Monday, March 3, 2014

Milwaukee's Mentally Ill Should Be Spared From Corporate Punishment

For decades, the delivery of mental health services in Milwaukee County has been subject to debate and controversy.  But at no time did it reach such high levels as it did in recent years.

It is pretty well known that during his tenure as Milwaukee County Executive, Scott Walker showed his disregard for the mentally ill by cutting service, cutting staff and deferring maintenance to the mental health complex.  As a result, there were spikes in the number of assaults of both staff and patients and the building was found to be in "shoddy" condition, requiring tens of millions of dollars in immediate repairs.

To address the poor condition of the building, Walker thought the solution would be to move the facility into the old St. Michael's Hospital, a building which was older and in worse repair than the mental health complex.  In fact, the old hospital was so bad that it was razed not to long ago.  And Walker thought it would be a good place for our mentally ill for the next generation.  (The real reason Walker wanted to move the facility is that the complex sits on prime real estate which land developers - and Walker campaign donors - were salivating over.)

Things hit an all new low when it was learned that Walker's hand-picked director, John Chianelli, brushed off a series of sexual assaults of female patients as a "trade off" for lower physical assaults.  Even when public outrage was at its highest, Walker never fired Chianelli, but transferred him to a high-salary, do-nothing job especially created for him.

The disdain the Walker administration had for the mentally ill recently came to the surface again when the emails from the Kelly Rindfleisch trial were made public.  It became evident that Walker was more concerned about keeping the facts around the death of patients under wraps, so that it didn't hurt his gubernatorial campaign, rather than addressing the problems.  They felt justified in this calloused approach because, as Rindfleish had written, "No one cares about crazy people."

Sadly, when Chris Abele took over from Walker as county executive, he chose to follow Walker's example by fully abdicating his responsibilities to the mentally ill by starting the process of shutting down the complex.  Abele's "best practice" was to evict the chronically mentally ill and developmentally delayed and hand them over to profiteers who would take money from the system before kicking the patients back into it.

This truth was recently reemphasized by an article from Dr. Tony Thrasher, the medical director of Milwaukee County's Psychiatric Crisis Services:
Aside from the fact that this continued portrayal of BHD as the scapegoat is disheartening, my larger concern is that it will keep citizens from focusing on more pressing issues in the community. Our own data show how difficult it is for patients to be accepted and treated in the private sector (recent efforts by Aurora Psychiatric Hospital being an exception).

Additionally, I note about 20 cases a month in which patients are transferred to the private sector and then "returned" to BHD — or the patient is in a private health system requesting covered psychiatric treatment and is refused. The reasons for this vary but generally pertain to "behavior," "lack of cooperation," "housing problems," "previous experience with that person" and "not fitting in with our other patients." These statements are pejorative (and sickening to me as a mental health provider), but they are indicative of our community's interest in providing psychiatric treatment.
One problem with Abele's agenda is that not all the patients at the mental health complex are able to succeed in the community regardless of how many services are made available.  Another problem is that there are insufficient services int he community to keep many of the patients safe.

When these issues were brought before the Milwaukee County Board, they made the sagacious decision to put safety measures into place, such as requiring the necessary services be available before a person is placed in the community and tracking the patients after they are discharged.

Abele found these common sense measures to be insufferable.  So Abele did what he does every time he doesn't get his way.  He ran to his friends in the state legislature - this time Representative Joe Sanfelippo and the Wisconsin's Miss ALEC, Senator Leah Vukmir - to take local control of the mental health system away from the county board.

What Abele, Sanfelippo and Vukmir came up with was a board of 13 medical health experts, all of whom would be appointed by Walker.  Abele could recommend three and the county board could recommend three, but Walker doesn't have to follow those recommendations.  True to Walker's nature, look at those appointments to be lobbyists and campaign contributors who could profiteer from these vulnerable citizens.  This panel would meet once every three months, whether there was a crisis or not and would have no real oversight of what is happening at the complex.

Adding to the shenanigans is a clause that would let this very part time panel take over other parts of Milwaukee County government if it is deemed to be intertwined with the mental health system.  For example, this panel of profiteers could take over the transit system because patients depended on the bus and/or paratransit services.  The panel could also take over the Departments of Aging, Disability Services and Family Care, since those departments serve the same clientele.

Furthermore, under the Abele/Sanfelippo/Vukmir plan, Milwaukee County taxpayers would still be on the hook for the bills but would have no say whatsoever in how the money is spent.  In other words, there would be no accountability.

There is still time to stop this attack on Milwaukee County's mentally ill.

I have learned that Sanfelippo will be in attendance at this month's meeting of the Milwaukee County Combined Community Services Board.  The meeting is this Wednesday, March 5, at 9:30 am in Room 104 of the Coggs Building, which is located at 1220 W. Vliet Street.  The meeting is open to the public.

It is important that everyone who is able to attend this meeting to do so.  We need to let Sanfelippo that these vulnerable citizens deserve more than to be treated like cash cows by the profiteers.  We also have to make it explicitly clear that the solution to the issues with Milwaukee County's mental health system is not to give it to Walker, who made things so much worse in the first place.

We have to make it perfectly clear that people do indeed care about the mentally ill and we will not tolerate them being further used and abused.


  1. Thanks Capper. Since it's their bill, Rep. Sanfelippo and Sen. Vukmir have to explain where the accountability is. When there's a problem, where are the lines of accountability?

    Especially as champions of privatization, they have to explain why the taxpayers are still paying for this. If their legislation is so good, why isn't the private sectors steppin in?

  2. I've linked this blog post to my own, related post today over at Uppity Wisconsin. I also just updated my own post to clarify that we don't know the scope what's going on at the state level with respect to denying BadgerCare Plus coverage to mentally disabled people, which is not supposed to be the policy. But in these days of increasingly dysfunctional governance, we certainly do need to know and we certainly do need to let lawmakers hear us loudly and clearly. "A nation's greatness is measured by how it treats its weakest members." ~ Mahatma Ghandi