Supporting the Wellbeing of Every Wisconsinite

Everyone in Wisconsin, regardless of their county, age, or profession deserves to live in a community that supports their wellbeing. This means access to quality, affordable mental health and substance use disorder services. Governor Evers’ proposed budget expands access to care, strengthens schools’ and counties’ ability to provide mental health supports, provides funding to community-based mental health providers and farmers, and continues support for services provided by people with lived expertise of mental health and substance use challenges. All of these investments would make for a broader continuum of care and support a wide range of providers at the state, regional, and local level. 

Supporting School-based Mental Health Care

Youth are experiencing a mental health crisis. The latest Office of Children’s Mental Health Annual Report shows that more than half of high school students have significant problems with anxiety, more than one in three report feeling sad or hopeless, and nearly one in five teens have seriously considered suicide. However, severe racial disparities exist. Among Wisconsin high school students surveyed in 2023, 45% of Multiracial students, 39% of Latine students, 37% of Black students, and 23% of Asian American students reporting feeling sad or hopeless almost every day for at least two weeks (Black, Asian American, and Multiracial students in this survey did not identify as Latine). In contrast, 34% of white students reported feeling the same way. These disparities are not surprising given the blend of significant stressors Black and Brown families experienced during the early days of the pandemic and Wisconsin’s history of systemic racism. Wisconsin ranks among the worst states in the nation for racial inequality.

The Governor’s proposed budget includes about $300 million in general purpose revenue (GPR) to support school-based mental health. Rather than schools having to rely on competitive grants, much of this funding would be distributed using a per pupil basis formula, which would give schools a more stable, reliable source of funding to better plan for and provide mental health support. 

The Governor’s budget would also better fund school services, which Medicaid helps to cover, by sending more federal dollars back to schools for providing services (starting in 2027). This change would result in about $50 million more for school-based services reimbursed by Medicaid in FY 2027. 

“Families are worried. It is hard enough to care for and support a student who has significant needs. Parents should not have to worry about losing financial support for necessary therapy services and access to appropriate medical care.”

– Speech Language Pathologist, Wisconsin rural school district

A 2023 survey of Wisconsin high school students revealed urgent mental health needs among our youth that are too often going unmet. For Latine, Black, and Multiracial students, only one in six or seven students reported receiving the help they needed. Among Gay, Lesbian, and Bisexual students,* 40% reported seriously considering attempting suicide in the past year, but only 14% reported receiving the help they needed most or all of the time. Yet our schools are severely lacking the necessary staff to support students’ mental health. Wisconsin’s average of 1 counselor for every 362 students in the 2023-24 school year was far behind the ratio of 1 counselor for every 250 students recommended by the American School Counselors Association. 

“It’s a really hard thing to be Transgender and gay in this state. I will always feel uncomfortable and unsafe here. No matter whether in school, in the store, or on the streets, I feel I’m always going to get judged or worst hurt.”

– student, 2023 Wisconsin Youth Risk Behavior Survey

Boosting Medicaid funding and investing in school-based mental health is critical for the health and wellbeing of Wisconsin’s kids. In addition, policymakers should dedicate investments for students experiencing higher levels of depression, anxiety, and suicide risk who are not accessing the help they need. Notably, Latine, Black, and Multiracial students—as well as Lesbian, Gay, Bisexual and Transgender students—and others who are more likely to report anxiety and/or depression and have difficulty accessing treatment and support.

Reforming Wisconsin’s Emergency Mental Health System

Wisconsin’s emergency mental health system relies heavily on law enforcement, hospital emergency departments, and jails, none of which were designed to meet the needs of people experiencing a mental health emergency.

This has meant that people with mental illness are unjustly overrepresented in jails and prisons. Furthermore, systemic racism has meant that people of color in Wisconsin are even more likely to be unfairly incarcerated for mental health or substance use-related emergencies, instead of receiving the actual care they need.

The Governor’s budget proposes $20 million to fund two new regional crisis urgent care and observation centers with staff who are better trained to support people with mental health and/or substance use disorder needs. The two regional centers would accept “custody” of people under the emergency detention process. This would better utilize law enforcement personnel because officers would not need to wade through the often lengthy medical clearance process in hospital emergency departments.

The proposed budget allocates about $8 million over two years to support development of regional crisis stabilization facilities for adults who require short-term stabilization services, diverting them from more restrictive and likely costly settings, such as inpatient hospitalization.  The budget also allocates $1.8 million to develop a psychiatric residential treatment facility, which would provide treatment for up to 25 children and youths under the age of 21 with complex behavioral health conditions. It also expands Medicaid benefits so that it covers care at a psychiatric residential treatment facility. Lastly, the budget includes $23.2 million in funding to expand the Juvenile Treatment Center at Mendota Mental Health Institute.

Investing in Suicide Prevention and Crisis Lifeline Support

In 2024, the state’s 988 lifeline received more than 100,000 calls and messages from Wisconsinites seeking support, guidance, and resources, a significant increase in demand from its inception a couple of years ago. The proposed budget aims to fully fund Wisconsin’s 988 lifeline by providing $12 million over two years to support our state’s 988 suicide and crisis lifeline call centers. This will allow centers and staff to better meet the increasing support needs of people calling 988. 

Investing in Medicaid to Improve Mental Health and Substance Use Services and Better Support Counties

Medicaid—including BadgerCare which provides health insurance for children, parents, and adults with lower incomes—is the largest payer for mental health and addiction treatment services in the US. This is also true in Wisconsin. As illustrated in a recent report, Medicaid plays an especially critical role in rural communities and small towns, where household incomes are generally lower and fewer people have employer sponsored health insurance. Medicaid expansion, which the governor proposed in his budget, would likely increase access to mental health treatment and decrease instances of people delaying care due to costs. 

The budget proposes several investments that will help increase access to mental health care and substance use disorder treatment. Most notably, the budget proposes that Wisconsin pay the non-federal cost of Wisconsin’s Community Support Program, which offers community-based care and treatment for adults living with a severe mental illness diagnosis that interferes with their activities of daily living. Statewide, this would free up roughly $40 million over the biennium that counties can use to meet other community needs, such as housing or education. 

The budget also includes $9 million to increase Medicaid reimbursement rates for medication assisted treatment for individuals struggling with addiction. 

Strengthening Peer-delivered Services

People with lived experience of mental health and substance use challenges are uniquely positioned to provide support to others who are navigating the behavioral health system. Many studies have demonstrated the effectiveness of peer support services in reducing hospitalization, increasing use of outpatient services, and improving quality of life. The Governor’s proposed budget makes several important investments in peer-delivered and peer support services, like:

• expanding Medicaid funding of services provided by certified peer specialists;
• increasing support for existing peer recovery centers that provide resources, skill training, and peer support to adults with mental health and substance use disorder challenges;
• $1 million over the biennium to support the statewide peer-run warmline, which provides support and connection for non-emergency mental health and SUD needs; and
• $2.7 million in stabilizing funding that supports the five regional state-funded peer-run respites, including one run by and for veterans. Peer-run respites are for adults experiencing increased stress or symptoms related to mental health and substance use concerns who want support and encouragement from people who have experienced similar challenges. Either through short-term overnight stays or by phone, peer-run respites provide an important resource in the continuum of care and can be an alternative to hospitalization for some people.

Investing in and Supporting Providers of Mental Health and Substance use Disorder Services

More than 1.5 million Wisconsin residents live in our state’s 169 mental health care professional shortage areas. As of today, providers can only meet about 40 percent of the state’s needs. According to County Health Rankings there was, on average, one mental health provider per 400 people in Wisconsin – considerably worse than the national average of 320:1. Governor Evers’ budget proposes targeted investments to increase the number of mental health providers and makes it easier for them to get education and training by: 

• Dedicating $3 million to support a trainee grant program that aims to increase the number of mental health providers to help address shortages in the workforce. 
• Allocating $5 million to increase access to health education and training grants and expanding eligibility to include mental health providers. The Governor also recommends removing matching fund requirements to reduce barriers to would-be grantees. 

Supporting Mental Health Needs of Farmers and Farm Families

While farmers experience higher levels of distress and depression than the general population, they are less likely to seek help. For those who do seek help, it might be very hard to find. Across the nation, 60 percent of rural Americans live in a designated mental health shortage area.

In Wisconsin, 35 of our 45 non-metro counties have the entire county considered a mental health professional shortage area. The governor’s budget allocates a modest $200,000 over the biennium which would be a $100,000 increase, to continue to provide and expand mental health assistance to farmers and farm families. 

Governor Evers’ proposed budget creates a more robust mental health system, better equips schools to provide care, expands the continuum of care, and rethinks and reduces the role of law enforcement in addressing mental health and SUD emergencies. Addressing student’s mental health needs as well as strengthening programs that prevent and divert from more intensive services will likely improve quality of life for families and communities, reduce trauma and stress from incarceration or forced hospitalization, and reduce costs associated with confinement in jails, prisons, and psychiatric hospitals. Investments in Medicaid, county mental health/SUD services, and supporting the mental health needs of farm families would benefit residents in rural Wisconsin communities and small towns. 

*Sexuality, sex, and gender data are collected separately on the YRBS. As a result, LGB is used instead of LGBT or similar acronyms to most accurately reflect how student data was collected.