Wisconsin agency's change team includes law enforcement

When JoAnn Geiger, Behavioral Health and Clinic Manager for the Juneau County Department of Human Services in Mauston, Wisconsin, was assembling her 2016 change team for the NIATx Wisconsin Mental Health Collaborative, she invited members of her county’s law enforcement agencies.

“I wanted to get their perspective and give them some ownership of the change process we were working on,” says JoAnn. “They respond to calls at all times and have a unique perspective on barriers and systems issues.”  

Having the police perspective (see NIATx principle #4: Get ideas from outside the organization) prompted a change to the crisis response process in 2015. “We found that people were going to the ER for a mental health crisis when they didn’t really need to. Now, if a consumer does not need immediate medical attention, we send a mobile crisis worker to do the client assessment in the family room at the sheriff’s office, which is a much nicer environment than the ER.”

Juneau County is a small county (population: about 25,000) in southwest Wisconsin. The county seat, Mauston, is 75 miles northwest of Madison.

The Juneau County Behavioral Health Clinic provides traditional outpatient mental health and substance use disorder counseling, along with comprehensive community services, mobile crisis services, and case management. It also has a very active Community Support Program for people with serious and persistent mental illness.

The 2016 change team consists of representatives from every police department in the county, along with behavioral health staff: the emergency detention supervisor, community support program managers, the after hours supervisor, and JoAnn.

The team’s 2016 change project aim is to decrease emergency detentions where law enforcement detains a person with mental illness, sometimes involuntarily. Says JoAnn, “We want to improve diversions to non-crisis services and also improve communication between law enforcement and crisis workers.”

A walk-through of the emergency detention process revealed that it has too many steps. The walk-through also uncovered a lag in communication between law enforcement and crisis workers.

As a result, the change team has changed the phone tree. Now, a law enforcement officer can press “1” for immediate assistance from a crisis worker instead of having to wait for a callback. This change will be tested in all county jurisdictions throughout the month of June 2016. 

 “The goal is to provide the best care for consumers in crisis,” says JoAnn.

The NIATx Wisconsin Mental Health Collaborative provides a tailored framework for reducing inpatient readmissions in designated Wisconsin counties. The project is funded by the Wisconsin Department of Health Services, Division of Mental Health and Substance Abuse Services.