Adult Services Planning Summary: Psychiatric Crisis Redesign in Milwaukee County

HSRI and its partner the Wisconsin Policy Forum were asked to facilitate a project aimed at redesigning the psychiatric crisis service system in Milwaukee County. The project stemmed from the impending outsourcing of Milwaukee County Behavioral Health Division (BHD) inpatient services and the anticipated closure of the county’s Mental Health Complex, including BHD’s psychiatric emergency department. It was steered by an Advisory Committee comprised of public and private sector behavioral health leaders and administrative representatives. 

Following the completion of Phase I of the project, we published this adult behavioral health care delivery system conceptual plan developed by the committee, along with an “environmental scan” report that guided the planning effort. The child and adolescent psychiatric crisis system has yet to be fully evaluated.

Key items reflected in the conceptual plan include:

• To the maximum extent possible, psychiatric crisis treatment and resolution should occur “upstream.”  
• A dedicated psychiatric emergency department still will be needed as part of the continuum of psychiatric crisis services.  
• An increase in private hospital emergency department service capabilities is also recommended, although better front-door triaging and back-door coordination should reduce private hospital ER admissions and lengths of stay and improve care continuity. 

The psychiatric crisis redesign planning effort was jointly commissioned and funded by Milwaukee County and the health system members of the Milwaukee Health Care Partnership.

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