Madison at ‘critical crossroads’ with mental health services

Too many go to jail who need mental heath help
Madison at ‘critical crossroads’ with mental health services

Too many people wind up in the Dane County Jail who should be getting mental health services instead.

About half of the inmates are on some kind of psychotropic medications and Sheriff Dave Mahoney says the solitary confinement cells where the jail is forced to house them at times are inhumane because they can make their psychological conditions worse.

Last month–out of frustration–Madison police chief Mike Koval launched a new unit of five mental health officers to help find services for mentally ill city residents they encounter before their situation worsens.

“There probably isn’t a worse time for me to launch this pilot initiative,” Koval wrote on his blog, noting concern among his police force about removing five officers from patrol. “But I believe that we have reached a critical crossroads where somebody has to step up and do more.”

The city of San Antonio, Texas, reached that conclusion five years ago, when it took what officials called a Moneyball approach to evaluate the money spent on mental health across all departments and programs. They reached the same conclusion officials have reached in Madison: treatment, not jail, works for people with mental illness.

Today, San Antonio is saving more than $10 million a year by consolidating all mental health-related services under one roof in a facility located across the street from a homeless shelter. The city’s restoration center has a forty-eight-hour inpatient psychiatric unit and detox centers, as well as outpatient primary care and psychiatric services. It also provides housing for people with mental illnesses, job training and a program to help people transition to supported housing. For San Antonio, collaboration among the courts, jails, hospitals, police and county government was key to building its new system. New investment was needed, but how the money is spent matters just as much, if not more.

Here at home, Dane County supervisors Carousel Bayrd and Leland Pan generated a list of potential solutions after hearing testimony at multiple meetings. Some of them, as reported by the Wisconsin State Journal, echo what is happening in Texas, including a stand-alone facility to serve those with mental health needs and putting current alternative-to-incarceration programs under one roof to ease the transition among them. Candidates vying to replace Madison Mayor Paul Soglin have also emphasized the need for more services to address mental health and substance abuse.

The county spent $29.6 million on mental health services in 2013 and Dane County executive Joe Parisi has indicated he’ll review mental health care spending to help prepare his 2016 budget.

“We’re all in agreement that the practice right now needs to be changed,” Parisi told the Capital Times. “We need to figure out how to get there.”

Koval, for his part, is skeptical that the right words from political leaders will lead to substantive change.

“It comes down to money and a catalyst to act,” he wrote on his blog. “Frankly, I have grown weary with the rhetoric and have not seen any substantive change[s] that provide me with any hope for real movement in the near future.”