It’s no secret Michigan has been underfunding mental-health services for years.
It’s no secret that over the past quarter-century, the state has phased out most of the state-run psychiatrist hospitals, shifting those services to the private sector.
It’s no secret the private sector has declined to file the void.
Here’s the bottom line: In the early 1990s, Michigan had about 6,800 licensed in-patient psychiatric beds. Today, it’s less than half – about 3,200.
That means people in psychiatric crisis can’t get the help they need. It’s put a strain on community hospital emergency departments, who are seeing more and more mental-health patients – and the ERs have nowhere to send them.
It’s an issue that needs addressing.
It’s not an unsolvable problem. But it’s going to take some money, as well as political willpower.
A big reason for the bed shortage is the abysmal reimbursement rate for mental-health services. Hospitals get three times more money for a standard acute-care bed vs. the reimbursement rate for a psychiatric bed.
But the state could put serious pressure on health insurers to raise their reimbursement rates. Other budgetary tools include leveraging federal Medicaid dollars to increase services and merging the state’s mental health budget with the Medicaid budget to allow more flexibility in spending.
There also are multiple cost-neutral strategies. Perhaps the biggest and best tool in the state’s toolbox are Certificates of Need, which hospitals are required to get from the Michigan Department of Health and Human Services whenever they undergo a major renovation or expansion. As a matter of course, Michigan could require any children’s hospital to include a psychiatric unit. It also could use CONs to encourage any community hospital to expand or add psychiatric services.
Meanwhile, part of the state 2020 budget proposal being pushed by Republican lawmakers includes provisions that would hand off millions in state mental-health dollars to private health plans. Considering how privatization has worked so far in the mental health, one has to wonder about the GOP’s commitment to genuinely improving access to care. At the very least, that shift in dollars should be leveraged to ensure systemic improvements.
There is a growing awareness of the pervasiveness of mental-health issues, and the importance of those issues in regards to overall health and well-being.
But awareness is not enough.
It’s time for the Whitmer administration and the Michigan Legislature to take leadership of this issue. And it’s time for Michigan’s health insurers and health-care providers to step up.
For too long, people have been wringing their hands and pointing fingers. We need action.
You can share your thoughts on Michigan’s funding of mental health treatment with Gov. Gretchen Whitmer at Gretchen.firstname.lastname@example.org; Senate Majority Leader Mike Shirkey at SenMShirkey@senate.michigan.gov and House Speaker Lee Chatfield at LeeChatfield@house.mi.gov