1. Increase the number of psychiatric beds in the county. Many organizations have recommended 30-50 beds per 100,000 people, so Milwaukee County should have 300-500 beds - and they aren't even close.
2. Stop the "revolving door." Keep patients in the hospital long enough to stabilize them, then make sure the care continues on an out-patient basis.
3. Provide supportive housing/community-based residential facilities (CBRFs) in safe neighborhoods for those with serious mental illness (SMI) who are unable to live safely on their own.
4. Decriminalize serious mental illness (SMI). Treat people in hospitals, not jails. Require a psychiatric evaluation for everyone who enters the criminal justice system. Over 50% of the inmates at the Milwaukee Secure Detention Facility have a mental illness, according to their own website.
Reforms at the State Level (Wisconsin)
1. Amend the Chapter 51 Involuntary Commitment standard for being able to get care from "danger to self or others" to "in severe psychosis and in need of immediate treatment." It is not possible to predict whether a person will harm themselves or others while in severe psychosis.
2. Fund the Community Support Program (CSP) by matching the federal Medicaid funding, which will reduce hospitalizations and criminal justice involvement by providing support to those with serious mental illness.
3. Provide funding to keep the988 Crisis Linegoing. Update: 988 has been partially funded!
4. Allow Psychiatric Advanced Directives (PADS), or safety plans (WRAP) so people can let their families know their wishes before they become psychotic and unable to make coherent decisions.
5. Fund mental health and substance abuse treatment courts, which will reduce the costs of incarceration and recidivism.
Reforms at the Federal Level
1. Reform HIPAA (the Health Insurance Portability and Accountability Act) to allow families of those in active psychosis to be involved in their loved one's treatment. Right now they can only be involved in certain extreme circumstances.
2. Eliminate the 1965 Institute for Mental Diseases (IMD) exclusion. If those between 21 - 65 on Medicaid go to any hospital for treatment, they are covered and the federal government reimburses the state. If they go to a mental health hospital, the federal government won't reimburse the states for Medicaid unless there are 16 or fewer beds. This results in a shortage of psychiatric beds across the country.
3. Reclassify serious mental illness (SMI) from a behavioral issue to what it is - a neurological condition.
4. Prioritize and provide more funding for those with SMI.
