Election 2019: Hear from the Madison Mayoral Candidates on Mental Health Issues Before Tuesday's Vote

Wisconsin State Journal Photo Illustration  Madison mayoral candidates. Clockwise from upper left, Satya Rhodes-Conway, Toriana Pettaway, Paul Soglin, Nick Hart, Raj Shukla and Mo Cheeks are looking to lead Madison for the next four years. The primary is Tuesday.

Wisconsin State Journal Photo Illustration

Madison mayoral candidates. Clockwise from upper left, Satya Rhodes-Conway, Toriana Pettaway, Paul Soglin, Nick Hart, Raj Shukla and Mo Cheeks are looking to lead Madison for the next four years. The primary is Tuesday.

NAMI Dane County invited all Madison Mayoral candidates to respond to five questions aimed at addressing candidates’ stances on several key mental health issues. Of the six candidates, four provided a response: Paul Soglin, Satya Rhodes-Conway, Mo Cheeks, and Raj Shukla. Candidates Toriana Petteway and Nick Hart did not provide a response.

Candidate responses are listed in the order in which they were received.

*NAMI Dane County is a non-partisan organization and does not endorse any candidate. We support policies that improve the quality of life of people affected by mental illness.

Questions:

NAMI: HOW WILL YOU HELP CHILDREN AND YOUTH IN MADISON GAiN EARLY ACCESS TO MENTAL HEALTH CARE? WHAT PROGRAMS OR INITIATIVES CURRENTLY UTILIZED DO YOU SUPPORT OR WOULD YOU SEEK TO EXPAND?

Paul Soglin: Before I proceed to answer your questions allow me to tell you what we are doing which is, in part, responsive to all of your questions.

Madison was one of the first to join Cities Thrive a collaboration organized by New York City’s First Lady, Chirlane McCray. Our Federal Legislative Agenda  is one to which I subscribe.

Also, as I answer these questions, please keep in mind that County and State government are charged with mental health, behavioral health, and substance abuse treatment. That said, the City of Madison and I will aggressively work to see expansion of services.

First, we must enroll the 20,000 families in Dane County that are still uninsured.  Second, we must work with Governor Evers to expand Wisconsin’s participation in the Affordable Care Act, expanded Medicaid enrollment, and BadgerCare. Third, we need to work with the health insurance companies and get them to expand service for behavioral health treatment, particularly as it applies to substance abuse. Fourth, all providers need to provide treatment that is culturally appropriate. Obviously, children should not be subject to conversion therapy and the State of Wisconsin must join Madison in adopting legislation banning that form of abuse. We must all work together to remove the stigmas associated with mental illness and substance abuse.

Satya Rhodes-Conway: Mental health issues develop early. The best chance of preventing recurrent or life-long mental health issues is early intervention and treatment. Depression, anxiety and suicidal thoughts and actions have increased in our society over the past decade. Therefore, easy and early access to mental health services is crucial. The City should be a stronger partner with Dane County and organizations like NAMI working with to schools, MSCR, child care centers, neighborhood centers and other places where children and youth gather or are served. Staff of these places will be able to give information about the issues and needs of the children they are seeing. Many students in MMSD have either primary or secondary trauma that needs to be recognized and treated.

The City should help to educate the public about mental health issues and normalize accessing mental health care. For all communities, but especially those that are marginalized, there needs to be targeted public education to normalize issues of mental health and mental illness (e.g., anti-stigma messages), about mental health services available, and to offer guidance about how to access them. This is especially true for communities of color and immigrant communities who do not have the same mainstream beliefs or understanding of/language for mental health/illness.

Access to services is complicated and can be exhausting; a by-product is often that families give up and do not even get to the point of finding out what their child needs. The City can help increase awareness about the services that NAMI and United Way’s 211 provide to give advice about how to make ”the next call the right call.” City RFPs should include direction that proposers explain how they can notice, serve, or refer their consumers or members who need mental health services.

Mo Cheeks: Crisis intervention and mental health services for young people in Madison are critical. I support intervention and counseling services, such as those provided by Briarpatch and would look to expanding services. Also, as mayor, I will lead an effort of city, county, non-profit and private-sector stakeholders to build a strategic framework that funds, builds and operates a Mental Health Crisis Center.

Raj Shukla: Madison has a strong but somewhat disconnected network of programs that help children in targeted neighborhoods. As we seek to expand programs, we need to work directly with service providers in neighborhoods where the population has been identified to have higher risk factors. According to reports put out by Race to Equity (Kids Forward) and the University of Wisconsin, risk factors to identify include communities with:

  • Disproportionately high incarceration rates 

  • Low Graduation rates

  • Higher unemployment

  • Highest rates of teen pregnancy

  • Epidemic STD rates

  • High infant mortality rates

  • Higher diabetes rates

  • High obesity rates and the lowest level of access to fresh, health foods and sources for recreation in the city

As mayor, I will work directly with neighborhood service providers so we can all collaborate on best practices and provide comprehensive coverage throughout the city. What I have found from my conversations with leaders in all corners of the city is that the leaders who work directly in neighborhoods know what is best for the kids who live there. The city should empower these leaders and support their efforts rather than pushing a bureaucracy upon them.

Dane County has a large human services budget (over 200 million dollars) and most of the service providers are funded through the county. The city and county have historically operated in silos and in order to avoid duplicating services, we must establish and grow a strong city and county partnership. The County has hired a new human services director after long time director Lynn Green retired. This is a perfect opportunity with new leadership at the city and county level to forge strong partnerships. This is one of many areas where we need to strengthen our relationship with the county.  The city should view them as

If elected mayor, I will make early childhood education and comprehensive round the clock mental health care and support a top focus. I have seen how my daughter who has a disability has thrived with community support and I will make sure the support that was given to her is given to all of the kids in our city.

NAMI: HOW WOULD YOU SUPPORT THE MADISON METROPOLITAN SCHOOL DISTRICT TO ENSURE THAT SCHOOLS HAVE RESOURCES AND SUPPORTS TO INCREASE UNDERSTANDING IN REGARD TO MENTAL WELLNESS, PROVIDE SERVICES TO UNDERSERVED POPULATIONS, AND REDUCE DISCIPLINARY DISPARITIES FOR CHILDREN AND YOUTH WITH MENTAL HEALTH NEEDS?

Paul Soglin: First, I would have the state remove the spending limitations on public school districts and provide greater shared revenues to our public school system. Lack of adequate funding is probably the greatest impediment to schools having appropriate resources. Several years ago, the Madison School District dropped its ‘zero tolerance policy.’ That was a step in the right direction recognizing that severe punishment, including arrest, was not the answer to aggressive or uncontrollable behavior on the part of a student.

Now we must take the next step – recognizing the role of trauma in shaping behavior and treating violence as a health issue. Simply put, every student must be provided culturally appropriate treatment. I see the absence of qualified group homes and treatment facilities as a major problem in Dane County. They would provide an alternative to Lincoln Hills and other more severe punishments for troubled youth.

Satya Rhodes-Conway: It starts with being able to work with people. As Mayor, I would partner with MMSD in their efforts to train staff in mental health awareness and to connect students (and staff) to mental health care. One venue for this partnership could be the Education Committee, since there are representatives from the County there as well. Another would be to help MMSD advocate for more resources from the State. While I think this effort needs to be led by MMSD, some ideas for these services include:

  • Peer support – some school districts have peer supports within the school setting. These are students who are trained and willing to listen non judgmentally, some have identified themselves as having mental health issues

  • Better use of IEPs, including an opportunity for students to direct in advance how they would like to be helped when they are in crisis and not able to make good decisions about their behavior

  • Mindfulness/meditation quiet rooms, along with staff training for how to direct/redirect students to the room

  • More support staff from social workers to aides to provide one on one de-escalation techniques—with enough resources, all school staff would be able to call on those with behavioral health training to help whenever possible

Mo Cheeks: Children and youth in Madison should be growing up in a city that believes in and demonstrates support for all of our kids. As Mayor, I’d proactively work to collaborate with the district to identify ways to ensure that families with students suffering from mental health wellness concerns have the support that they need. Connecting these youth with mental health support, health support, or mentorship, are all things that the city could play a role in.

Raj Shukla: I have three daughters in the Madison public schools. A strong education system is vital if we are to continue to prosper. The future of the city is only as strong as the quality of its educational system. It is critical that the city pursue every opportunity to further collaborate with and strengthen the Madison Metropolitan School District.

Our city has much wealth, and many resources. It should escape no one, that while the average household income is almost $60,000, well over 15% of our residents live in poverty. This is reflected in the 48% of MMSD kids who are considered low income. We are a city splitting into the haves and have nots. 

We must offer more wrap-around services for families who are struggling with housing and food insecurities, and we will have to develop support from the private sector and non-profit community in order to accomplish that goal.  My career began working on economic development in Wisconsin’s poorest zip codes, and I believe that my experiences will be a real asset in this area.

Teachers tell us that no student can learn if they are tired or hungry. Children with disabilities have had services cut and are increasingly pitted against other students with acute needs for resources. I will work with community partners to offer stable housing options for stressed families and expand programs like Madison Out of School Time (MOST).

We must also make sure quality early childhood care is available for all families. I will work to assemble the people and resources necessary to scale up effective early childhood care models. I think if we could gather a coalition around providing quality early childhood care, specifically ages 0-3, it could do wonders to close the achievement gaps we see in our city.

The city can assist children with disabilities by ensuring equal access to safe transportation, recreation, and after-school options. That means city services and amenities that impact youth with disabilities will be equipped to offer reasonable accommodations.

The city must also be a vocal advocate for public education in the Capitol. Working with municipal leaders across the state, I believe we can turn the tide and bring back bipartisan support for public education.

NAMI: WHAT WOULD YOU DO TO INCREASE CAPACITY OF LAW ENFORCEMENT TO SUPPORT INDIVIDUALS WITH MENTAL HEALTH NEEDS IN CRISIS? WHAT OTHER IDEAS OR PROGRAMS WOULD YOU ADVOCATE FOR THAT WOULD REDUCE THE LIKELIHOOD OF USING LAW ENFORCEMENT TO DEAL WITH INDIVIDUALS EXPERIENCING A MENTAL HEALTH CRISIS?

Paul Soglin: Adding mental health officers to the Madison Police Department was a good first step.  Training all officers and providing all officers the authority to refer a potential arrestee to the Madison Area Recovery Imitative (MARI) as an alternative to arrest is another positive step we have taken.

I would like to see a system evolve where the criminal justice system has greater flexibility in recommending treatment beyond situations involving substance abuse. That is, extending treatment in cases where the subject’s own experiences with violence and trauma are at issue, should be an option. But that will only work if treatment is readily available – something I support and will continue to work for so long as proper restraints are in place, particularly in domestic abuse cases.

Satya Rhodes-Conway: Mental health should be treated as a public health issue not a law enforcement issue. Except in situations of imminent danger or violence, law enforcement should NOT be the first response. We need to increase awareness of and access to mental health services to help prevent crises. And we need to make sure that law enforcement officers have training in mental health awareness, so they can compassionately get people the help they need while keeping everyone safe. That might include:

  • Mental Health First Aid, an evidence-based practice endorsed by the National Council of Behavioral Health

  • NAMI’s Crisis Intervention Team (CIT) and Crisis Intervention Partner (CIP) training

I also support the work that Dane County has done on the emergency mobile mental crisis program. And of course, one of the chronic problems is access to adequate treatment. As Mayor, I will ensure Madison is an advocate with the County and the State to increase access to treatment.

Mo Cheeks: On the City Council, I’ve supported funding for the Madison Police Department’s mental health team. As mayor, I’d work to ensure that public safety in Madison starts with an intentional role for social workers to be part of the first response when necessary. I’m also interested in being strategic about how we can deploy social workers. I’d like to see if there could be a role for social workers to be deployed as first responders through the fire department, and thereby removing the stigma of policing from the experience when dealing with someone in trauma. Finally, I will work to build a mental health crisis and restoration center, that will seek to eliminate the existing dependence on officers to drive people all the way to Winnebago Mental Health Institute when they need help.

Raj Shukla: MPD has been a leader in acknowledging mental health issues and adding mental health workers to assist with their work. I have met with MPD’s mental health liaison, and they need more assistance. MPD has also hired a significant percentage of women and people of color.  The department should work to ensure there are more women and people of color in leadership roles. More can be done to diversify the force and improve relationships with the community. 

NAMI: AS MAYOR OF MADISON, HOW WOULD YOU REDUCE OR ELIMINATE BARRIERS TO ACCESSING TRANSPORTATION, GAINFUL EMPLOYMENT, AND HOUSING FOR INDIVIDUALS WITH MENTAL HEALTH NEEDS?

Paul Soglin: Actually, I would suggest that the availability of housing is a barrier to just about everything including transportation and employment so that is where we need to start.

Rethke was a good first step and we, the City of Madison, learned a lot in providing 50 units of housing for chronically homeless individuals, almost all of whom had behavioral health or substance abuse challenges.  The bottom line is we can do a lot but the City, or should I say the individual residents, need more assistance in regards to case management and treatment. The City is undertaking the capital cost of building the apartments and lowering their operational cost. We can do only so much.

I will be blunt. There are plenty of people out there with advice as to what needs to be done: there are very few people and organizations prepared to step up and provide the appropriate management, case management, and supports the residents need. Please help us, and work with us, to move toward solutions.

Satya Rhodes-Conway: First of all, we need to recognize that mental illnesses and other severe mental health issues are real diseases or disabilities just as are physical conditions. As such, we need to know that mental health problems can result in thought or mood disorders that make it difficult to navigate the world to access basic needs. Of course, this is even more difficult if one has inadequate housing—and maintaining housing is fraught with its own problems of affordability and the necessary skill sets of housekeeping, being a good neighbor, etc. In all of these areas, one must have the motivation and confidence to take on the myriad tasks of daily living, tasks that are incredibly difficult when one is dealing with depression, anxiety, stress from trauma or episodes of psychosis. So these issues are intertwined and circular.

To help overcome these barriers, the City can:

  • Lead by example in hiring and supporting individuals with mental health issues, and encourage the private sector to do so as well

  • Champion anti-stigma efforts

  • Continue and improve our Housing First approach

  • Advocate for more and better AODA services

  • Continue to work to provide transportation that is accessible and affordable for all

  • Work with the Evers administration and the State Dept. of Human Services to work on a Wisconsin-based service to provide Medicaid transportation services

Mo Cheeks: The barriers for individuals are unfortunately apparent when some employers or landlords may perceive that some people with mental health needs have extra costs associated with them. Access to housing that is accessible and affordable is sparse, and not necessarily near businesses that are accommodating, so then transportation becomes a barrier.

Access to knowledge is a key place to start. United Way of Dane County now has a 211 program. This is a great addition to the community and a service that I’m grateful that as Mayor is already in place. Ensuring it has up to date information at all times about how to assist folks with mental health needs to access transportation, employment, or housing would be important to me. 

Raj Shukla: Many barriers are rooted in poverty.

  • Employment. There is a huge opportunity for the city to create family-sustaining jobs while we transition Madison to a sustainable city. Greening our transit system, investing in energy efficiency and expanding renewables in the city are priorities. We can use this opportunity to support training and access to green jobs for people able, and interested in building a green infrastructure in Madison, but who may need a helping hand. My career began in Milwaukee working in economic development, and that background has prepared me to take an active role in bringing together city government, residents, and even the utility companies to reach our sustainability and economic prosperity goals.

  • Housing. I think that historically single-family zoning was used to keep people of color and people who were struggling out of certain neighborhoods.  One option that I think Madison should explore is to consider zoning reforms like those implemented in nearby Minneapolis, MN and Grand Rapids, MI. These changes have already been implemented to increase housing choices for everyone. They revolve around limiting or even eliminating single-family zoning. Other cities have implemented minimum density requirements for new development in certain neighborhoods. All options have to be on the table to create a formula that meets both our equity and environmental standards.

  • Transportation. The bus is not just an “option” for many people. It is a necessity. Many people can’t afford a car. Others aren’t able to drive because of age, disability, or medical concerns. We need to look at our transit system as an extension of our roads, not as an alternative to cars. Metro has to be for everyone. As mayor, I will establish a transit equity council to imagine a transit system that works for everyone. I will explore options to create fare-free or extended service zones that compensate for slow service, add service options and drive investment toward areas that need it most.  We can and must also work diligently to expand access to safe cycling and pedestrian options for everyone.

NAMI: AS MAYOR OF MADISON, WHAT WOULD YOU DO TO MEET THE MENTAL HEALTH CARE NEEDS OF IMMIGRANTS AND REFUGEES?

Paul Soglin: Last year we stepped in an interim basis to assist when the County’s contractor failed to continue services for the Hmong/Kmer community. I even put money in the 2019 budget to make sure there was no gap in services. But that is not a viable long-term solution.

First of all, we need providers who can demonstrate culturally appropriate services for the respective communities. That means educational institutions have to aggressively and affirmatively recruit individuals to serve their communities. Second, those who provide services must pay salaries commensurate with professional standards. Lastly, we are back where we started with the first question: everyone needs insurance that covers mental health services, regardless of their citizenship status. Again, I will continue to meet with the health care providers and the insurance carriers to urge their expansion of coverage.

Satya Rhodes-Conway: We need to make sure there is culturally-competent and specific mental health care available to all Communities of Color in Madison. We should have RFP processes in place for all funding (except short-term emergency situations). Decisions about who gets City funding for culturally-specific mental health services should be informed by the potential users of those services, including having representatives on the RFP committees.

Education is needed—both in terms of what mental health issues are, normalizing them and explaining available resources and responses AND in providing assistance in how to access resources including how to write proposals, and how to testify at committee meetings. Specific efforts and programs are needed so that the services and responses are culturally resonant to the target population. The city’s grants for emerging programs and peer supports are examples for initiatives suited to new groups in the community. Other purchase of service programs, such as those in the Aging services area, should also be reviewed to ensure that applications from immigrant and refugee groups are being invited.

Collectively, we must deliver services in the ways they will be used. The services offered by the Cambodian Temple for the Khmer is a good example. When mainstream services were not being used by a group that was in need of treatment for severe post-traumatic stress disorders due to the war and dislocation experiences they had been through, city leaders met with their community leaders. They learned that the way people would be comfortable considering treatment was if the monk gave his blessing to such treatment. Thus, a monk was sponsored and brought to this country and services were attached to the Temple. It has been a successful and effective strategy that is instructive for how to serve immigrant and refugee communities as they arrive in our city.

Mo Cheeks: As our community works to establish a mental health crisis and restoration center, I believe that the facility needs to prioritize being culturally competent for all of our residents. I also believe the work of Freedom, Inc. is important for our immigrant and refugee communities; as well as the Kajsiab House and Access Community Health. As mayor, I’d seek to continue to support facilities that focus on addressing the mental health needs of marginalized populations.

Raj Shukla: As a person of color and son of immigrants, this issue is personal to me. We must find ways to hire more therapists of color.  I believe that right now, the Goodman Center on the east side in collaboration with Anesis Therapy has one of the only counseling centers in Dane County staffed by therapists of color.  We should reach out and ask the UW to partner with the city on this manner.  We must do more to ensure there are therapists who understand what people are facing.

The ongoing funding crisis around Kajsiab House is troubling and should remain a priority for the city and Dane County. Culturally sensitive mental health counselling and therapy is essential. Personal services that offer a variety of wrap-around services, help with the navigating the social service system, English and citizenship classes, daily meals, and social connection were vital to the Hmong/Kmer community. The same types of services are essential for other cultural groups and it is imperative that city lead efforts to adequately fund such services.

BEST OF LUCK IN TOMORROW’S PRIMARIES AND THANK YOU FOR YOUR RESPONSES!