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Michigan mental health care being squeezed

HOUGHTON — A May 3, 2021, social post published by the Keweenaw County Sheriff’s Office criticized Michigan for its lack of mental health care access, along with an appeal to the public:

“We are asking that you help us start the discussion locally, contact your state representatives, contact your mental health board and help us figure out how we can fix this problem,” the appeal read. “These are our brothers, sisters, sons, and daughters who are crying out for help. We owe it to ourselves to make a change.”

Unfortunately, finding a solution to the problem may be more complicated than it may appear. In Michigan, as well as across the nation, there are several factors that inhibit access to behavioral health care, including many of those in need, or who qualify for financial assistance for it, simply do not not want it. But there is more.

A study was funded by The Michigan Health Endowment Fund, the report of which was published in July 2019 by Altarum.

Among the Altarum study’s finding was that a significant portion of Michigan residents with a behavioral health condition are not receiving treatment for a variety of reasons that include: Provider availability and financial concerns, along with cultural attitudes that lead to reluctance to seek care.

At the same time, a February 2019 report, published by the Community Mental Health Association of Michigan, “Addressing the systemic underfunding of Michigan’s public mental health system,” funding to the public system does not reflect actual and growing need.

“While the demand for (a) wide range of mental health services in communities across Michigan has grown dramatically over the past several years, the funding for the public mental health system responsible for meeting those needs has not,” the CMA report stated. “Some of these needs include: addressing the opioid crisis, preventing suicide, and respond to mental health crises, serving children and adolescents with autism, preventing arrest and incarceration, preventing homelessness, keeping kids in school safe and successful, support persons with disabilities to live in the community.”

The Altarum study, however, found that funding aside, not everyone needing mental health care wants it. The study found that of a total Michigan population of 9.9 million people, it is estimated that 1.76 million experience any mental illness (AMI).

“We find that 38% of those with AMI, more than 666,000 people, are not receiving care,” the report stated. “For SUD (Substance Use Disorder), the access gap is even larger – the majority of Michiganders with SUD are not receiving care. Of the 638,000 Michiganders experiencing SUD, 80% of them, more than half a million people, are not receiving care …, among other barriers, a sizable share of those untreated for SUD may be unwilling or unready to seek care.”

The study also found that with AMI, the conditions with the largest shares going untreated are anxiety disorders and depressive episode. More serious conditions such as bipolar disorder, recurrent depression, and post-traumatic stress disorder (PTSD), as well as other stress disorders, are less prevalent among Michigan residents, and show lower shares going untreated.

While there are many who choose not to seek help, for those who do, another challenge is simply finding it.

According to the Altarum report, Michigan, like most of the country, has a shortage of psychiatrists and other behavioral health providers. While there are pockets of low supply throughout the state, shortages are especially concentrated in the northern half of the lower peninsula and parts of the upper peninsula. There are 25 counties in Michigan with no psychiatrist. Ten of these counties have neither psychologists or psychiatrists. Two of those counties are Keweeanw and Ontonagon.

So, while one study found that Michigan is facing an under-funding of public health care, another study found that not everyone who could benefit from health care wants it, while a third factor figuring into the crisis is a shortage of mental health professionals across Michigan.

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