Marianne E. Huff, LMSW, President and CEO, Mental Health Association in Michigan
Imagine this: You enter a hospital emergency department for chest pain. The clinicians onsite confirm you’re having a heart attack, but before can receive lifesaving care, you must wait for a second pre-admission screening from an agency outside of the hospital. The process could take hours – maybe even days.
The odds of that happening are not likely; However, it’s often the reality for Medicaid beneficiaries who come to the emergency department experiencing a behavioral health crisis.
In my role at the Mental Health Association in Michigan, I’ve had the privilege of advocating for patients and communities across the state who are living with mental illness. Unfortunately, a part of this job is having to witness the lasting impact that barriers in the system have on patients, providers and the overall care landscape.
When it comes to getting patients with Medicaid coverage inpatient behavioral healthcare, there are a series of unnecessary hurdles. One of the most time-consuming steps is that following an assessment by qualified ED clinicians, a patient with Medicaid must receive a secondary pre-admission screening from a community mental health (CMH) agency. Although it’s required for a CMH to perform the pre-admission assessment in a three-hour window, that’s rarely the case.
This effects people at all walks of life, but I’ve seen a troubling number of pediatric patients suffering as a result. In one case, a mother sat in the emergency department for weeks with her young daughter who was in dire need of inpatient behavioral healthcare services.
Sadly, that experience is not uncommon. I’ve seen parents put their jobs at risk to accompany children boarded in the ED. Oftentimes mental health conditions are compounded with acute medical issues, which further complicates the process of finding care.
As an association, we strive to transform the way our state and nation approaches mental illness. This is not possible if we don’t uphold a system that supports early intervention and gets patients the care they need without unnecessary delays.
Alongside the MHA and Michigan hospitals, our association agrees that one solution is to expand the three-hour assessment responsibility to allow clinically qualified ED staff to conduct pre-admission screenings. As a result, we can help improve the delivery of care for behavioral health patients who enter hospital EDs across Michigan.
The Mental Health Association in Michigan is the only statewide, non-governmental agency concerned with the broad spectrum of mental illness across all age groups.