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By Annysa Johnson
The Milwaukee Journal-Sentinel
MILWAUKEE — The latest plan to ensure that patients in mental health crises are admitted more quickly at the Milwaukee County psychiatric hospital is coming under fire after two West Allis residents, one of whom was thought to be suicidal, waited under police guard a total of 106 hours for beds to open at the facility late last month.
Local police agencies, whose officers have racked up thousands of dollars in overtime pay in recent years sitting with patients in hospital waiting rooms and squad cars, say the county and private hospitals aren’t doing enough to serve the most vulnerable mental health patients and are pushing their costs of monitoring them onto local governments.
“Our concern is for the welfare of these individuals, and that they get appropriate treatment in a timely manner,” said South Milwaukee Police Chief Ann Wellens, whose department started billing the county for overtime after repeated incidents of waiting with patients last summer.
“Officers should be on the road,” said Wellens, who will address the issue at today’s meeting of the Intergovernmental Cooperation Council, a coalition of the communities that make up Milwaukee County. “This ultimately ends up costing the taxpayers of my city.”
The problem is one part of the larger crisis in the mental health care system, which has seen dramatic cuts in the number of inpatient beds and funding for many community-based programs that keep patients out of them, according to mental health advocates.
Milwaukee County has been criticized for failing to admit patients in need of “emergency detention” — those deemed a danger to themselves or others — in a timely manner.
Because it had reached capacity, the county limited admissions 66 times last year, with the minimum delay lasting an average 2.6 days, according to John Chianelli, who oversees the psychiatric hospital as head of the county’s Division of Behavioral Health. In addition, it blocked all but walk-in admission 13 times last year for an average 26 hours each time.
Changes to staff, crisis teams
As part of its latest strategy, developed last fall, the county said it would add staff at the mental health complex and redeploy its mobile crisis teams to evaluate patients in private emergency rooms. In addition it secured agreements with three community hospitals — Aurora, Rogers Memorial and Columbia St. Mary’s - to accept transfers of insured and “clinically appropriate” county patients to open more beds for emergency cases.
Chianelli said the county is recruiting new staff, with 20 new hires on board, and is transferring patients on a regular basis.
“It’s helped immensely,” said Chianelli, who said he hopes to have two more hospitals signed on this year.
But police say the problem persists, in part because the hospitals want as transfers only those who have insurance and are more likely to comply with treatment — a small subset of the people served by Milwaukee County.
“This is not what the system was designed to do,” said West Allis Deputy Police Chief Michael Jungbluth, whose department is considering billing the county for part of the $3,750 it paid officers to sit with patients last week at a hospital waiting for a county bed.
“When we put someone in emergency detention, it’s because it’s an emergency at that point in time, not 56 hours later,” he said.
Drop in public, private beds
William Henricks, executive director for behavioral medicine for Columbia-St. Mary’s Hospital, defended the hospitals’ decision to limit transfers, saying they too have limited capacity and that the county is better equipped to serve the “more acute, more chronic, more difficult patients.”
Mental health advocates say the delays are just one fallout from the dramatic drop in inpatient beds for psychiatric patients in Milwaukee County.
According to a report by the Milwaukee Mental Health Task Force, between 1987 and 2004 the number of public beds declined from 428 to 96, and private beds from 742 to 268.
The county operates 96 inpatient beds, Chianelli said. About 12,000 people sought treatment in its emergency room last year, most uninsured and brought in on emergency detentions.
Chianelli said the delays are necessary to manage the volume of patients.
“We have to be able to safely treat people as we bring them in,” he said.
Copyright 2008 The Milwaukee Journal-Sentinel