A plan in the works would downsize the Milwaukee County Mental Health Complex by moving many patients to community-based care
by Erin Toner, WUWM News
Thursday, the Milwaukee County Board will consider whether to apply pressure to the troubled Mental Health Complex. Twice during the past two years, regulators have declared patients to be in “immediate danger” following reports of abuse. Administrators have been working for a year-and-a-half on a plan to mitigate problems and move patients to community-based care. But as WUWM’s Erin Toner reports, some county leaders say the process isn’t moving fast enough.
The Mental Health Complex is a sprawling treatment center on the county grounds in Wauwatosa. It was built in the 1970s, when communities regularly institutionalized people with severe mental illness. In the decades since, many other states and counties have closed or downsized their hospitals and moved patients to community based care. But the Milwaukee complex continues to operate mainly as an inpatient facility for children, adults and seniors.
County Sup. Joe Sanfelippo says multiple reports over the past 25 years have detailed serious problems regarding patient safety.
“These reports have come on, when there’s problems at the mental health company, they’re in the news, the board takes action, and as soon as it’s not headlines in the news anymore, it kind of gets forgotten about,” Sanfelippo says.
Sanfelippo is referring to high-profile cases, including reports of patients being sexually abused by other patients, and a recent death the district attorney is investigating. An independent study recommended the county shift patients to services in the community, but he says so far, progress has been slow.
“The HSRI report said they scoured the entire country and they cannot find any other county that’s running an institutional based facility for mental health care like this. If you take a look in Madison, Waukesha, they all rely on more of a community based program, which really has been the approach for the last 30 years. It’s just Milwaukee County has never taken the initiative to transition into that type of care,” Sanfelippo says.
Last week, a county board committee voted to require administrators to submit a detailed plan and timetable for reforms at the Mental Health Complex.
But the committee’s chairperson, Sup. Peggy Romo West, dissented. She agrees improvements are overdue – and she’s been helping design them, but Romo West says the county must proceed responsibly and not simply rush the process.
“The issue at hand obviously is, how do we finance this and how do we do this in the safest way that we can for our mental health consumers?” Romo West says.
Romo West says studies have shown the county will need $25 million to complete the mental health redesign, and so far, the county executive has allocated $3 million. In addition to money, she says the county cannot transition patients out of the facility without having a strong community care network in place to serve their needs, and it will take time to develop.
Romo West says because there are so many moving parts, it’s not practical to force planners to outline a timetable.
“We refer to our redesign plan as a living document, because we’re dealing with human beings and there’s constant changes now in our health care policies and legislation and coverage and so, how long is it going to take? I’m really unsure at this point,” Romo West says.
Many meaningful changes have already taken place, according to Paula Lucey, administrator of the Milwaukee County Behavioral Health Division. She says recent initiatives have allowed the Mental Health Complex to close one inpatient unit. For example, the county has overseen the creation of a crisis resource center to give people an alternative to visiting the emergency room.
Lucey says the county has also boosted programs in the community to help those who are discharged stay on track with their recovery.
“That’s decreasing our number of re-admissions and our number of people that are coming back into the emergency room because it didn’t quite work when they got discharged,” Lucey says.
Lucey says there are solid plans for continuing the reforms in 2013, such as developing “step-down” housing for patients not quite ready to live independently. She says the approach to reform has been inclusive and thoughtful, which may not lead to the pace of change some county supervisors want.
“We have very vulnerable patients here at the core of these discussions. And so I think if we’ve made any errors, we’ve erred on the side of being careful about those patients and making sure that they’re not lost in the cracks and they’re not lost in the community,” Lucey says.
The full County Board is set to vote today on whether to require the Behavioral Health Division to outline specific goals and deadlines.
Administrator Lucey says her team has been reporting its progress all along, and would have no problem providing a more detailed plan.
November 17, 2014 //
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