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.
My 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 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
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. State aids requested for this program in 1961-63 are $1,100,000. In the current biennium (1959-61) $414,450 is
the estimated actual expenditure.
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 institutions 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%. Drug therapy, more professional treatment staff and improved psychiatric technique have been responsible
for the quickened pace of treatment of treatment that has enabled patients to return home and to their jobs and families sooner.
This, in turn, has avoided the necessity of constructing expensive additional bed space in our psychiatric hospitals. However,
as the state's population continues to grow and as admission rates continue to rise, more attention must be given 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 accomplish 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
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 preadolescent children. In addition, the Children's
Treatment Center will conduct a program of specialized research and professional training 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 psychotherapy, 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. The completely
new 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.
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 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 completed. 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.