The Mental Health Association in Michigan

is the only statewide, non-governmental agency concerned with the broad spectrum of mental illness across all age groups.

September 12, 2019

Opinion | Time to close Michigan’s access gap to mental health services

https://www.bridgemi.com/guest-commentary/opinion-time-close-michigans-access-gap-mental-health-services

Hundreds of thousands of Medicaid-enrolled Michiganders need mental health support, but only about half receive help. We can do better for family members and neighbors in need. 

That’s why we, the leaders of six leading mental and behavioral health organizations in our state, are calling on state legislators and our governor to allocate the needed resources to fill funding gaps amid rising rates of behavioral health-related conditions locally and across the United States.

Society’s inattention to mental and behavioral health needs is the result of misinformation and misunderstanding. Stigma and the inability to pursue treatment continues to hold back the effectiveness of Michigan’s behavioral health structure. 

A new study commissioned and funded by the Michigan Health Endowment Fund confirms behavioral health care in Michigan needs more attention. The report recommends the following to improve care in our state:

  • Increase retention of behavioral health providers in Michigan;
  • Fully leverage all members of the health care team for better coordinated response to behavioral conditions;
  • Promote effective use of trained lay providers such as peer support specialists, parent support partners, youth peers and recovery coaches;
  • Use telemedicine to extend the reach of the behavioral health workforce;
  • Expand school-based behavioral health care; 
  • Integrate primary care and behavioral health care delivery at the service delivery level. 

We strongly support these findings and call for collaborative action, by public and private leaders to raise awareness of these recommendations and remove barriers leading to workforce shortages, prohibiting real utilization of proven approaches such as tele-behavioral health, school-based mental health services, peer support enhancement and increased para-professional, or lay-person assistance. These challenges are not new, but they remain largely unaddressed. 

As this study points out, there are serious unmet mental-health needs in urban, suburban and rural communities across our state, with large mental health service “deserts” spanning rural parts of Michigan. This is especially prominent in northern Michigan and the Upper Peninsula, where few mental health providers are located and where people with limited transportation face travel challenges to even attempt to access specialty care.

As this study indicates, the gap in access to needed mental health care is large across all groups of Michiganders: those with commercial insurance, Medicaid coverage and the uninsured. 

If all of Michigan could achieve the rates of care seen in the best access areas of our state, we could serve 57,000 more people with mental health needs and 27,000 more people with substance use disorders. This is a goal that is possible and within reach – if our state prioritizes the needed funding and addresses barriers. 

To the study’s recommendations, we would add two more. 

There is also a need to increase public and private dollars for mental health and drug addiction. This past spring, the Community Mental Health Association of Michigan released an analysis finding a $150 million gap between the cost of care and funding provided to Michigan’s public mental health system. The financing gap is not limited to publicly-funded care. 

Fifty-three percent of those with mental health needs and 39 percent of those with substance use disorder needs, with insurance coverage, cannot afford the cost of treatment or have enough health insurance coverage to fully recover. A system that is too expensive for the population who needs it most is a disservice to our people. 

Similar increases seen in the mental health benefits of commercial/private insurance plans must be provided by employers wishing to ensure a sound and stable Michigan workforce long term. 

Michigan should also adopt a law similar to laws on the books in more than 40 other states, specifying how our state government is to monitor, report on, and enforce federal behavioral health parity (equality) law. Without it, many privately insured Michiganders will continue experiencing discrimination in their behavioral health care services, compared to the care they receive from other medical conditions.  

Together, we can and must increase access to behavioral health services for Michiganders and support populations with the highest need. That’s why we are calling on the leadership of Gov. Gretchen Whitmer, the Michigan Department of Health and Human Services, the state legislature, and commercial health insurance companies to address these challenges with us as allies.

This commentary is jointly written by Mark Reinstein, CEO of the Mental Health Association in Michigan; Kevin Fischer, CEO of NAMI-Michigan; Jane Shank, CEO of the Association of Children’s Mental Health; Greg Toutant, CEO of Great Lakes Recovery; Sam Price, CEO of Ten16 Recovery Network; and Robert Sheehan, CEO of Community Mental Health Association of Michigan.​