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Yahoo
a day ago
- Health
- Yahoo
People agree change is needed in mental health services. Partisan gridlock stalls progress.
At the sober living facility in Milwaukee, a man sits alone in his room ruminating. He's recovering from an addiction to crack-cocaine and has lived with schizophrenia since he was 12. He remembers the number, 988, and he calls it. His parents, Rick and Sandy Schultz, are well aware of the consequences if their son acts out at the facility: he could be physically restrained, the police might be called, and he could be expelled from the program and placed back on probation. But that's not what happened. A counselor at 988 Wisconsin Lifeline stayed on the line with him and helped walk him back from the ledge, Rick Schultz said. Access to that conversation made the difference between safety and the perils he could have faced on the streets. Rick and Sandy Schultz know the stakes are high for people with severe and persistent mental illness. It's why they founded ADMIRE, an advocacy group in the greater Milwaukee area that stands for Advocates for Mental Illness Treatment Reform. And it's why, as an organization, they crowded the dais at a public hearing May 27 to deliver an urgent message to lawmakers about why the state must preserve 988 Wisconsin Lifeline. "The counselors at 988 will not hang up. They will never hang up on you," Rick Schultz told the Milwaukee Journal Sentinel. "You can talk to them for an hour or more. They give you perspective, they ground you." The federal grant for 988 is scheduled to sunset at the end of the year. Since July 2022, it has been largely funded through the Substance Abuse and Mental Health Services Administration, or SAMHSA. State Sen. Jesse James, R-Thorp, introduced a bill that would create statutory requirements to fund 988 Wisconsin Lifeline in the budget. It's estimated to cost a little more than $12 million, according to NAMI Wisconsin and the American Foundation for Suicide Prevention. It's one of a dozen bills James, chair of the Committee on Mental Health and Substance Abuse Prevention, introduced this session as part of his focus on sustainable, bipartisan efforts for advancing mental health in Wisconsin, he told the news organization over email. James is far from the only lawmaker introducing bills related to mental health this session. Lawmakers on both sides of the political aisle have introduced a raft of mental health bills that would create permanent state funding for the 988 Wisconsin Lifeline, address behavioral workforce shortages, expand upon and improve emergency crisis facilities, and improve access to mental health services. But whether they can see eye to eye on their bills will determine whether the state advances the call to improve mental health care in Wisconsin, one that advocates have been urging it to do for years. Between federal funding streams ending for 988 and workforce shortages unable to keep pace with a steadily aging population, "the time to act is now," said Mary Kay Battaglia, executive director of NAMI Wisconsin. Most recently, on June 2, Rep. Robyn Vining, D-Wauwatosa, introduced a new package of 10 bills dubbed "Mental Healthcare is Healthcare," which aims to advance persistent problems like behavioral health workforce shortages, diversifying the workforce, expanding access to youth and college students, and widening the scope of insurance coverage to include mental health. Vining, who has a background in psychology, told the news organization these bills were built from scratch to represent the needs of Wisconsinites. "We want to make sure that we have mental health access for every Wisconsinite. We've said this over and over again," Vining said. For any bill to get a public hearing in the Republican-controlled Legislature depends on whether a Republican lawmaker authors or signs on to support it. That can make or break Democrats' authored bills and packages. The deadline for Republicans to sign on to Vining's mental health package is June 13, but already, Republicans have cast doubts on it. Much of that concern stems from aspects of the bills that touch what's become the third-rail issue of diversity, equity and inclusion. One of the bills in the package, for example, would create a grant program funded through the Department of Public Instruction to hire school mental health professionals who are part of a racial minority. Another would train school counselors and school social workers to better understand LGBTQ+ rights. Nearly 75% of mental health professionals in the United States are white, a statistic that health care organizations like Anxiety and Depression Association of America say could create a barrier to care for people of color, especially if a clinic's demographics don't match the school community. That's been part of Vining's argument for the bill, after talking with mental health professionals around the state about the racial disparities in mental health care. Diversifying the field could help improve outcomes for Wisconsin's children of color, at a time when Wisconsin has the largest gap between the well-being of White children and children of color in the country, according to a 2022 report from the Annie E. Casey Foundation. But James expressed concerns about bills that involve significant spending or prioritize certain groups over others. "Every child in our state deserves to grow up knowing they are not alone and that they have the resources they need to fight these often-silent battles," he said. Meanwhile, Senate Democratic Leader Dianne Hesselbein said James' 988 bill "is not a serious bill," according to a recent article by the Cap Times. Hesselbein cited a lack of information on funding, the size of the grants or how those grants would be administered. That bill would require the state Department of Health Services to award grants to organizations that provide crisis intervention services and resources to individuals who contact 988. No fiscal projection has yet to be tied to the bill, which gives lawmakers like Hesselbein pause. Just as Vining's package of bills has no Republicans' support, James' 988 bill also lacks Democrats' support. When Vining introduced a similar package of bills last session, no Republicans agreed to co-sponsor. She attributed this to filing the bills late in the session ― a decision she made while trying to persuade her Republican colleagues to author them. This time around, once her bills receive numbers and are assigned to committees, Vining intends to hand-deliver a letter to the committee chair and ask for a hearing. "I am one of the Democrats that's gotten hearings from my bills doing that, so it has worked. We'll start talking to more and more Republicans," Vining said. Cementing 988 Wisconsin Lifeline into the state budget is mandatory, said Battaglia from NAMI Wisconsin, who called James' 988 bill "a no-brainer" and a high priority for the mental health organization. "The 6,000 to 7,000 calls per month should be an indication that we want mental health support and services in our state," Battaglia said. "Legislators must understand that (988 Wisconsin Lifeline) helps navigate people to services and resources. This is the time for them to act on that." For years, mental health advocates have pushed the Wisconsin Legislature to expand mental health services in ways that go beyond crisis response. Creating a state-funded stream for 988 is among NAMI Wisconsin's priorities, Battaglia said, but the behavioral health workforce shortage increasingly has Battaglia worried. Battaglia supports Vining's bills that would expand the workforce. One bill would create stipends for prospective school social workers who are required to pursue one to two semesters of internships before they can be certified. Typically, these internships are unpaid, which creates a barrier for some students to get licensed. But legislative sessions can sometimes feel like the movie "Groundhog's Day" to mental health advocates. Each year, advocates stress the need for the state to fund community support programs that reach people where they are ― days, months and even years before a crisis. Gov. Tony Evers has included provisions for the state to support community support programs, which are currently funded on a county-by-county basis, in the last two bienniums. Yet every other year, that funding is cut from the state budget. Related: Republicans scrap over 30 programs dedicated to behavioral health care from Evers' budget A major reason efforts to improve mental health care tend to fail, says Battaglia, is because "we don't have a real mental health care system" to build on. Instead, it's largely a reactionary system, one where the lion's share of funding goes to emergency crisis services. "It's very hard for (lawmakers) to look at the long game," Battaglia said. "If you were going to look at the long game, you would invest in community services, and instead, what we do is we invest in crisis services." Natalie Eilbert covers mental health issues for the Milwaukee Journal Sentinel. She welcomes story tips and feedback. You can reach her at neilbert@ or view her X (Twitter) profile at @natalie_eilbert. This article originally appeared on Milwaukee Journal Sentinel: Wisconsin lawmakers divided by party on how to improve mental health
Yahoo
04-03-2025
- Health
- Yahoo
You call the 988 Crisis Lifeline. After that, where do you go? Study shows drop in options.
More than 150,000 calls, texts and chat messages have been answered by counselors working for the 988 Wisconsin Lifeline since the National Suicide Prevention Lifeline shifted to a three-digit number in July 2022. But what do people do once they hang up — not just in Wisconsin, but across the country? For people who need more support once their call ends, finding a crisis center might be harder to come by today compared to when 988 first launched. That's according to a new national study published in JAMA Psychiatry. It found that, despite increases in calls and messages to 988, the number of community crisis facilities has mostly decreased since the launch of 988. The report also highlighted a slight uptick in peer-support services, in which people facing behavioral health challenges are paired up with counselors who have overcome similar challenges. While facilities in general decreased, peer-support services saw an increase. Wisconsin was a bit of an outlier. It saw neither an increase nor decrease in crisis community centers — although it did see a jump of more than 5% in peer-support services. Jonathan Cantor, a policy researcher at American nonprofit think-tank RAND, which conducted the study, told the Journal Sentinel that the success of 988 depends on whether people have follow-up access to crisis facilities. In other words, the volume of calls can only do so much if a caller has nowhere to go with after it. "There's been this large increase in engagement with 988, but 988 is just one component of the broader crisis infrastructure," Cantor said. "We wanted to see if there was any change in the availability of crisis services after the launch of 988 because there was this increased demand. But we really didn't see any except for peer-support services." Wisconsin's current and developing crisis facilities run counter to some of the national trends outlined in the JAMA report. Caroline Crehan Neumann, crisis services coordinator for Wisconsin Department of Health Services, told the Journal Sentinel that many of the people who receive support in the state from talking with a Lifeline counselor are not simply left to their own devices once the conversation ends. Rather, they are are set up with one or more referrals to explore ongoing behavioral health services, such as therapy, local support groups, or financial assistance support. That's been helped by the growth in staff at Wisconsin Family Services, the organization that hires and trains 988 Wisconsin Lifeline counselors. Currently, 988 Wisconsin Lifeline is staffed by 74 counselors, a 37% increase since last December. "This data shows us that 988 is not only for immediate support but also for ongoing, local care," Crehan Neumann said. "The data also gives us insight into why people are looking for support." While the RAND study found a small but significant decrease in mobile crisis response and suicide prevention services, Cantor said that Wisconsin's mobile crisis slightly increased, making it "relatively stable" compared to the rest of the country. Mobile crisis response is a type of intervention that allows for face-to-face counseling services to take place in someone's home, neighborhood or community. The idea is to avoid unnecessary emergency department visits and hospitalizations, which can themselves be traumatizing. Access Community Clinics, which provide mobile crisis response, have cropped up in recent years across Milwaukee County and Dane County. That tells Cantor that researchers need to continue tracking changes in the future to determine where unmet needs are. The hope is that these conversations pave the way for the creation of more crisis facilities across the country. Crehan Neumann said plans are in the works to use 988 data to better understand the impact the three-digit number has had on people's emotional and mental wellbeing. A consumer satisfaction survey went out a few months ago to 988 chatters and texters to learn more about their interactions with counselors. "988 is here and so, for best success, we're going to need a coordinated crisis services system where, once you call 988, counselors can help you identify where to go," Cantor said. This article originally appeared on Milwaukee Journal Sentinel: More Wisconsinites are calling 988, but crisis services have not grown
