Medical Society of Milwaukee County (MSMC)
Position Statement
BEHAVIORAL HEALTH

BACKGROUND
The lack of inpatient beds in Milwaukee County for seriously ill patients with psychiatric disorders has reached crisis proportions. The problem appears to be one of money. Private hospitals lose too much money treating uninsured and underinsured patients, and the Milwaukee County Mental Health Center (MCMHC) does not have enough money from the county budget to provide adequate services for that population. Despite a sharp increase in the number of patients needing care since 2002, there has been no increase in funding, staff or space to accommodate the need.

The Psychiatric Crisis Service (PCS) of the MCMHC has been consistently running at 30% over capacity for the last several months. This results in long waits for Milwaukee County residents on emergency detentions to be evaluated by the PCS staff. It has also meant delays of hours to days for patients on emergency detention seen in the emergency departments of local hospitals, to be transferred to MCMHC. The backup appears to be primarily due to lack of inpatient psychiatric beds in the county as a whole, both at MCMHC and community hospitals. When the plan was put into effect several years ago, it was determined that there were so many psychiatric beds in both general and free-standing psychiatric hospitals, that the number of beds at MCMHC could be significantly reduced. It was expected that bolstering the Community Support Programs (CSPs) would be effective in reducing the number of patients needing in-hospital care. Unfortunately, such has not been the case. In addition, during the last several months, some community hospitals have closed their psychiatric units. At this time, the only facilities in Milwaukee County that can accept psychiatric inpatients between the ages of 16 and 64 years old with Title XIX are St. Michael, Columbia St. Mary’s (Columbia Campus) and St. Luke’s South Shore. Some CSPs have closed or drastically reduced their staffing levels, and, consequently, the number of patients they can serve has diminished.

SOCIETY POSITION

• MSMC believes that the need for psychiatric services in Milwaukee County is not likely to decline any time soon. The trend, in fact, is that the need for inpatient beds is increasing.
  
  
• MSMC is asking the County Board to reconsider funding levels for these services, particularly by increasing funding to support beds and staff positions.
  
  
• Because it is a crisis, MSMC is requesting that other community organizations also look at short-term interventions that can assist in alleviating this dilemma.
  
  
• MSMC requests that other Milwaukee County organizations work collaboratively to influence the Milwaukee County Board and, if necessary, state legislation that will address solving these issues.

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