Opinion: During pandemic, Wayne County mental health crisis looms
There is a hidden health care crisis in Michigan that existed long before this pandemic, that if left unaddressed, will have an immediate impact on the health and safety of almost 10,000 children and adults in Wayne County, long-term consequences within our communities, and will threaten the financial stability of the state’s public mental health system.
While Gov. Gretchen Whitmer has stated that mental health services are an essential part of Michigan’s response to COVID-19, the community mental health professionals charged with the responsibility of service delivery in Wayne County have yet to receive any of the additional financial support from the Michigan Department of Health & Human Services (MDHHS) or Detroit Wayne Integrated Health Network (DWIHN) needed to address the COVID-19-related mental health consequences in our community.
The implications of this crisis go well beyond people served and their families. For example, the untreated mental health problems impair a child’s ability to learn, an adult’s ability to work or retain employment, and an adolescent's judgment that leads to criminal activity that would have otherwise been averted, all of which have long-lasting negative consequences not just for individuals, but for families, communities, and regions. If the state continues to neglect mental health today, just imagine the problems local governments, schools, businesses and families will have to deal with on their own in the future.
Treatment providers in Wayne County are facing not only neglect from our state government to provide financial support for the essential care the governor has stated our communities need, but now DWIHN is preparing to reduce Provider rates by 7%, threatening the future ability of agencies to deliver mental health services to the people of Wayne County.
Michigan’s mental health system is underfunded, understaffed, underserved, and overwhelmed. Given the impact on our front line physical health care workers, those impacted by COVID-19 directly and everyone experiencing the trauma of this pandemic, especially our children, we need to look for ways to strengthen the behavioral health network instead of jeopardizing it.
As responsible providers of public services, we never stopped working on behalf of Wayne County residents. We sought federal government assistance through programs like the Paycheck Protection Program (PPP). While we were appreciative to have those funds while adjusting our operations and opportunities to engage the persons we serve in ways that neither they nor we were accustomed to or immediately equipped, those funds, which were never intended to be long-term, have run out.
We need our state’s help to stabilize the provider network and prevent the closure of any additional programs. We need the Michigan Department of Health and Human Services to remove the regulatory rules and barriers that prevent on-the-ground providers to effectively perform their job and take away the strain from our hospitals during a crisis.
In addition, the current fee-for-service funding model used in Wayne County does not work. Funding for a public system does not reflect the actual and growing need for behavioral health services in the state of Michigan. While the demand for mental health services has grown dramatically over the past several years, the funding for the public mental health system responsible for meeting those needs has not.
Some of these needs include: addressing the opioid crisis, preventing suicide and responding to mental health crises, serving children and adolescents with autism, preventing arrest and incarceration, preventing homelessness, keeping kids in school safe and successful, and supporting persons with disabilities to live in the community. The pandemic has exposed the gaps in how we care for our state’s most vulnerable population, including the need for a new funding model. It is time we rethink how the state contracts with community providers through their network of Prepaid Inpatient Health Plans (PIHP).
We encourage the MDHHS to remove any additional barriers and give the PIHPs authority to make payments to pay providers at historical rates and change to create a payment system that reflects the realities of our time so that our community-based providers can continue to focus on the health and the safety of their staff and the people they serve.
We know Michigan's governor, house speaker, and senate majority leader are all thinking about the public’s health. In a joint statement outlining a recent budget deal, they said, "Our collective priority is a healthy state and a healthy economy. We are committed to working together to address the remaining shortfalls in next year's budget and we are looking to our partners in Congress for support to help maintain the essential services relied upon by our families and small businesses."
We would encourage our state’s leadership to shift its focus to the mental health of Michigan residents. Our staff has always been on the front line of protecting the health and safety of our community. For many Wayne County residents, we are the primary source of health care for individuals with mental illness and substance use disorder. It is our job to keep our kids and adults well and out of the hospital for mental health and physical health reasons. The state of Michigan has failed thus far to allocate appropriate financial resources based on population and need and it is time that our state leaders recognize the urgency of supporting the state’s mental health system.
In a recent poll by the American Psychiatric Association, more than one-third of Americans say this pandemic is having a serious impact on their mental health. Now is not the time to reduce funds to the frontline providers of care.
If behavioral health services are essential to sustain and protect life, then they must continue to be provided and the state must find a way to support the front-line mental health providers before it is too late. Without any guarantee to pay providers at historical rates and forgo any future rate reductions, we will have no choice but to reduce our operations and our staffing and begin to evaluate which services we will need to scale back or eliminate over the next few months.
The families and children who rely on our services are also relying on the state to appropriately support mental health providers. They are also looking to DWIHN to reconsider its plans to impose a 7% rate reduction on providers, and we all hope that DWIHN and the MDHHS will find a way to stabilize the provider network and provide guarantees that we can continue to care for Michigan’s most vulnerable population.
Daniel Cherrin is the President of North Coast Strategies, a public relations firm, and leads the MI Behavioral Health Wellness Collaborative ('Collaborative') as its executive director. The Collaborative, a 501(c)(6), represents 17 of the leading community mental providers in Wayne County, providing services to over 200,000 adults and children, with comprehensive integrated care, in an efficient and cost-effective way.