provides a roadmap for the first time, Kaul said. The goal is to have better outcomes for people affected, reduce the strain on the system and make sure tax dollars are better spent, he said.
The problem is that with county facilities at capacity, law enforcement agencies are increasingly forced to make sometimes hourslong trips to the only state facility that will take emergency mental health detentions in Oshkosh. Officers have also complained for years that the system forces them to spend too much time waiting in emergency rooms for doctors to clear people for transport and driving them to facilities rather than patrolling.
A 2019 state Department of Justice survey of 154 police and sheriff’s departments found emergency detention transports involve an average of more than two officers and take nearly eight hours to complete.
Police in Wisconsin can temporarily detain people if they appear to be mentally ill, developmentally disabled or dependent on drugs and could pose a threat to themselves or others. Once the detainees clear a medical exam, officers must take them to a state- or county-approved treatment facility.
Kaul brought together groups representing sheriffs and chiefs of police, counties, the Wisconsin Department of Health Services, hospitals, mental health advocates, public defenders and others. Eric Borgerding, president of the Wisconsin Hospital Association, praised what he called the group’s holistic and comprehensive approach to improving the system.
Some of the coalition’s proposals will be included in Gov. Tony Evers’ budget that he is expected to submit to the Legislature on Tuesday, while others may be introduced as separate legislation or implemented without a change in the law.
Kaul, a Democrat, said he has talked with Republican lawmakers who recognize the need to do something.
“There is certainly bipartisan consensus that this is an issue that needs to be addressed,” Kaul said.
Putting together a broad coalition that presents a comprehensive package of ideas should also be of interest to many in the Legislature, he said.
The coalition recommended diverting a larger share of cases away from emergency detention, which can be achieved through more and earlier access to crisis services before the person comes into contact with law enforcement. The coalition also said the process and capacity to handle such cases must be improved when inpatient treatment is required.
The group recommended making inpatient stays at a psychiatric hospital a last resort, after all other alternatives have been exhausted. It called for supporting the establishment of more regional crisis stabilization facilities, which would be alternatives to admitting someone to a psychiatric hospital and keep people closer to home. The coalition also called for additional mental health mobile crisis teams, which could be useful in more rural parts of the state, more regional crisis services and community-based support for suicide prevention.
Those recommendations will be included in Evers’ budget proposal.
The group also recommends establishing more inpatient beds statewide, rather than just at the facility in Oshkosh that accepts emergency detentions that counties can’t handle. Other recommendations include expanding telemedicine offerings and streamlining court proceedings to cut down on transportation time by using videoconferencing.
Mentally ill patients spend substantially longer time in emergency rooms than people with non-psychiatric problems, a 2019 paper published by the Wisconsin Chapter of the American College of Emergency Physicians and the Wisconsin Psychiatric Association found. Complicating matters is the lack of a universally accepted definition of medical clearance, the paper said.
The coalition attempts to address that concern by recommending that a standard method for hospitals to use when assessing someone having a mental health crisis be adopted.