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Barriers to Mental Health Services Could Remain Despite Budgetary Help

Wisconsin soon could see a big increase in funding for mental health services.

That comes as mental illness took center stage in politics this week. President Barack Obama convened a National Conference on Mental Health at the White House Monday. Speakers included the president, vice president and Secretary of Health and Human Services.

Here in Wisconsin, this week’s Joint Finance Committee schedule includes a vote on increased funding for Comprehensive Community Services for the mentally ill. That’s the last element of Governor Scott Walker’s plan to increase community mental health funding by about $16 million. It’s in addition to the committee’s approval of $12.5 million for the Mendota Mental Health Institute.

Advocates largely applaud the idea but say money alone can’t overcome every obstacle.

Walter Laux is the director of Behavioral Health Services for Community Advocates. The Milwaukee-based group helps meet the basic needs of those who are struggling.

While he calls the governor's funding increase "fantastic," Laux says barriers to care remain, including people not recognizing they need help, not having access to services, physical and geographical limitations, being unable to find a provider or simply not having insurance.

"Putting money into mental health services is always a good thing," he says. "(But for) the population that we see at Community Advocates, it's probably not going to have a huge impact." 

Laux's organization largely works with the homeless population. Much of the new funding geared toward adults is for bolstering admission units that evaluate patients for the state-operated facility Mendota Mental Health Institute. And Laux says this doesn't go far enough to help the majority of Community Advocates' clients.

"It's not enough for a provider to hang an open sign on the door and expect people to magically show up," he says. "The populations that we work with typically don't do that, so it's really incumbent on us to go to them."

Another barrier to mental health services is insurance. Gov. Walker's plan includes $10 million for comprehensive community services. But Laux explains that people must be on Medicaid to be eligible for these services.

"Most people who are homeless don't have Medicaid, so part of what we do is assist them to get benefits," he says. "Once they become eligible for Medicaid, then they might be able to take advantage of some of those services."

But Laux says even people who have insurance often find it difficult to access providers, particularly psychiatrists. It can take up to 6 weeks to get an appointment. Because of that, many insured patients will go first to their primary care physicians, who may or may not prescribe them the right medication to deal with their mental health issues.

Another problem that Laux says isn't addressed by the new funding is the need for wrap-around care. Particularly among the homeless population, he says many people who need mental services also need medical care. But both problems are exacerbated if they don't have insurance. Moreover, many homeless individuals suffer from paranoia or drug and alcohol addiction, or simply have had previous bad experiences with interventions.

These issues make helping this population especially difficult, Laux says, and unfortunately, many mentally ill people end up incarcerated.

"Criminal justice facilities have become the de facto mental health institutions, so individuals who may commit offenses, due to their psychiatric symptoms, due to their behavioral health needs, end up in the institutions," Laux says.

The homeless aren't the only vulnerable population when it comes to not getting mental health care. Children are in special need of services, Laux says.

Milwaukee boasts a national model for children's mental health services in the Wrap-Around Milwaukee program. It helps make sure that children, even those who have insurance, are being properly screened for these issues.

"If your primary care doctor who might have first interaction with children or even the parents who are working with them, don't know what to look for, it might make it more difficult to coordinate those services," he says.

If you or someone you know has an untreated mental illness, Laux suggests you check out Mental Health America or the National Alliance on Mental Illness. You can also call 2-11 for a range of social services.