Study details growing crisis of untreated mental illness in Michigan

July 30th, 2019
From the study "Access to Behavioral Healthcare in Michigan" commissioned by the Michigan Health Endowment Fund

About one in six Michigan residents experience mental illness, and 38% of those individuals are not getting treatment for their mental health issues, according to a new, comprehensive study that examines access to behavioral healthcare in the state. This means that more than 660,000 Michiganders who need treatment are not receiving it.

In the Detroit area, almost half of those experiencing mental illness are not being treated.

The study also looks at substance use disorder (SUD) treatment in Michigan. It found that 638,000 Michiganders are experiencing SUD, and 80% of them are not receiving care. That’s more than half a million people.

The human and societal toll of the growing numbers of people with untreated mental illness and untreated SUD is staggering.

Here are other findings from the study, which was commissioned by the Michigan Health Endowment Fund:

  • Across payer types, Medicaid enrollees are the most likely to remain untreated for a mental illness. About one-half of Medicaid enrollees, one-third of the privately-insured, and one-fifth of Medicare enrollees with a mental illness do not receive care.
  • Of the nearly 2 million Michiganders covered under the Medicaid program, 481,000 experience mental illness and 148,000 experience a SUD. Despite having coverage, nearly half (49%) of Medicaid enrollees with mental illness, nearly 236,000 people, are not receiving care, and 69% of enrollees with SUD, or 102,000 people, are not receiving care.
  • Of the 5.6 million Michiganders with private health insurance, 890,000 experience mental illness and 372,000 experience SUD. Despite having coverage, one-third (34%) of those with mental illness, more than 305,000 people, are not receiving care and 87% of those with SUD, nearly 324,000 people, are not receiving care.
  • In Michigan, 46 percent of people with anxiety disorders, 53 percent of people with depressive episodes, and 85 percent of people with alcohol use disorders are not treated for their conditions.
  • In Michigan, 41% of male children (0-17) with mental illness are not getting care and more than a third of female children who need mental health treatment are not receiving it.
  • A shortage of psychiatrists and other behavioral health providers limits access to services. The shortage is especially acute in the northern half of the Lower Peninsula and parts of the Upper Peninsula.
  • Michigan has 11 child and adolescent psychiatrists per 100,000 people, far short of the recommended ratio of 47 to 100,000.
  • Mental health facilities offering residential services are in short supply in Michigan. There are only 17 such facilities, which amounts to 590,000 people per facility in Michigan compared to the U.S. average of 240,000 people per residential facility.

A combination of many factors accounts for the crisis of untreated mental illness and SUD in our state. These include unaffordability, inadequate insurance, reductions in services and a shortage of treatment professionals and places, transportation problems, stigma, concern about taking medications, and insufficient understanding of mental illness and SUD and the benefits of treatment.

To improve access to behavioral healthcare and address the crisis of untreated mental illness, the study recommends:

  • Increasing the retention of behavioral health providers in Michigan
  • Removing restrictions on scope of practice to fully leverage all members of the healthcare team
  • Promoting effective use of trained lay providers such as Peer Support Specialists and Recovery Coaches
  • Using telemedicine to extend the reach of the behavioral health workforce
  • Expanding school-based behavioral health care
  • Integrating primary care and behavioral health care delivery

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