MHA CEO Report — Change to Our Behavioral Health System Can’t Wait

MHA Rounds Report - Brian Peters, MHA CEO

“Not until we are lost do we begin to understand ourselves.” ― Henry David Thoreau

I don’t suspect that many of our Michigan colleagues are Ohio State football fans, but regardless, if you have not heard the recent NBC Today Show story of offensive lineman Harry Miller, it is a great reminder that behavioral health challenges can significantly affect individuals of all ages, races, socio-economic status and athletic prowess — even those who seemingly have it all. Miller was not only a star football player and prized recruit, but also a high school valedictorian who was carrying a 4.0 GPA as a mechanical engineering major in college and made multiple mission trips to Nicaragua to help those in need. It was a shock to those who passionately follow the team, and even to family and friends who knew him well, that after multiple suicide attempts, he finally quit football.

His parents have been effusive in their praise of the support provided by Ohio State head coach Ryan Day since this revelation — and this is no accident. Coach Day lost his own father to suicide when he was only 9 years old, which led him to become deeply engaged in behavioral health advocacy efforts that have included the formation of his own charitable foundation dedicated to pediatric and adolescent mental wellness.

Suicide represents the extreme tip of a proverbial iceberg of massive proportions, with a wide range of issues affecting more people than we likely realize. Unfortunately that iceberg is growing; while COVID-19 has occupied headlines and healthcare resources for more than two years, this global pandemic has also exacerbated the crisis of limited behavioral health access that has existed for decades in our state and beyond. While some small strides have been made to improve behavioral health coverage parity and in reducing the stigma around mental health challenges, there are nowhere near the necessary number of professionals, facilities and resources to build a system that is not only adequate, but excellent, for our residents in need. Quite simply, it is unacceptable for a state with our talent, industrious history and legacy of caring to be in this situation in 2022.

Since 1949, May has been recognized as Mental Health Awareness month. While we will join many other voices in shining a light on this issue during that month, the fact is we can’t wait another month — or another day — to address what has become a true crisis. In 2018, suicide was the leading cause of death in 10- to 14-year-olds and the second most common cause of death in 15- to 24-year-olds in Michigan. This was well before the stressors brought on by the pandemic.

Michigan’s behavioral health system is stressed to its limits. While we do have a small number of outstanding facilities dedicated entirely to mental healthcare services, as well as acute-care hospitals with special units dedicated to these services, it is simply not enough. According to data from the Citizens Research Council of Michigan published in 2020, Michigan has a total of 3,195 inpatient psychiatric hospital beds spread across dedicated inpatient psychiatric facilities and acute-care hospitals to serve adults and children. This number of beds is not adequate to serve Michigan’s population of nearly 10 million. In fact, since 1993, the number of psychiatric beds available in Michigan has decreased more than 30%. However, simply adding beds is not an adequate solution because we do not have enough of the right kind of professionals to staff these beds and serve more patients. The Research Council also reported that Michigan has “11.84 psychiatrists per 100,000 residents in the state overall and 33 of the 83 counties do not have a single psychiatrist. As of 2019, Michigan ranks third in the shortage of mental healthcare professionals, surpassed only by Texas and California.” This makes convenient access to behavioral health services in many rural communities nearly impossible.

Patients, particularly adolescents and children, have few places to turn for care after experiencing a mental health crisis. There are no child or adolescent psychiatrists in 55 of Michigan’s 83 counties. Kids and people with intellectual and developmental disabilities are at risk for long stays in the emergency department — a setting that is typically not equipped to handle complex behavioral health patients. Bed availability for children and adolescents with complex needs is limited, and providers are forced to hold patients in acute-care settings sometimes for weeks or months while seeking appropriate placement for treatment. It is unacceptable for those patients, their families and the caregivers trying to manage their treatment and keep them safe. Not only is it bad for patients, but it often leads to violence against healthcare workers that is escalating at alarming levels.

The MHA and our members have been intricately involved in identifying potential solutions to address this complex system. The MHA Behavioral Health Integration Committee has been instrumental in documenting the specific challenges confronted by our members and developing guiding principles as we consider emerging public policy proposals emanating from the Whitmer administration and the state Legislature. For example, the MHA is working with the Michigan Council for Maternal and Child Health and the University of Michigan to increase funding for telesupport services for primary care providers who treat children with mental illness.

Additional financial resources and cooperative planning dedicated to behavioral health could create transformational improvements to our broken and fragmented system. Based on feedback from our members, the MHA believes an appropriation to fund additional support for pediatric behavioral health, a grant pool to improve behavioral healthcare in emergency departments and recruitment support for behavioral health providers would have significant and lasting improvements in access to care and quality. This appropriation would help address a major barrier to improving access right now, which is the lack of appropriately trained and educated behavioral health providers available in Michigan. It would also help modify the way emergency departments are prepared to temporarily care for patients in behavioral health crises — especially Michigan’s children.

These resources would not fix everything. However, they would start the process and provide critically needed relief to some of the elements of our care delivery system that is crumbling before our eyes, leaving patients in the rubble. It is a good starting point in a process that will ultimately be an all-hands-on-deck affair, requiring the best efforts of multiple organizations both inside and outside of healthcare.

Change to our behavioral health system can’t wait. Let’s fix this system together, once and for all, for all Michigan patients.

As always, I welcome your thoughts.

If you or someone you know is at risk of suicide, please call the U.S. National Suicide Prevention Lifeline at (800) 273-8255, text HOME to 741741 or go to for additional resources.