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Psychiatric Crisis Services Planning

Since 2007, the Milwaukee County Behavioral Health Division (BHD) along with health system, MCW and health center members of the Partnership, have been working together to redesign and improve the public/private behavioral health delivery system, by expanding access to care and improving care coordination.  Together, Partnership members have sponsored various studies, implemented new programs and services, and worked to move care into the most therapeutic and least restrictive care environments.

As BHD  looks to outsource inpatient psychiatric care to Universal Health Systems, who will build a new inpatient psychiatric hospital to serve children and adults; much work has been done to learn more about the need for psychiatric crisis services in our community.

A recently issued Psychiatric Crisis Redesign report, lays out the findings from a collaborative process among health care providers, law enforcement, leaders, advocates,  and individuals with lived experience to fully understand the current psychiatric crisis delivery system and recommend future models of care  for individuals experiencing a mental health crisis. The report was co-sponsored by BHD and the Partnership’s health system members and facilitated  by the Wisconsin Policy Forum and the Human Services Research Institute.

Considered Phase I of a comprehensive psychiatric crisis services redesign plan, the report highlights four key strategies for effective crisis serves in Milwaukee County:

  • Maximize and expand to the extent possible, existing psychiatric crisis prevention, early intervention, upstream treatment and resolution services with the recognition that expanded community-based resources such as crisis resource centers, mobile crisis teams, crisis stabilization houses, and community-based access clinics can contribute to  crisis prevention and a reduction in ER utilization.
  • Implement new crisis intervention and supportive services including telepsychiatry, “air-traffic-control” navigation supports, enhanced transportation and health information exchange capabilities.
  • Maintain a dedicated psychiatric emergency department as part of the continuum of psychiatric crisis services, anticipated to serve fewer, but still the most acutely ill patients who require true emergency services. It is recommended that the new ED be jointly managed and financed by BHD and the private health systems and provide for urgent care options as well.
  • Simultaneously, increase private hospital behavioral health emergency department service capabilities for improved service to voluntary patients needing treatment and linkages to inpatient, outpatient, residential, peer-supported and community-based services.

Phase II of the Crisis Redesign Plan is moving the conceptual model for adult services into due diligence, as well as the completion of a Child and Adolescent Psychiatric Crisis model.  Sponsored by Milwaukee County Department of Health and Human Services and the Milwaukee health systems, with the support of the Mental Health Board, Phase II is being led by a newly created Steering Committee with support from a health care finance consultant.  Phase II planning is expected to deliver more detailed implementation recommendations in mid-2019.

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