STATE OF WISCONSIN

Gaylord A. Nelson GOVERNOR

Madison 2 December 30, 1960

Mrs. Albert D. Lasker
National Committee Against Mental Illness, Inc.
1028 Connecticut Avenue N.W.
Washington 6, D.C.

Dear Mrs. Lasker:

I can assure you that my executive budget, which I will send to the
legislature about February 1, will provide for an expansion in the
field of mental health. Just how extensive this will be I cannot say
at the moment; I am currently in the process of examining budget requests;
like most other states, Wisconsin faces a critical financial crisis.
But I feel strongly that we must meet these needs, even though the
financial aspect may prove to be painful to many.

!Xy staff has prepared a summary of the proposals made by the Department
of Public Welfare so that you may see what we are contemplating in
this field. I shall enclose the welfare department's budget proposal
in case you are interested in more detail. I shall also enclose a
preliminary report on the problems of mental retardation which is soon
to be issued by the special committee on mental health which was
established last year and which has been working diligently at this
aspect of the problem.

The summary follows:

In Wisconsin the state mental hygiene program is administered by the
Department of Public Welfare through its Division of Mental Hygiene.
This program operates through a system of eight state administered
institutions and 36 county mental hospitals which receive financial
aid and program supervision and consultation from the State. (Milwaukee
County operates a more complete program of treatment for its own
mentally ill residents.) In addition, community mental health clinics
are developing rapidly under a new program of state aids.

Executive budget requests for the mental hygiene program total
$63,644,351 for the 1961-63 biennium. This represents an increase
of $12,782,806 over estimated expenditures of the current 1959-61
biennium, a 25.1% increase. Major factors in this increase include
928 added positions costing $6.5 million (433 to staff new facilities);
the increased cost of 2943 existing positions ($1.7 million); and
anticipated increases in state aids to county mental hospitals
($2.8 million); and community mental health clinics ($.7 million
increase) .

Mrs. Albert D. Lasker
December 30, 1960
Page 2,.

Wisconsin's community mental health clinic program received impetus
in 1959 with the adoption of a program of state financial aid to
local clinics.' Since then the program has expanded more rapidly
than anticipated, making it necessary for the Department of Public
Welfare to request supplementary funds in the current fiscal year.
There are presently 13 clinics receiving reimbursement; the 1961-63
program anticipates 19 such clinics. Indicators of this expansion
of community services are a 44.8% increase in professional staff
time available to patients and a 16.5% increase in number of
patient interviews between program year 1958-59 and 1959-60.
aids requested for this pro ram in 1961-63 are $1,100,000.
current biennium (1959-61) $414,450 is the estimated actual expendi-
ture.

State

In the

Further emphasis upon community mental health improvements include
a requested expansion of psychiatric social worker field staff from
two to eleven workers. This promising program offers two major
areas of service; (1) Direct casework services aimed at rehabilitation
and psychiatric maintenance of patients discharged from institutions,
and (2) Consultation and developmental services to local communities
attempting to improve their programs for the mentally ill,

Wisconsin's county hospital system comprising 36 separate institu-
tions located throughout the state offers many potential benefits
to local mental health programs, During the coming biennium the
Department of Public Welfare will undertake the administration of a
code of minimum standards for these county hospitals as developed
by a legislatively established study committee. In addition, the
Department is requesting 12 professional consultants in the areas of
psychiatric nursing, social work, and activity therapy to aid the
county mental hospitals in program planning and development.

Wisconsin's three psychiatric hospitals have experienced much the
same population pressures as have other intensive treatment hospitals
throughout the nation , Since 1953 patient populations have remained
fairly constant but the number of admissions has risen by 32.6%.

to improving treatment effectiveness within these institutions.
Increased treatment effectiveness is sought through additional
trained psychiatric treatment staff - more psychiatrists, nurses,
therapists, psychologists and social workers. It also requires
additional supporting administrative and service personnel to absorb
the increased needs of a treatment hospital. An additional 215
staff members are requested to accnmplish this increased treatment
effectiveness in the Department's three mental hospitals. Drugs and
medical supplies account for $326,842 (approximately $70 annually
per patient) of the operating budget requested for 1961-63.

Mrs. Albert D. Lasker
December 30, 1960
Page 3.

Recognizing the importance of developing and maintaining a supply of
trained professional staff to operate its treatment programs, the
Department of Public Welfare training program proposes an expansion
of educational stipends to psychiatric residents, social work
trainees, and psychology trainees. Twenty-three social work trainees
and twelve psychiatric residents would enter the training program
each year under proposals of the Department for 1961-63. Seven
psychology trainee positions plus special in-service training programs
for the entire mental hygiene program would also be included in the
total $324,378 mental hygiene training program budget for 1961-63.

A new institution, the Children's Treatment Center, is scheduled to
open in January, 1962. The Center will provide a much needed program
of intensive psychiatric treatment for emotionally disturbed pre-
adolescent children. In addition, the Children's Treatment Center
will conduct a program of specialized research and professional train-
ing in cooperation with the University of Wisconsin. The Children's
Treatment Center will initially accommodate 30 patients and employ
69 staff members. Its requested budget for 1961-63 is $448,599.

Special programs are also planned for adolescent mental patients
within the two state psychiatric hospitals. Approximately 170 of
these patients will be in the general patient population in 1961-63.
Treatment programs centering around educational activities, group and
individual psycotherapy, activity therapies, and casework and
rehabilitation planning are proposed for these patients. Twenty-nine
additional staff members will be needed to accomplish this program
goal. Cost of these positions would be $320,424 for 1961-63.

Significant advances in meeting the problems of mental retardation
are also planned in the 1961-63 budget request.
Central Colony will come into increased operation in the next two
years to relieve serious overcrowding at the State's two existing
colonies. Central Colony will provide specialized treatment and
training to the most severely retarded patients in the Department's
institutional population. Its operating cost for 1961-63 would be
$4,574,351.   It will hold 608 patients by the end of this period.

The completely new

Located in Madison, near the University of Wisconsin, Central Colony
will provide special facilities and staff for the conduct of research
into causes of mental retardation and methods of caring for the
mentally retarded. A staff of 14 will devote its time exclusively
to research in this area. The two year budget of this research
activity would be $85,843.

Central Colony would also conduct a special "evaluative-developmental''
program which will attempt to accurately diagnose and evaluate
mentally retarded patients referred by private physicians. The skilled
staff of this unit would also provide recommendations for the
continued care and training of patients referred to them.

Throughout its program for the mentally retarded, the Department is
experiencing increasing numbers of more severely retarded patients

Mrs. Albert D. Lasker
Cecember 30, 1960
Page 4.

as Wisconsin s child population continues to grow . A transition
from custodial-general training programs to a more intensive type of
hospital care is occurring in many areas of the existing institutions
as patients with medical care problems increase in number. The
elimination of patient workers for health and sanitation reasons is
another factor in the request for 213 more positions for the two
existing colonies. Greater attention is also directed to the
important areas of family care and community programs for the mentally
retarded in requests for additional consultants to work within the
state organization.

If it would be of interest to you, I will send you a report on my
recommendations in respect to this budget when my work on it is com-
pleted. We appreciate your interest and your devotion to this cause
and will do anything we can to help.

My executive secretary, Ed Bayley, who enjoyed your hospitality in New
York a year ago, asks me to send his regards to you and Mike Gorman.

If you have any comments after reading this material, I should like to
have them.

Governor

GAN: ka