Wisconsin State Capitol on a snowy day. (Baylor Spears | Wisconsin Examiner)
A recent CDC survey found that 42% of high school students reported experiencing persistent feelings of sadness or hopelessness in 2021. The findings were more alarming for teenage girls and LGBTQ students with nearly 60% of female students and nearly 70% of LGBTQ students reporting experiencing these feelings.
Gov. Tony Evers referenced the statistics during his budget address to the Republican-led Legislature, calling on the Legislature to do something about the persisting crisis.
“No one who has the privilege of working in this building can read these statistics and say with a straight face that we’re already doing enough,” Evers said during his budget address. “Folks, ‘enough’ will be enough when these are not the statistics we’re reading about our kids in the news. It’s time to get serious.”
Evers, in the weeks leading up to unveiling his complete budget proposal, declared 2023 the “Year of Mental Health.”
As a part of this focus, Ever included a long list of policies and spending proposals, totaling around $500 million, in his budget proposal. The plan would address the “quiet, burgeoning” mental health crisis in Wisconsin by increasing school mental health supports and expanding access to mental health services to people across the state.
“The governor has proposed broad investments that would strengthen mental health services and supports across both age populations and then also people in schools, people who are deaf and hard of hearing people who are looking for different kinds of mental health care delivered across the continuum,” said William Parke-Sutherland, a health policy analyst at Kids Forward, a nonprofit that advocates for solutions that break down barriers to success for children and families in Wisconsin.
Significant investments for school-based services
The largest portion of the money — $270 million — would go towards expanding mental health support in Wisconsin public schools.
Evers wants to use $117 million of that to make his ‘Get Kids Ahead’ initiative a permanent state program, making mental health funds more predictable and stable for schools. He used one-time federal funds to jumpstart the initiative last year.
The current initiative allowed all public school districts and independent charter schools to receive a minimum of $20,000 to develop their mental health systems, including providing direct mental health care, hiring mental health navigators and providing mental health first aid and trauma-based training.
Under Evers’ budget proposals, funds would be distributed through base and per-pupil payments, which would be a shift from how schools currently receive state money to support student mental health.
According to the Budget in Brief distributed by the Department of Administration, Wisconsin currently invests $22 million total in state money for two school mental health aid programs. Current programs distribute money to schools through competitive grant processes, so not every school is guaranteed funds.
“The pandemic has really strained health systems and mental health of children and also exacerbated racial disparities,” Parke-Sutherland said. “We need substantial investment.”
Evers also proposes dedicating $18 million each year to supporting school mental health professionals by making expenses by school counselors, psychologists, nurses and telehealth services reimbursable by the state. Another $580,000 in each budget year would go towards training school staff on mental health, bullying prevention and other practices.
Apart from direct state spending, Evers also recommends modifying how much federal funding schools get back for providing Medicaid school-based services. Currently, participating schools get 60% of the federal funding, while 40% goes to the state. Evers wants to give schools 100% of that money, and the Budget in Brief estimated schools would receive an additional $112 million of federal funding over the biennium with the policy change.
Parke-Sutherland said there’s been growing bipartisan agreement that something needs to be done about the student mental health crisis, and the real question is how it will get addressed.
“There is definitely an opportunity to make significant investments and I think there’s room for compromise,” Parke-Sutherland said. “I wouldn’t be surprised to see some compromise and some coming together on school based mental health.”
Targeted spending and policy changes to improve quality of care
The approximately $230 million that’s not targeted at school-based mental health support looks to support a range of communities and expand access to care throughout Wisconsin.
Some spending would, again, target children’s mental health. Evers wants to establish a 25-bed residential treatment facility to serve children with intensive behavioral health needs as well as the establishment of three youth crisis stabilization facilities, giving Wisconsin a total of six of these types of facilities.
Several proposals would focus on expanding access to peer-based mental health support. Parke-Sutherland emphasized that peer support is often valuable for helping people through recovery. One proposal would allocate around $3 million in the second year to allow Medicaid to cover certified peer specialists. “Those are people with lived experience of mental health or substance use disorders who have received recovery based training on how to support people with mental health challenges or substance use challenges,” he said.
Evers also included $450,000 in ongoing annual funding for the state’s peer-run respite center for veterans and a $260,000 annual allocation for existing peer recovery centers as well as to support two new peer recovery centers in areas not yet served. Wisconsin currently has 11 of these centers.
Survival Coalition, a group of more than 20 state and local organizations that advocate for improving policies for people with disabilities, issued a statement praising Evers’ plans.
“There has been a decreasing ability to access community-based mental health care over the past years and this has led to more and more people with mental illness ending up in facilities, jails or prisons,” said Kit Kerschensteiner, a representative with the coalition. “We need to restore and improve the access people experiencing a mental health crisis have to the services they need to remain safely in the community and reduce reliance on overly restrictive inpatient and institutional settings.”
Certain policies would target specific communities throughout Wisconsin. One proposal would create statutory language to remove barriers that first responders with post-traumatic stress disorder encounter when seeking worker’s compensation.
Parke-Sutherland also pointed out a proposal that would help improve quality of care and diagnostic accuracy for deaf, hard of hearing or deaf-blind individuals for a relatively small amount of money. This includes around $2 million in the second year for establishing a statewide behavioral health treatment program that is tailored for those who are deaf, hard of hearing or deaf-blind.
The program would also recommend offering direct treatment to those who are deaf, hard of hearing or deaf-blind from a provider fluent in American Sign Language and educated on the culturally unique challenges.
“[It] would go a long way to providing services that would be much more accessible to people, rather than having to rely on an interpreter,” said Parke-Sutherland. “It can be difficult to establish a relationship just when we’re talking together, add an interpreter into that situation, and it’s even more difficult.”
Republican leaders have mostly criticized the amount of spending included in the Evers’ budget proposal, making it unclear what parts of Evers’ plan could potentially be adopted. The Joint Finance Committee will spend the next several months rewriting the budget before the Legislature votes on the spending plan and then sends it to Evers to be signed.
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