Milwaukee Journal Sentinel: The time is now for mental health reforms

February 18, 2013

by Joe Volk

There are times when the clouds part, the path becomes clear and the solutions to vexing social problems become focused, only waiting for bold and decisive leadership to grab the moment. The issue at stake is comprehensive reform of Milwaukee County's mental health system, as recommended by the Mental Health Redesign Task Force and proposed by County Executive Chris Abele. Now is the time to implement a new vision for mental health services in Milwaukee County.

The county still relies too heavily on institutional care facilities. For decades, experts have recognized that a community-based mental health system will provide improved care and treatment. Community-based mental health services are used successfully by most other cities and counties. These services include independent or transitional housing with supportive services and supervision, accessible psychiatric services in general hospitals, local primary care medical services, day centers, community mental health centers and peer support groups.

Due to lack of these services, Milwaukee has the second-busiest psychiatric emergency room in the nation. Many who are compelled to seek ER services lack access to community services, which could have prevented emergency care. Consider if physical health in Milwaukee County were treated in the same way we treat mental illness.

If people with diabetes had no treatment plan, no medication and no access to routine health care in the community to manage their illness, they would be compelled to wait until symptoms became so acute that emergency room assistance is required for a wholly preventable condition.

This is often the case for those with mental health issues. The ER serves as a crisis abatement facility, a treatment center or simply a dispensary - all preventive services that could have been delivered by more accessible and less expensive providers.

In April 2011, Supervisor Peggy Romo West introduced a resolution creating the Mental Health Redesign Task Force "to provide the County Board with data-driven implementation planning." The resolution notes the "abundant discussion" and the numerous studies and plans surrounding mental health service delivery in Milwaukee County over the previous year to three years. In adopting the resolution, the County Board agreed to support "the overall principle of integrating mental health care into the community."

Abele, in his recent "state of the county" address, has taken the next step.

"We need to reform the way we deliver mental health services in Milwaukee County to be in line with the best practice models across the county," Abele declared. "We have aggressively laid the groundwork and are now moving into the next phase. Today, I am making a commitment to shift patients in our long-term care units at the Behavioral Health Hospital and move them into integrated, community settings within the next three years."

The next phase must move beyond studies, find consensus within the strategic plans and quickly begin implementation of the task force recommendations. We encourage Abele to present an action plan that is reflected in his 2014 budget, and we urge the County Board to fulfill its legislative duty - to discuss, debate and adopt a budget that will implement community mental health services and a comprehensive prevention and treatment strategy

We often speak of the need for political cooperation and bipartisanship. Reforming Milwaukee's mental health system provides our elected leaders with a singular opportunity to pull in the same direction. Whatever differences Abele and the County Board have on other matters, they agree on the need to fix our broken mental health system.

They also agree on the need to take action now. And however sharp the disagreements between Gov. Scott Walker and President Barack Obama on a dozen other matters, they, too, agree on the need for a better mental health system.

That is why the governor will be proposing important new funding for mental health initiatives in his next budget. And the president has been firm in pushing forward with implementing the Affordable Care Act, which will extend health insurance - including treatment for mental illness and addiction - to millions.

Whether the county executive, County Board, governor and president intended to cooperate and achieve a bipartisan solution, the direction in which they are moving Milwaukee's mental health system is the same direction. We dare not lose the momentum and squander the opportunity.

Abele understands where we need to go and how to follow our moral compass to get there. He has articulated a vision of a Mental Health Redesign plan that funds assertive community treatment that is accessible, helps prevent mental health crises and lessens social exclusion.

I've also heard him say, "It's simply the right thing to do."

There will be obstacles. There are some who are content with preserving the status quo. But the time is now and the cause is just. The vision and direction, as laid out by the county executive, is worthy of our support.

Joe Volk is chief executive officer of Community Advocates, a Milwaukee-based advocacy and human service agency.

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