The state of mental health policy as nation is somewhat dismal to say the least. Though there is a continued call to reform the mental health system in the country, amidst the wake of public shootings frequently committed, there has been no substantial policy shift nationwide. With this issue, more significant reforms can be identified at a state-by-state basis. Though, even this observance shows that some states have made much greater strides than others in changing their funding, policies, and overall stances on mental health policy. Unfortunately, Michigan ranks in the lower tier of the 50 states on several scales regarding the resources being put into bettering the statewide system.
According to the National Alliance on Mental Illness (NAMI), the overall grade given to the country regarding public mental health services as of 2009 was a D. This was based off of a multitude of factors that centered on the build-up and improvement of mental health systems while combatting a growing demand for these resources and a shortage of funds to provide them. This grade was an average of each state’s grades, and it was observed that Michigan aligned with the national average by also scoring a D. Almost half of the states in the nation (21 to be exact) shared Michigan’s D rating. For Michigan, this was a regression from the previous held C grade in 2006. To come up with this grade, NAMI set out four pieces of criteria that the states were assessed on: Health Promotion and Measurement, Financing and Core Treatment/Recovery Services, Consumer and Family Empowerment, and Community Integration and Social Inclusion. Within these categories, Michigan fared better in some and almost shockingly poor in others.
With Health Promotion and Measurement, Michigan scored a failing grade overall. This is due to the fact that our state provides little funding towards promoting the health and wellness of individuals with mental disorders. The promotion of healthy lifestyles for people with such disorders is crucial to preventing premature deaths by factors like cardiovascular disease or suicide, which are major contributors to the low mortality rate of individuals with mental disorders. States like Connecticut, Maryland, and New York, to name a few, are investing in programs that post nurses at community mental health centers to track these health concerns in patients with mental disorders. Michigan has no such programs in place. Regarding the financing of core treatment and recovery services, Michigan did show some positive results. They were given a B rating in this category, which means that comparatively, we are financing services to those with mental disorders. This data is mostly observed through the amount of Medicaid funding allocated to mental health services. However, the 2015 fiscal year budget for the state cut $156 million towards behavioral health. Michigan joins only six other states that reduced their mental health budget for 2015, while 29 other states have increased their budgets towards these services. For the third and fourth categories, the issue focuses more on cultural changes towards mental health by means of existing institutions. This includes practices like inspections of community mental health programs by consumer and family groups or public education about mental illnesses. States like Arizona and California are requiring such monitoring of these programs, and Mississippi, New York, and New Jersey have incorporated extensive education programs throughout their state. Michigan does not have requirements on inspections of mental health programs by consumer and family groups, and though we are in the stages of developing educational programs like this, it is by no means adequate.
The issue of need versus access to mental health programs is much more telling in the study conducted by the organization Mental Health America. In comparing the amount of individuals who are in need of these programs and the number of programs accessible to them, Michigan has an overall ranking of 41 in the United States. This means that we have a great amount of citizens in our state that are in dire need of appropriate programs, but we are less capable than 4/5 of the rest of the country in providing them adequate care. This startling number proves that Michigan needs to allocate more towards mental health programs to combat the disparity. When we have one of the highest numbers of individuals suffering from a mental disorders (48 out of 51), we must have effective mental health policies that look to remedy this occurrence. What is perhaps even more startling is the ratio of mental disorders in youths compared to their access to care. Michigan ranks 44th in this need vs. access comparison. After comparing these numbers, it becomes clear that Michigan has to prioritize mental health policy much higher.
Though there is so much more that could be done, and the current trend of mental health policy seems to be bleak in Michigan, there have been some measures that have helped to deal with the issue. Though the amount of money in the state budget put towards behavioral health has sharply decreased, the expansion of Medicaid through the Section 1115 waiver has given Michigan a unique opportunity to enhance federally matched funds for individuals who newly qualify for Medicaid. A key feature of this waiver is healthy behavior incentives, which may help to combat the side effects of mental disorders like cardiovascular disease. Also, in 2012 the Autism Insurance Reform bills were passed in the state legislature that required companies to provide insurance benefits to their employees that covered services related to the diagnosis and treatment of autism spectrum disorders. Such policies have certainly helped to positively impact the climate of mental health programs within our state. However, it is nowhere near enough. The issue of restructuring mental health policy in Michigan needs to be taken seriously by our state leaders, as the need for improved and innovative programs is only increasing.