Wisconsin youths have a higher suicide rate, more psychiatric hospitalizations and less access to mental-health care in school than children in many other states, according to the first report of the newly formed Office of Children’s Mental Health.
The report lays out what many advocates already know. That the state’s county-run system of providing mental health care is fragmented, with children in some areas of Wisconsin receiving good care and others little to none.
According to the report, children in the state are significantly more likely to take their own lives than the national average, with a child suicide rate in 2012 at the highest level since at least 1999.
Many Wisconsin counties have few, if any, psychiatrists who treat children. A small poll of health-care providers in December found that when children are covered by Medicaid-funded health insurance such as BadgerCare — the primary funder of children’s mental-health care in Wisconsin — 81 percent had trouble locating a psychiatrist to treat them.
Schools across the state also have just a fraction of the recommended number of care providers. According to the report, Wisconsin school districts would need to add nine times more nurses, five times more social workers, twice as many school counselors and 50 percent more psychologists to be adequately staffed.
And, as is common across Wisconsin on a variety of fronts, there are pronounced racial disparities in school discipline, juvenile detentions, dropout rates and foster-care placement — negative outcomes that can have a mental-health component.
Creation of new office
Gov. Scott Walker created the Office of Children’s Mental Health in the last state budget at a cost of $535,400 over two years to improve provision of mental-health services to Wisconsin’s children, a system it describes as “complicated” involving “multiple agencies and disjointed services.”
Licensed social worker Elizabeth Hudson was appointed the office’s director in January 2014, reporting directly to the governor. Through a spokeswoman, Hudson declined an interview request for this story.
“The timing isn’t quite right,” Department of Health Services spokeswoman Stephanie Smiley said. “We believe that in the next month or so we will be in a better position to provide an update ... on the Office of Children’s Mental Health.”
Some of the answers may be found in the Feb. 3 release of Walker’s proposed two-year state budget. While his administration has been mum on budget details, the Office of Children’s Mental Health’s Jan. 2 report to the Legislature’s Joint Finance Committee offers some clues about what might be in it.
It said the office in 2015 likely will focus on tracking the growing statewide interest in school-based mental health, helping train parents to work as “peer specialists,” monitoring the use of psychotropic medications in foster care and examining the high rates of youth psychiatric hospitalization.
The office’s focus — and Hudson’s expertise — is in “trauma-informed care.” For six years before her appointment to head the office, Hudson, who worked for the UW-Madison School of Medicine and Public Health, was a consultant to the state Department of Health Services in trauma-informed care.
Beginning in 2012, she worked with first lady Tonette Walker on Fostering Futures, a public/private partnership that seeks to bring trauma-informed care into communities across Wisconsin.
According to the Fostering Futures website, trauma-informed care “recognizes the presence of trauma symptoms and acknowledges the role that trauma has played in their lives.” The idea is to shift the focus from “What’s wrong with you?” to “What has happened to you?” which “reduces the blame and shame” of mental-health problems and leads to “connections that progress toward healing and recovery.”
Advocates optimistic, wary
Mental health advocates universally praised creation of the four-person Office of Children’s Mental Health and recent increases in state funding for mental health care.
Shel Gross, chairman of the state Mental Health Council, said Walker and the GOP-run Legislature have brought heightened attention to children’s mental health.
“We’re optimistic,” said Gross, director of public policy of Mental Health America of Wisconsin. “We’re seeing more coming from the governor’s office and the Legislature than we’ve seen — really — ever.”
He noted that of the $28.9 million in additional state funding for mental-health services included in Walker’s current two-year state budget, some of it is targeted at children, including statewide expansion of a program of “coordinated service teams” who care for children with complex behavioral health issues.
In addition, the Legislature added $1 million for long-distance consultation for psychiatrists treating children and $1.5 million in tax-deductible grants to encourage up to 12 psychiatrists and 12 primary care physicians to practice in underserved areas.
One advocate, Hugh Davis of Wisconsin Family Ties, said the “jury is out” on whether the new office will lead to better services for the estimated 100,000 youngsters with mental illness.
Indeed, the office’s first annual report issued earlier this month was long on statistics but short on specific recommendations. Annabelle Potvin, advocacy coordinator for National Alliance on Mental Illness-Wisconsin, said she’s not surprised.
“Given that the OCMH is taking a long-term, public health approach to improving children’s social and emotional well-being and has limited funds to carry out their mission, my guess is that one year would be a quick turn-around to see any major improvements,” Potvin said.
Gross agreed, saying he’s “very pleased with what we’ve seen to date. We assumed this year would be one of getting organized. I think they’re being smart and deliberative and not rushing in to just be doing something.”
Marykay Wills, director of children’s mental health for Dane County Human Services, praised the office for working “diligently to educate Wisconsinites on the benefits of trauma-informed care and the need to provide quality mental health treatment to all Wisconsin children.”
Davis, whose group serves families of children with mental illness and trains parents to help others navigate Wisconsin’s mental health care system, said he has not seen any concrete proposals for improvement coming from the office yet.
“Has there been any influx of funding for these issues in the past year? The answer is no,” he said.
But Davis acknowledged Wisconsin’s county-run mental-health system is “complex” and making changes could take time, since there is no agency with “overarching responsibility” for the state’s mental-health system.
“There’s a lot of work to do,” he said.
Editor's Note: This story corrects the spelling and title of Shel Gross.