GLOSSARY of MENTAL HEALTH TERMS Collaborative Assessment and Management of Suicide (CAMS): An approach to treating suicidality that emphasizes problem-focused intensive outpatient treatment. Columbia Suicide Severity Ratings Scale (C-SSRS): A tool to assess suicidal ideation, commonly used in emergency departments. Free on-line training and forms available at http://www.cssrs.columbia.edu/ Corporation Counsel: In Wisconsin, civil commitment cases are prosecuted by a county’s Corporation Counsel. A person who is involuntarily hospitalized or committed to treatment will be appointed counsel through the Wisconsin Public Defender’s Office. See Wisconsin statutes § 51.20(3) and § 51.60. Council on Mental Health § 51.02: Created in 1983, among other duties, the council on mental health is to serve as an advocate for persons with mental illness and advise DHS on the expenditure of federal funds received under the community mental health block grant plan. Counseling on Access for Lethal Means (CALM): Free on-line training to promote the recognition among healthcare providers of the danger of ready access to lethal weapons with the goal of educating patients and families, decreasing access to lethal means, and saving lives. Crisis Assessment Response Team (CART): a partnership between the Behavioral Health Division of Milwaukee County’s Department of Health & Human Services and the Milwaukee Police Department, the team is comprised of crisis team clinicians and police officers who can respond to situations when police intervention may be needed. Crisis Mobile Team: A service of the Milwaukee County Behavioral Health Division, the crisis mobile team is a telephone and mobile crisis service for adults and is available to provide assessments in the community if it is impractical for the individual to come to the Behavioral Health Division’s psych assessment center. Emergency Detention (commonly “ED,” “Chapter 51 Hold,” “Chapter,” “Hold,” “24 hour hold”) – Milwaukee County § 51.15 (4): A police hold (in the case of an adult, or a hold by a person authorized under Ch. 48 “Children’s Code”) which allows an individual to be involuntarily detained up to 24 hours* (does not include time directly attributable to evaluation or stabilizing treatment of non—psychiatric medical conditions) because a police officer has filed a statement in support of commitment that the individual evidences a substantial probability that they are dangerous to themselves or others. The officer or authorized person under Ch. 48 must also believe that the dangerousness is related to mental illness or drug use or a developmental disability. The Behavioral Health Division treatment provider must make a determination within 24 hours whether or not to continue to detain the person, and the Probable Cause Hearing must take place within 72 hours. *See also, Treatment Director’s Supplement. Emergency Detention – other than Milwaukee County § 51.15(5): Same as above except the detaining officer’s statement in support of commitment allows the individual to be held up to 72 hours before a probable cause hearing is held. Emergency Detention (Detention Pilot Program; Milwaukee County only) § 51.15(4m): 2013 Wisconsin Act 235 established a pilot program effective April 10, 2014, that authorized certain mental health professionals in Milwaukee County to carry out emergency detentions and requires the Legislative Audit Bureau (LAB) to conduct a performance evaluation audit of the pilot program to include the effectiveness of the emergency detention procedure under the pilot program. The Pilot Program was established in response to criticism of Wisconsin’s usual practice of utilizing law enforcement rather than mental health professionals to make emergency detention decisions. The law remained in effect until July 1, 2017. The LAB’s audit report was published December 2017 and concluded that too few individuals were assessed and too few emergency detentions were conducted under the pilot program to allow for meaningful comparison with those assessed before the pilot program. Emergency Mental Health Services Program (“Crisis Intervention”) DHS 34, Subchapter II: Most counties have what’s commonly called “crisis intervention” programs, which are the agencies charged with approving hospitalizations for individuals under an emergency detention by authority of Wisconsin Chapter 51.15. 2015 Wisconsin Act 55, §1881 amended Wisconsin Chapter §51.15(2) in relation to emergency detentions to require a “physician who has completed a residency in psychiatry, a psychologist, or a mental health professional to perform a crisis assessment on the individual and agrees with the need for detention and the individual will not voluntarily consent to treatment necessary to stabilize the individual and remove the substantial probability of harm to himself, herself, or others.” The crisis assessment may be conducted in person, by telephone or by telemedicine or videoconferencing technology. The amendment took effect July 1, 2016, and is likely to have substantial effect on some (smaller) counties, and little or no effect on other (larger) counties. Involuntary commitment for treatment § 51.20 (see “Three Party Petition”). Lessard, Alberta – The Wisconsin woman whose landmark lawsuit changed the mental health commitment landscape nationally. The schoolteacher’s case was heard by a federal district court in Milwaukee, with the court finding Wisconsin’s commitment laws unconstitutional, rejecting the traditional parens patriae grounds for commitment, and replacing it with a dangerousness standard. Additionally, the court for the first time required that commitment proceedings provide the mentally ill with all the protections afforded the criminal suspect such as right to counsel. The case was appealed to the U.S. Supreme Court. See Schmidt v. Lessard, 414 U.S. 473 (1974). Mental Health America of Wisconsin (MHA of WI): An affiliate of the nation’s leading community-based non-profit dedicated to helping all Americans achieve wellness by living mentally healthier lives, MHA of WI’s website provides information on MH services in all Wisconsin counties: http://www.mhawisconsin.org/search-stateresources.aspx Milwaukee County Mental Health Board (MHB): established in 2014 through Wisconsin Act 203, the board is made up of 13 volunteer members and includes mental health professionals, consumers and advocates. The MHB is responsible for setting policy for the Behavioral Health Division of the Milwaukee County Department of Health & Human Services. Mobile Urgent Treatment Team (MUTT): A service of the Milwaukee County Behavioral Health Division, MUTT is a telephone and mobile crisis service for children and adolescents (under age 18) and is available to provide assessments in the community if it is impractical for the child to come to the Behavioral Health Division’s psych assessment center. National Instant Criminal Background Check System (NICS): The federal background check system intended to prevent the dangerously mentally ill from purchasing firearms. A person subject to a federal “mental health prohibitor” may not legally possess or receive firearms. To date, the NICS is generally regarded as ineffective in fulfilling its intended purpose. Office of Children’s Mental Health § 51.025: Created by legislation in 2013, this office is to study and recommend ways to improve mental health services to children. Each January 1st it must submit a report summarizing how the state’s delivery of mental health services for children could be improved. Probable Cause Hearing § 51.20(7): A preliminary hearing at which typically a court commissioner decides if there is probable cause for commitment. Probable cause is found if there is evidence of mental illness (and/or drug use or developmental disability) and dangerousness, and that the person is an appropriate subject for treatment. Note: most cases do not go through the full commitment process. Usually, the individual improves sufficiently before the trial and is released OR the individual agrees to treatment and signs a settlement agreement. Psychiatric Crisis Service (PCS) Admission Center/Observation Unit: A program of the Milwaukee County Behavioral Health Division, the Psychiatric Crisis Service - Admission Center (PCS) is located at 9499 Watertown Plank Road. PCS provides 24-hour, 7-day psychiatric emergency service. As part of the crisis service, PCS provides assessment and evaluation, crisis intervention, medications, and the capacity for observation for up to 48 hours as needed. In addition to referral and coordination with other mental health providers, persons are evaluated for possible admission into the Behavioral Health Division inpatient units or for admission to a community psychiatric hospital. Request for Discharge (“R.F.D.”) § 51.10(5)(b): A document that a patient who voluntarily agreed to inpatient psychiatric treatment can request to sign which puts in writing their wish to be discharged. From the time this request is made known to the treating staff, the treating physician has up to 24 hours to address by either releasing the patient OR filing a “Treatment Director’s Affidavit.” 51.10(5)(c). The probable cause hearing must then be held within 72 hours. Settlement Agreement § 51.20(8)(bg) – At any time after the commencement of the commitment proceedings, the subject of the commitment can agree to waive the time period for the probable cause or final commitment hearing and to receive treatment for up to 90 days. The settlement agreement must include