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Introduction:
My son committed suicide in 2010. When my son was alive I became aware of how we stigmatize persons with mental health illnesses in Milwaukee and often send them to jail when they are sick. I decided to take a look at how we treat persons with brain illnesses, like schizophrenia or bi-polar disorder, today. Except for my son’s name, I have changed names to protect privacy but all the experiences below are true. The information about the present Milwaukee County mental health system comes from interviews with police and mental health professionals.
On a cold winter night in 1998 I was awakened by a phone call from Cathy, a friend of my son’s. My son, Peter, in a mental health crisis, was banging down the door of Cathy’s house. Cathy had helped Peter when he was struggling with his illness, but since my son stopped taking his medication, she had to back off. Cathy had called the police begging them to take Peter to the County Mental Health complex where he had been committed before. The police officer came and told her they could only arrest my son for disorderly conduct. She called me in the middle of the night so I could talk with the police officer about my son’s history of illness. I did, but he just repeated to me that he needed to arrest my son and put him in the county jail. I did not realize at the time that meant solitary confinement in a padded cell with nothing to do except get sicker. When I bailed out my son he was very angry and swore he would never go back to county jail. His greatest fear became being sent to jail again.
I became more aware of the horrendous situation of jailing persons with mental illness years later when, Sam, a friend of my son, who also had a mental illness diagnosis, called me crying to help him get out of these same isolation cells. Sam had been in a domestic quarrel with his girlfriend when someone had called the police. Since his girlfriend would not press charges the police put him in a holding cell at the police precinct until they claimed he broke something in his cell, arrested him on disorderly conduct charges and put him in the county jail isolation cell. It was a week after his arrest Sam, suffering a mental health crisis, that he was able to make this phone call to me.
During the years of 1995 – 2010 I watched as treatment at the County Mental Health Complex deteriorated due to cuts by three County Executives. This included among other things the loss of certification of the complex, reduction in staff and psychiatric beds, loss of the Froedtert\ Medical College unit and more. In fact, in one of my son’s commitments to the Mental Health Complex he was in the Froedtert\ Medical College unit. The doctor there really treated my son and us with respect. In our visit, when my son was leaving the complex, the doctor said that if Peter was ever brought there again she was going to try some new medicine that she thought would work. Peter was sent back there again but she and the Froedtert unit were gone and, as usual, there was no record of his past treatments.
The conditions at the Mental Health Complex due to lack of county funding and staffing have grown so bad that a few years ago the Milwaukee Journal Sentinel newspaper wrote a series on the dreadful conditions. Instead of improving the conditions the present County Executive has plans to close the Mental Health Complex and privatize services to persons in crisis with mental illnesses.
Now in 2016 the Milwaukee police are finally receiving Crisis Intervention Training (CIT), to learn how to better deal with persons in a mental health crisis. This training was started in 2006 but became mandatory for all police officers in 2015. Also, now there is a special unit in the County Jail and House of Corrections for a limited number of persons suffering serious mental health illnesses. There are 19 beds for the seriously ill in this unit and they are constantly full. The average stay in jail for a person with mental illness, for a variety of reasons, is about four times the length of others in jail. One or two persons ill persons a day are sent to the County jail from the County Mental Health Complex but is difficult, if not impossible, to send an ill person in county jail to the Mental Health Complex, even when a person judged to be dangerous to self and others is released by the courts. The county jail units are run by a private company whose role is to provide more humane jail conditions but not to run a treatment center.
No matter how well trained, police are limited as to where they can take a person in mental health crisis. If an ill person voluntarily seeks treatment, something rare with mental illnesses, and has not broken a law, the person can be taken by police to any hospital that has a psychiatric unit. But the large hospitals serving the city of Milwaukee such as Aurora Mt. Sanai, St. Luke’s, St. Joseph’s, and Fretter in Wauwatosa no longer have psychiatric units and thus the police cannot take an ill person to any of these facilities. There are only about 30 psychiatric beds in the two hospitals in the city of Milwaukee with psychiatric units. As distress, poverty, segregation, unemployment, violence, homicides and incarceration, all triggers for persons genetically predisposed to mental health illnesses increase in Milwaukee the numbers of beds for psychiatric treatment have decreased and thus more people are being jailed.
If a person suffering from a mental health crisis does not volunteer for treatment, he or she must be taken to the Mental Health Complex in Wauwatosa which has been reduced over the years to around 48 beds presently. If an ill person is judged not to meet the strict definition of Chapter 51 of the State “being a danger to self and others” he or she is released to the street or sent to County Jail if he or she has a ‘police hold’. If judged “danger to self or others” they can be committed to the complex or sent to other contracted facilities, like Rogers in Brown Deer or Aurora Psychiatric in Wauwatosa, depending on insurance and voluntary agreement. At these facilities the patient waits for a court hearing or is calmed down and released.
If a person in a mental health crisis commits a crime, like trespassing or disorderly
conduct he or she is taken to county jail or, if dangerous to self and others, a hold is placed on them at the Mental Health Complex.
Back in the 80’s there was a sudden increase in homelessness. Why the increase? Because there was a significant move during the eighties to deinstitutionalize persons with mental illnesses. It had become too easy to commit a person. The move at the time was toward community treatment. It sounded good but there was not enough money for community care and often persons with mental illnesses, like other illnesses, needed time in hospitals or treatment centers before returning to the community. I discovered that nearly fifty percent of homeless persons had mental health illnesses. Now Milwaukee County government is using community treatment to justify privatizing the handling of persons with brain illnesses. Would we take a person seriously ill with cancer to a community clinic rather than a hospital?
It has become harder and harder for families to get care for someone with a serious mental illness. In 1994, while we were living in Madison, our son Peter became seriously ill and refused treatment. We went to a psychiatrist to ask him what to do. He said that if it were his son with a mental health crisis he would seek to place his son in a hospital which in our case would mean a three party commitment. We did this and committed Peter for the first time at Mendota State Hospital. Shortly after Peter’s commitment expired he disappeared from Madison. Rumor had it that he had gone to New Orleans or Texas. We moved back to Milwaukee in 1995 and were glad when Peter was found in a mental health facility in Texas, where a kind public defender had arranged him to be placed from jail. We were able to move him back to Milwaukee.
From 1995 to his death in 2010 Peter was committed to the Milwaukee County Mental Health Complex by police, community agencies and my wife and I six times. Often I sat in the Mental Health Court waiting area with police and other family members of persons with brain diseases. I saw police and family members frustrated when someone from the complex would come out to tell them there had been a stipulation with the ill person who was then released. Once, when a very understanding police officer had taken Peter to the Mental Health Complex under an emergency detention, the secretary of the Milwaukee Corporation Counsel office called off the hearing and my son was released much to dismay of the Officer, the agency serving Peter at the time and us. Even when he was committed by court order the goal of treatment seemed to be to release Peter as soon as possible. The hospital staff, for the most part, was very understanding but they were understaffed and there was very little follow-up from previous commitments.
Once when the doctor said he had no response from a particular medicine I told him and the staff about the great skills my son possessed “cheeking” the medication. Peter done this at previous visits to the Complex but it had not been recorded. One of our greatest frustrations as family members was with the County Corporation Counsel office whose job was to pursue the case on behalf of County. I had become a skilled advocate and knew how to pressure the Corporation Counsel to do its job. Once when we were in the waiting room of the Corporation Council office I saw a mother and some family members waiting to pursue a commitment of a young man. In the little time we had together I tried to school them in how aggressive they would have to be to get their loved one help. However, I feared that their concern for this young man would be trumped by the Corporation Counsel’s goal to dismiss cases.
Friends of ours have a son, Adam, who was very ill but they were afraid to call the police since they feared he would be harmed by police or thrown in jail. After numerous trips to the Mental Health Complex they were able to get him there under an emergency detention. When they were waiting for the commitment hearing I tried to prepare them. However, he was sent to one of the subcontractors of the Mental Health Complex and was released with no stipulation before any hearing was held.
When I smashed my finger recently I drove myself to the ER of St. Joseph’s Hospital, the only hospital available in Milwaukee’s North Central neighborhood, the most segregated, distressed and impoverished area of Milwaukee. As I sat there waiting for medical attention I saw all kinds of persons including sick children with their mothers, elderly people in wheel chairs and persons who had suffered an accident like me. I thought if I were there for any medical emergency except mental illness I would be treated and hospitalized if necessary. However if I was ill with a mental illness, like schizophrenia, there would be no care for me in the hospital.
If a person suffers an emergency crisis like a heart attack, car accident, stroke or even being shot while committing a crime, police or emergency crews can take the person, voluntarily or not, to any ER, and he or she will be treated and remain in the hospital or treatment center until he or she could be released. There is one major exception to this system. Persons with mental illnesses and in medical crisis are not welcome at most hospitals. If they are low income persons they are likely to eventually end up in the County Jail, House of Corrections or State prisons. Jail and prisons have become our largest mental health facilities with over 35% of persons incarcerated having serious mental illnesses.
Conclusion:
The mental health system in Milwaukee County has changed since 2010 but, sadly, we are still sending ill persons to jail and prison. Milwaukee, City and County, we can do better than this. We need to stop sending our ill to jail.
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