Public Policy Forum Blog

Good News from the Milwaukee County Mental Health Complex

A story in today's Milwaukee Journal Sentinel describes the closure of the last long-term care beds at Milwaukee County's Mental Health Complex, and also details the heart-warming experience of one long-time resident who now appears to be thriving in a community-based group home. This rare "good news" story about a local government accomplishment is noteworthy on a number of fronts.

First and foremost, as noted by County Health and Human Services (HHS) Director Hector Colon, it is significant because it is "the right thing to do." "De-institutionalization" for long-term care patients has been taking place across the country for decades, as practitioners have recognized that better (and often less expensive) services can be provided in smaller, community-based settings. Nevertheless, Milwaukee County has stubbornly clung to its two long-term care facilities at the Complex despite repeated discussion about possibilities for downsizing or closing. 

Second, getting to this point shows the value of strategic planning involving both public and private stakeholders. This latest effort to close the two facilities emanated from a report produced by the Forum and the Massachusetts-based Human Services Research Institute (HSRI) in 2010, which was commissioned by an impressive list of public sector (County and State of Wisconsin), private sector (the region's major health systems, the Medical College of Wisconsin, and the Medical Society of Milwaukee County), advocacy (Disability Rights Wisconsin), and philanthropic stakeholders. Subsequent to the report's release, many of the same stakeholders worked together on system redesign planning, which ultimately contributed to the decision to downsize the Complex.

Finally, this good news shows that local government officials do have the ability to make and keep bold promises. When the County Executive and HHS leaders announced their plans to close the two 72-bed long-term care units within three years back in 2013, not many thought it could be done. While there have been some bumps in the road (including a controversial effort to site a group home on Milwaukee's south side) – and while there could be more bumps in light of the need to provide a more robust set of crisis services for the increased number of behavioral health clients now living in the community – it's notable that the job got done as announced.         

It is important to recognize that several of the major and well-documented challenges facing Milwaukee County's mental health system still remain. For example, the County's Behavioral Health Division is searching for a new leader for the fifth time in the past eight years; it still has not identified a private partner to take over mental health acute inpatient and emergency services per a plan announced last summer; and the community continues to struggle with a fragmented and uncoordinated system of behavioral health outpatient care, as the Forum and HSRI documented in a report released last October. (We'll be discussing those challenges at our County Executive debate on February 22.)

Still, today's news that the last long-term care bed at the Mental Health Complex has closed should be viewed as a positive indicator that local government can do big things when it involves the community and puts its mind to it.       

Rob Henken