EAGLE RIVER — Leslie Griffith, outpatient program director at Copper Country Mental Health (CCMH) spoke at the the May 27 mental health presentation in Eagle River, outlining some major issues facing mental health, not only in the Upper Peninsula, but across the entire state. One of those issues is the availability of in-patient beds for youth.

Griffith said that the Michigan Department of Health and Human Services (MDHHS) specifically recognizes a major shortage of youth in-patient beds, which culminated in a meeting conducted recently on the issue. The focus of the meeting, she said, centered on what some options are that the state of Michigan should be looking at.

“Some of the people at that meeting talked about having a youth sitting in ERs (Emergency Rooms) for up to three weeks downstate,” she said.

Fortunately, she said that scenario has not played out in the four-county area, at least not to that length of time, but it remains an issue across the state.

In fact, a workshop report published by the Michigan Inpatient Psychiatric Admissions Discussion in 2018 stated that while there were 729 inpatient psychiatric beds for children and adolescents in community hospitals in 1993. By 2017, that number had decreased to 276.

Currently, there are now a total of 389 inpatient psychiatric beds for children and adolescents.

In the Upper Peninsula, according to michigan.gov/mdhhs, as of May 3, there are two facilities that provide psychiatric beds. UP Health System – Marquette, which has 37 adult licensed beds and six child/adolescent beds, and Chippewa County’s War Memorial Hospital, in Kinchelo, which has 20 adult licensed psychiatric beds, provides none for child/adolescents.

A statewide inventory of psychiatric developmental disability beds listed no such units in the Upper Peninsula, and only three facilities downstate, in Detroit, Pontiac and Kalamazoo, with an unmet bed need in excess of 173.

Rural Insights, a primary research and information source for the Upper Peninsula, published an report authored by Isabelle Nebel and Brian Cherry, on April 2, 2020, that stated t the number of children and youth committing or attempting suicide is on the rise in a dramatic and disturbing way. Officially, suicide is the second leading cause of death among youth age 15-24, and for every suicide death among this population, there may be as many as 100 to 200 suicide attempts.

According to the Office of Adolescent Health, in 2018, access to care generally included three components:

– Gaining entry into the healthcare system, usually through insurance coverage.

– Accessing a location where needed health care services are provided, based on geographic availability.

– Finding a health care provider whom the patient trusts and can communicate with. As examined in this report, Michigan’s Upper Peninsula lacks adequacy in all three areas of access.

Rural Insights stated that although it is common for individuals to experience temporary emotional distress as they progress through childhood, rates of mental health diagnoses are alarming and for a variety of reasons. Children are not receiving the mental health services that they need in order to live healthy and productive lives. In the case of the Upper Peninsula, the problem is intensified by geography. Its rural nature creates added barriers to accessing mental health care, exacerbating a national shortage of physicians and psychiatrists further, where only one child psychiatrist serves the entire Upper Peninsula.

“There are no inpatient beds for children who experience serious mental illnesses,” the Rural Insights report states, “and instead, they are driven up to nine hours away from home to a facility either in Grand Rapids or Green Bay. The financial costs of mental health care can prove to be too heavy a burden for Medicaid carriers, private insurance carriers, and especially the uninsured.”

None of these problems are new to the Upper Peninsula. In 2018, the Western Upper Peninsula Health Department conducted an Upper Peninsula Community Health Needs Assessment disclosed that every U.P. county but Marquette is a federally designated HPSA (Health Professional Shortage Area) for mental health care based on the number of psychiatrists per capita. Across the U.P. there are just 39 inpatient beds and 8 full-time psychiatrists serving the population of 311,000, roughly one psychiatrist per 39,000 people. There is no full-time in county child psychiatrist.

The report also stated that among 10 U.P. counties where 12th graders took the Communities That Care Youth Risk and Protective Factors Survey in 2016-18, in two counties, more than 45 percent of students reported symptoms of depression, and in another six counties between 31 and 45% reported symptoms of depression. Further, nearly one quarter of adults in the Upper Peninsula were on medication to help with mood, emotions, or mental health and 8% received counseling from a mental health professional in the previous year.