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The money has been approved and the planning process is underway for two new emergency mental health centers in Wisconsin, but residents will have to wait for well over a year before the facilities will be open to help them.
That’s how long the process is expected to take to set up rules and operating procedures, figure out who will get the funding and identify where the centers will be placed.
In a rare show of bipartisanship, the Republican-led Legislature and Democratic Gov. Tony Evers have agreed on $10 million in state funding to create the centers, where residents experiencing a mental health crisis can receive comprehensive care closer to home. Wisconsin now has only one state-run mental health hospital in Oshkosh — sometimes hours from someone experiencing a crisis.
“We really will try to focus on where high-needs areas are in the state of Wisconsin,” said Teresa Steinmetz, director of the Bureau of Prevention, Treatment & Recovery for the Wisconsin Department of Health Services.
One of the key goals behind the centers will be to offer care in areas of the state that don’t have adequate crisis resources. The law establishing funding for the centers stipulates that each facility must be at least 100 miles from the Winnebago Mental Health Institute in Oshkosh.
The bill to create the crisis urgent care centers was originally proposed by Sen. Howard Marklein, a Republican from Spring Green, who quickly gained the backing of Republican and Democratic lawmakers.
Marklein, who represents a rural portion of the state that lacks many of the resources he hopes this funding will provide, told the Cap Times upon introducing the bill that the increase in care was “desperately needed.”
The senator, along with health department officials and advocacy groups, had been working on the legislation for more than a year before it was brought forward in the Legislature.
Sen. Howard Marklein, R-Spring Green, said “it is absolutely necessary to implement the Crisis Now model in Wisconsin, which we all agree is desperately needed.”
Central care for psychiatric emergencies
Currently, if someone in Wisconsin experiences a psychiatric emergency, police officers are often the ones to respond. While cities as large as Madison and Milwaukee have crisis intervention teams that can respond to mental health emergencies, in much of the state a person in crisis is taken to the hospital or a medical facility by police and then transported to the Winnebago facility.
“Our mental health crisis service system is woefully lacking for places for people to go,” said Mary Kay Battaglia, executive director of the National Alliance of Mental Illness (NAMI) Wisconsin.
The urgent care clinics, which state officials call Crisis Now centers, will serve as a psychiatric emergency room, providing medical care, psychiatric evaluations and mental health care in one location.
A person experiencing a mental health emergency will be able to check themselves in, or be checked in by a first responder or family member, to receive a medical assessment, as well as psychiatric evaluation and substance use screening, a monumental step in streamlining the treatment process.
“This gives a first step in the process of us being able to create places for people to go, closer to their home to receive services quicker,” Battaglia said.
These first two centers will hopefully lead to more across the state, particularly in western Wisconsin, where people live the farthest from resources like Winnebago Mental Health Institute, said Sita Diehl, public policy and advocacy director for NAMI Wisconsin.
Beyond having a central and more accessible place to get help, the centers are expected to require less police involvement in emergency mental health cases.
Current practice dictates that a police officer who responds to a mental health crisis call has to stay with the person in crisis until they’ve received medical clearance and can be admitted to a treatment facility of some kind. A patient might spend hours sitting in a hospital’s emergency room under police supervision awaiting an initial medical screening.
Police prefer ‘help, not handcuffs’
Reducing the involvement of law enforcement will help to decriminalize mental health, Diehl hopes. It will also allow police officers to resume standard public safety duties instead of supervising psychiatric waits.
“The vast majority of law enforcement officers would prefer to have help, not handcuffs, for the people that are in their custody,” Diehl said.
The two centers will be required to accept emergency cases within 20 minutes of the patient’s arrival — decreasing the amount of time a person spends with police.
A crisis response model that reduces police involvement would have benefited Kjersta Lind, a 22-year-old from Neenah, she told the Cap Times.
Lind began struggling with depression her freshman year of college — a developmental time when many people begin experiencing mental illness symptoms. Pre-existing anxiety and a diminished sense of self-worth was made only worse when the COVID-19 pandemic sent her, and millions of other college students, home from universities across the country. Back in Neenah and living in her parents’ basement, Lind’s loneliness and isolation became unbearable and her depression reached a boiling point.
When someone is experiencing a mental health crisis in Wisconsin, the first response is often to call the police, who may put people on involuntary holds until they are cleared for treatment and then transport them sometimes hours away to the nearest facility.
Lind first attempted suicide at age 19. The following three years would be marked by five hospitalizations, bouts of therapy and ongoing treatment — none of which Lind said she was in a headspace to benefit from at the time.
“I wasn’t really ready to get better,” Lind said.
At the height of her depression, Lind recalled sneaking out of treatment to attempt suicide once more. At the last minute, she called her therapist, who then contacted the police. What happened next left Lind traumatized and blanketed in a stigma and shame experienced by many who struggle with mental health.
“I had called the therapist and was on the phone for like an hour, talking and calming down,” Lind remembered.
Then four police squads arrived at the parking lot where Lind sat in her car.
“That was terrifying,” she said.
Lind didn’t understand why four patrol cars were necessary and their presence made her feel like she was in trouble.
“Police are associated with criminals,” she said. “And then I felt like I was a criminal because I was associating with the police.”
Officers informed Lind she could voluntarily check herself into residential treatment or go involuntarily, but gave no explanation of what each situation would look like. Because she didn’t want to go back to treatment, she selected an involuntary admittance, not realizing she would soon be handcuffed and placed in the back of a squad car.
“It was the lowest of the low,” Lind remembered. “I was just wishing I had killed myself because I didn’t want to be there… I would have gone to the hospital voluntarily if I had known what (an involuntary) hold was.”
Health department officials have noted that the first of the new centers will be aimed at underserved areas of the state, and Lind’s hometown might not qualify given its proximity to St. Elizabeth Hospital in Appleton where she spent much of her treatment. Neenah is also near the Winnebago Mental Health Institute, although Lind never spent time at the facility.
But had one of the state’s specialized crisis urgent care centers been available to her, the police involvement may not have been necessary — or at the very least Lind wouldn’t have spent four hours in handcuffs while she awaited the required emergency medical clearance prior to her admittance to treatment.
Kjersta Lind says she feels fortunate to have had financial support from her family and resources nearby when she struggled with mental health emergencies. She knows many people in Wisconsin are lacking services.
Despite the trauma associated with many of her hospitalizations throughout her years of treatment, Lind said she was one of the fortunate ones among Wisconsin residents needing urgent mental health care.
“I was insanely lucky to have almost every resource available to me. I come from a well-off family who were able to support me financially. I’m still on my parent’s insurance, so I didn’t need to worry about that, and therefore was able to afford my meds and go into great treatment programs,” Lind said. “I have a great support system of people who were willing to help me. With all of that, I was able to drop everything and focus on my mental health. Not everyone has that luxury.”
‘Not … equipped for these types of episodes’
Kody Green, a resident of Vernon County near La Crosse, said his area lacks the access Lind had.
“We have some peer support groups and stuff but not a lot for urgent care or emergency care,” Green told the Cap Times. “The goal is always to get people immediate access to help, especially if people are in crisis. And we’re just not seeing those kinds of resources readily available.”
Green received a schizophrenia diagnosis at age 21 — seven years ago. Like Lind, he began experiencing symptoms his first year of college. But his experience with the disorder links back to his time as a teenager, acting as a caregiver for his mother, who was diagnosed with schizoaffective disorder — a mental health condition that often presents a combination of schizophrenia symptoms, including hallucinations or delusions, and mood disorder symptoms like depression.
Kody Green says there are few resources for people suffering with mental health emergencies in his hometown of Westby. He’s among those who lobbied for the state to create crisis care centers that are more accessible to Wisconsin residents.
“Watching my mom go through her diagnosis was already really difficult because this was, you know, early 2000s. Mental health wasn’t as talked about, especially in rural communities,” Green said.
He grew up in Westby, north of Viroqua, with a population of about 2,000 residents.
“It’s already hard to have these conversations. It gets a lot harder when the people that are struggling don’t have resources to reach out to,” Green said. “There’s not a lot in the area. You can go to the emergency room in the hospital, but they’re not usually equipped for these types of episodes or any sort of psychiatric emergencies.”
The new Crisis Now centers will be staffed with emergency medical personnel but also psychiatric providers who can treat mental illness symptoms, provide emergency psychiatric care and prescribe medication.
“When someone is experiencing a psychotic episode or experiencing symptoms of mental illness, like bipolar disorder or schizophrenia, the most important thing we could do is have those resources readily available,” Green said.
His first resource was a peer support group he found through the National Alliance of Mental Illness. He now serves as vice president on NAMI Wisconsin’s board.
Both Green and Lind have each worked in their own ways to help educate others on the gaps in care Wisconsin experiences when it comes to mental health — their own experiences informing the ways they communicate these issues to others.
Kjersta Lind plays with her dog at home in Neenah. Lind graduated from the University of Wisconsin Oshkosh in December and plans to earn a graduate degree in counseling.
Lind graduated in December from the University of Wisconsin-Oshkosh with a bachelor’s in psychology and interviewed for a graduate program in counseling earlier this month.
“I know what it takes to get better,” Lind said. “And I feel like I have that secret knowledge of how I can help other people get there too.”
Green shares the same perspective — spending his time working as a schizophrenia advocate, peer support mentor, motivational speaker and crisis intervention trainer for police. He has also spent the last year advocating for the crisis urgent care centers while lawmakers, health department officials and the Evers administration have worked toward a solution.
“Being able to get immediate care is going to be just crucial for getting people proper diagnosis and being able to get them the medication and treatment they need,” Green said.
‘Enhancing the system at all levels’
So, when will Wisconsinites be able to receive care at these centers? That remains less clear.
An advisory board assembled by the state health department will establish a framework of guidelines and certifications for the centers. Even with the project on an emergency fast track, the rulemaking alone can take nine months.
The health department must first create a “statement of scope,” or basis of ideas for how the centers will be run, after which point regulations can begin to be drafted. All of these rules must be reviewed at the top level of government before meeting final approval.
“Hopefully within a year we’ll start putting out the funding opportunity announcements,” Steinmetz said.
After that, the health department will begin accepting proposals for the $10 million in grant money, which will be split between the two projected centers.
The advisory board hasn’t yet been created, but Steinmetz said the group will likely include law enforcement, county-based health providers, people with lived experience and advocacy organizations.
It remains undecided where the centers will be located. That will largely depend on what entities apply for the funding and which proposals show the most promise for the funding.
The good news, Steinmetz said, is that by creating this framework of regulations surrounding the centers, more facilities like this can exist around Wisconsin beyond just the two that are slated to receive funding.
“We really are focusing on enhancing the system at all levels,” Steinmetz said.
