DOJ, health care leaders unveil proposals to overhaul emergency detentions in Wisconsin

State officials and stakeholders unveiled a package of policy and legislative proposals Thursday afternoon that would effectively overhaul the process in Wisconsin for handling crisis mental health calls where a person is a danger to themselves or others.

“I’m hopeful that we’ll see action taken in this year’s biannual budget to provide the kind of funding and support that’s needed to make progress,” Attorney General Josh Kaul said in Thursday’s press conference.

The emergency detention process has long been a concern for law enforcement and mental health care advocates in Wisconsin. A legal process that takes hours in medical clearance and long drives across the state to available crisis mental health institutions, people in mental crisis are taken into police custody before being transported first to a hospital to get medically cleared before being taken in a squad car to an available institution–usually the state-run Winnebago Mental Health Institute in Oshkosh.

The Wisconsin Department of Justice released research in 2019 showing the average time spent on an emergency detention was nine hours; some can stretch much longer. Chief concerns include the length of time it takes to get medically cleared, the lack of availability of crisis mental health care in local communities, strain on county and law enforcement budgets, and a process that can further traumatize someone in mental crisis.

Thursday, the DOJ issued recommendations based on about two years of coalition work that recommends diverting more cases away from the emergency detention process to begin with, and improving detentions when they become necessary. Many of the recommendations would need approval and funding from Wisconsin lawmakers.

“For many individuals experiencing behavioral health issues, an inpatient stay in a psychiatric hospital can be excessive, costly, potentially counterproductive, and not necessary to protect public safety,” the recommendations state.

Key proposals for diverting more cases away from an emergency detention include expanding regional crisis stabilization facilities throughout the state, a model currently used in a handful of places but needing significant state funding to implement on a broad basis. Crisis stabilization facilities paired with peer support respite centers and other regional, mobile crisis services are designed to bring more targeted mental health care to local communities–rather than taking an individual into custody and far away from their home for inpatient treatment or care.

Another set of proposals is designed to streamline and shorten the timeframe of an emergency detention itself. By definition a legal proceeding, proposals are targeted at simplifying and speeding up the process: more mental health training for officers, expanding telemedicine, streamlined court proceedings, broader use of a standardized medical clearance process, and the ability for departments close to state lines to transfer patients to other states where resources might be closer.

“What we haven’t seen is a comprehensive, holistic approach to this issue,” Kaul said at a press conference Thursday. “That’s what this set of policy recommendations is designed to be a roadmap for.”

Most of the proposals need legislative approval, which Kaul says he’s hopeful of getting. Some of the proposals like regional crisis centers are already included in Gov. Tony Ever’s budget priorities. While setting the state’s next biannual budget will be a tug of war between the Republican-controlled legislature and Democrat governor, Kaul says the proposals have bipartisan support.

Grant County sheriff Nate Dreckman has participated in the coalition working on solutions for two years. His deputies have to drive more than three hours to Winnebago Mental Health Institute, like many rural law enforcement officials around the state, for emergency detentions that can easily last ten to sixteen hours.

“There’s got to be a better way to deal with people going through a mental health crisis,” he said. “The question is–what priority is it for our current budget cycle?”