Crisis team reducing emergency detentions County looks at expanding CART program

Since Marathon County started its Crisis Assessment Response Team (CART) in 2018, the number of people detained by police due to mental illness has decreased, even as the overall number of calls for service has gone up, Lt. Nathan Cihlar told the county’s Public Safety Committee last week.

CART is a joint operation of the Marathon County Sheriff’s Office, Wausau Police Department (WPD) and North Central Health Center (NCHC). The program pairs plainclothes police officers with mental health professionals to handle 911 calls and other referrals that involve people suffering from psychological problems.

Lt. Cihlar, an officer with the WPD, said CART’s main goal is to reduce the number of people who go through the emergency detention process, which is both costly to the county and traumatic for the individual involved. He and representatives from the sheriff’s department and NCHC spoke to the committee at its June 6 meeting after county administrator Lance Leonhard previously mentioned that the county is looking at expanding the program.

In the past, before crisis training was provided to officers, Lt. Cihlar said it was common practice for anyone talking about killing themselves or exhibiting other signs of mental illness to simply be taken into custody and dropped off at a mental health facility. Now, as the result of statutory reforms passed in 2014, he said CART members spend more time with the person and help them find the least restrictive option for keeping themselves and others safe.

“We’re trying to keep them in the community, keep them in their homes, instead of cycling them through the crisis center and everything that comes with that,” he said.

Lt. Cihlar said CART members also follow up with people they’ve encountered, helping them connect with resources that can help break the cycle of problematic behavior. He said those with paranoid delusions often raise concerns among neighbors and others in the public who expect the police or someone else to do something. This is where CART comes in.

Nearly any call that officers respond to – from welfare checks and domestic violence to drug overdoses and traffic incidents – can involve mental illness in some way, Lt. Cihlar said.

“Mental health is intertwined in so many different kinds of calls,” he said.

Because the types of incident are so varied, Lt. Cihlar said it’s difficult to quantify exactly how many mental health calls the county responds to, but welfare checks and calls specifically designated as “mental health” incidents have been on an upward trend in recent years. At the same time, however, he said the number of emergency detentions is going down.

“Really, that’s been the whole goal of CART, to reduce that frequency at which we take people into custody,” he said.

Based on the number of emergency detentions so far in 2023, Lt. Cihlar said the county hopes to end the year with a record low. If the current trend continues, the result would be a 46 percent drop in detentions since 2017.

All officers, not just those in CART, are encouraged to take crisis intervention training, which is offered every year through Northcentral Technical College, with an emphasis on teaching de-escalation skills and reducing use-of-force incidents, he said.

Supervisor Stacey Morache noted that a Wausau PD task force has recommended expanding the CART program and she wanted to know what that would entail. Lt. Cihlar said the team currently has just two mental health professionals, and they’re sometimes needed at the crisis center, so it would nice to add more of them to the program.

“We’re going in the right direction, and more people would certainly help,” he said.

Vicki Tylka, managing director of community programs at NCHC, said unfortunately the center currently has a 40 percent vacancy rate among its crisis staff positions.

“We’re really at a point where that is our priority – to get those positions filled – before we can look at any expansion,” she said.

When CART got started five years ago, the WPD, NCHC and the sheriff’s department each added at least one staff member in order to provide fulltime support for the response team.

Tylka said NCHC is making progress with hiring new employees, but working in crisis management is “a hard job.”

“We do have some new people who started recently, so that’s great,” she said.

Budget discussion continues

As part of an ongoing discussion about the 2024 budget, Supervisor Morache asked a series of questions about the county’s court diversion programs, which are not mandated by the state.

Ruth Heinzl, director of the county’s diversion programs, said they prevent about 500 people per year from going through the court system, saving money spent on prosecutors and judges. She said participants pay a $75 fee to the county, but the state average for similar programs is $250.

Heinzl said she would recommend against raising the fee, simply because of how much staff time it requires to get people to pay it upfront, causing delays in the process.

“I would love for you to get rid of the fee – if you wanted to do that to save staff time – but I would just hesitate in increasing it to the state average,” she said.

County administrator Lance Leonhard said evaluating the court diversion fee is a great conversation to have as part of the overall budgeting process.

“Maybe we find out that the juice isn’t worth the squeeze on the $75,” he said.