Proposed Budget: Improving Mental Health and Crisis Services

The past few years have been tough on all Wisconsinites, and Gov. Evers budget recognizes that behavioral health is essential to overall wellness. Gov. Evers declared 2023 the Year of Mental Health and his budget builds upon that declaration by making significant investments in expanding the availability of behavioral health services so that Wisconsinites can receive care closer to home.

Crisis response

• Improve crisis response. In recent years, Wisconsin’s crisis system has faced rising service volumes, with counties responding to 35,000 crisis calls statewide in 2021. This has increased burdens on county services, law enforcement, hospitals, and other providers to respond to individuals who urgently need care. Gov. Evers’ budget supports the development of up to two crisis urgent care and observation centers that would serve as crisis service hubs and offer a range of behavioral health services to everyone from walk-in appointments to first responder emergency detention drop-off cases.
• Support youth crisis stabilization facilities. The state has recently developed three crisis stabilization facilities specifically designed for the needs of youths experiencing a crisis. This budget provides $1 million in stable, ongoing state support to ensure these facilities continue to serve youths closer to home, support the needs of the communities they are in, and reduce the need for more intensive treatments.

Investing in mental heath

• Continue funding peer recovery centers and expansion. Peer recovery centers provide no-cost person-centered advice, skills training, and a place to connect with others in the local community who have lived experiences with behavioral health conditions. The budget provides ongoing funding to support the existing eight peer recovery centers in the state and the establishment of two new centers to expand access to areas not currently served by any of the existing centers.
• Offer culturally and linguistically affirmative behavioral health services to those who are deaf, hard of hearing, or deaf-blind. In 2019, the University of Wisconsin’s Population Health Institute completed a Behavioral Health Gaps Study and among the results found the Deaf and Hard of Hearing community is underserved and lacks access to qualified direct service providers. Gov. Evers’ budget proposes developing a statewide behavioral health treatment program directly tailored for those who are deaf, hard of hearing, or deaf-blind, where people will receive treatment directly from a behavioral health provider.
• Improve accessibility and affordability of receiving critical mental and behavioral health care. Mental health treatment can be hard to find in rural areas of the state. Gov. Evers’ budget provides funding to provide vouchers for mental health services that can be used either in person or via telehealth appointment for farmers in rural areas. Affordability is often also a barrier to receiving care. In emergency situations people often do not have the ability to choose what type of care they receive or where they receive it. This budget would increase cost transparency and protect people against receiving unreasonably high medical bills for behavioral health services received during a crisis.
• Utilize marijuana excise tax to support behavioral health services. DHS would distribute excise tax revenue generated from the legalization of recreational and medicinal marijuana to counties to support their behavioral health services, alleviating revenue pressures that counties have been experiencing in recent years.
  
• Invest in mental health services in schools. To address the high and increasing prevalence of mental, behavioral, and developmental health concerns in children, this budget makes historic investments in improving and expanding services in school settings. Children spend a great deal of their day at school and are more comfortable receiving mental health services in a school setting than outside of school. Students in schools with access to mental health services are also less likely to experience depressive episodes, suicidal ideation, or suicide attempts. Among other initiatives, this budget would increase the amount of federal Medicaid reimbursement returned to schools through the School-Based Services program, increasing funding to schools by $112.4 million over the biennium.

Funding suicide prevention efforts

The Centers for Disease Control and Prevention (CDC) recently released its Youth Risk Behavior Survey report. The data show that in 2021, more than 40 percent of high school students felt so sad or hopeless nearly every day for at least two weeks in a row. One in 10 students attempted suicide and one in five students seriously considered attempting suicide. In Wisconsin in 2021, 2,749 children ages 10-17 visited an emergency department with a self-harm injury.

• Expand staffing and resources for Wisconsin’s 988 Suicide & Crisis Lifeline services. Lifeline service, answering calls, texts, and chats from residents throughout the state, went into effect in July 2022. The counselors at Wisconsin Lifeline are trained to listen and support people through their distress with a focus on de-escalation and coping skills. The budget provides state funds to maintain the call centers and support the increase in call volume the Lifeline has experienced since its launch.
• Establish a suicide prevention program. DHS will create a suicide prevention program to coordinate suicide prevention efforts across the state. The program will also develop and provide educational materials and public awareness campaigns on suicide prevention. The program will further provide grants specific to the prevention of suicide by firearm use and support staff trainings at firearm retailers and ranges on how to recognize those at-risk.

Expanding substance use disorder services

Eight percent of Wisconsinites, approximately 450,000 people, have a substance use disorder. In the last decade Wisconsin has seen opioid drug overdose deaths triple. Substance use and its adverse effects continue to impact our communities on a deeply personal level. Deaths involving the use of stimulants have also been on a continued rise in the state for the past 10 years.

• Develop integrated behavioral health stabilization, intoxication monitoring, detox facilities. The budget supports the development of two facilities by expanding Medicaid benefits to include these new facilities. These facilities will provide patients information on harm reduction strategies, connect them with community resources, and aid in transferring them to the level of care they need upon stabilization.
• Support addiction prevention and treatment response. Gov. Evers’ budget recommends providing funding to support stimulant treatment services in counties of high need to meet the increased demand for treatment service availability.
• Ensure accessibility of needed residential substance use services. Affordability can often be a barrier to getting treatment for Wisconsinites who are struggling with substance use disorder. Medicaid implemented reimbursement for residential treatment and recently expanded coverage to institutional settings. This reimbursement covers only the cost of treatment and not the cost of room and board at residential facilities. This budget provides funding to expand Medicaid benefits to include coverage of room and board costs for residential substance use disorder treatment.