Marianne Huff, LMSW, President & CEO, May 2026



The Mental Health system in our state has been a political football for years. For years, the state of Michigan has been struggling to make positive and creative changes to its mental health system and the broad but significantly lacking continuum of care. 

As a public policy and advocacy organization, MHAM has been around for a long time and in the past 90 years since its inception, we have participated in the politics of mental health treatment and services.  MHAM has watched the evolution and, at times, the devolution of mental health treatment in Michigan.   

“… the politics of health care are as broken as the system (and are a reason it is broken). For decades, Democrats and Republicans have not been able to agree on any major solutions to our health care problems and disagree sharply on the role of the federal government in health, forcing us to gravitate to smaller incremental changes where there might be some agreement. They also blow their importance out of proportion. I won’t name names in this short piece.” Drew Altman, Founding President and CEO, Kaiser Family Foundation. Posted: April 23, 2026.  

The quote from Drew Altman, founder of the Kaiser Family Foundation, which is a non-profit dedicated to health policy, journalism and polling, may have been focused on Congress, but the statement rings true for the history of mental health public policy in Michigan. 

In 2026, mental health continues to be treated like a stepchild of healthcare.  Of course, we know that the brain and the body are connected as evidenced by human anatomy.  The brain sits on top of the spinal cord. The spinal cord is the connection superhighway that conducts impulses from the brain to the body. We know that mental illnesses result from a combination of genetics, environment, and traumatic events that may activate mental health disorders with the right amount of stress.  We know that certain neurotransmitters, the chemicals that carry messages to various parts of the body from the brain, are implicated in the expression of these illnesses.  Medications are given under certain circumstances, and other therapeutic modalities are utilized.   

We know this.   

The 1990’s, known affectionately as the “Decade of the Brain”, made advances in our understanding of how the brain works.  We have more treatment options available.   

We understand this. 

If we know this, then why does the mental health system attract the amount of political controversy that it does in Michigan?  Why does Michigan seem to be less effective in solving the problems associated with the lack of access to quality mental health and substance use disorder supports?  The question evades a single response. There are times, however, when policy changes are proposed by the Michigan Department of Community Health (MDCH), the state department in charge of mental health, has not asked the Michigan legislature for its opinion. 

What does this have to do with the Mental Health Framework?   

Despite the political nature of mental health, the Mental Health Framework has not been on the radar of the legislature.  It was not on anyone’s radar because little was known until recently when healthcare providers sounded the alarm to advocates like MHAM. 

The Mental Health Framework, which has been in the works for a few years according to the Michigan Department of Health and Human Services (MDHHS), was unveiled in the Summer of 2025.  It is intended to make it easier (presumably) for individuals with Medicaid to get psychiatric treatment that is in alignment with the person’s level of care needs.  The Framework also proposes making policy changes to statutory requirements in the Michigan Mental Health Code. In other words, there are fundamental things like inpatient psychiatric hospitalization that are central to the mental health system’s responsibilities, and one wonders if the MDHHS can make certain changes without consulting the legislature. 

Beginning in October of 2025, the MDHHS has proposed that all providers of mental health services who serve Medicaid beneficiaries must be trained in certain assessment tools.  These tools, the LOCUS (Level of Care Utilization System) for adults and the MichiCans for children and adolescents, are supposed to make it easier for mental health clinicians to determine the appropriate level of care.  These tools have been used by the Community Mental Health System in Michigan for years.  They have not been used by mental health clinicians who work with people whose payer is a Medicaid health plan.   

The problems? 

• Insufficient training capacity: MDHHS doesn't offer enough opportunities for clinicians to learn the required assessment tools 
• No legislative oversight: Fundamental changes to how Michigan's mental health system operates are being made administratively, without input from the legislature that writes mental health law 
• Creates more confusion: People in crisis will face additional barriers, not fewer 
• Ignores real gaps: Michigan still lacks residential treatment programs, crisis beds, and long-term psychiatric care 

The list goes on and on, but the Framework fails to address these larger problems.   

Here’s an example of the impact to real Michiganders:

In October of 2025, MHAM received a phone call from a person with Medicaid  who has a daughter with a mental health condition. The caller has been receiving mental health services from a large provider in west Michigan.  The person was calling because she was going to lose her services because of the requirements of the Mental Health Framework, which was supposed to begin on October 1, 2025. The provider indicated that, due to the lack of available training required by he Mental Health Framework, the caller was going to lose her therapist and her psychiatrist. This phone call began MHAM’s investigation into the Framework. Ultimately, the individual did not have to seek a new provider. I am sure that this story is not an isolated incident.  The loss of a longtime provider such as a therapist or a psychiatrist can be detrimental to an individual’s mental health.  

The current legislature has been interested in the quality of the mental health system in Michigan.  The House Oversight Subcommittee on Public Health and Food Security held hearings over the summer in 2025 that sought to gain information about the lack of inpatient psychiatric treatment and an underperforming behavioral health system.  Chaired by Rep. Matt Bierlein, the Subcommittee produced a report from its investigation that included multiple hearings and testimony from a variety of sources. 

While it is true that mental health can be overly political, there are times when mental health public policy can and does benefit from the involvement of the legislature.