Opinion | Michigan must prioritize mental health care, eliminate systemic barriers

For generations, mental health was a taboo subject. Mental and behavioral health needs were considered separate and secondary to physical health — if they were considered at all. Finding resources was difficult or impossible. Getting help was costly. Often, issues were swept under the rug until they manifested in ways that were even harder to unwind— everything from violence, crime and recidivism to addiction and homelessness to students underperforming in school.

Under Governor Gretchen Whitmer, Michigan is leading the charge to eliminate stigmas around mental wellness, reshape mental healthcare and delivery, and provide a model for reform across the nation.

The core of our work is an understanding that mental and behavioral health are fundamental needs. They are inseparable from physical health and community welfare. That’s why the Governor’s 2025 budget calls for funding free mental health and substance abuse treatments for those in need. It also includes more than $193 million to establish more Certified Community Behavioral Health Clinics (CCBHCs). These centers provide 24/7 behavioral health and substance use crisis services to anyone who needs it.

CCBHCs have been a huge win for patients and providers since I helped bring them to Michigan in 2021. In the first year of the program alone, CCBHCs provided more than one million services to Michigan residents in need – nearly one in four of whom were children. They’re also helping address health disparities. In fact, 100% of surveyed CCBHCs reported progress in improving access to care and reducing health disparities for people of color and other marginalized groups. Along with the 988 Suicide and Crisis Lifeline, these expanded resources will help those struggling with mental health get the support they need when and where they need it.

Another key aspect of Michigan’s access to mental healthcare is our state’s hospitals. Hospitals are the only sites that provide around-the-clock emergency care, including in-patient psychiatric care. For many in our state, particularly in our low-income, minority, and rural communities, hospitals often represent the only nearby, accessible option for both acute and continuing mental health services. Hospitals treat every patient that walks through their doors. That’s an incredibly important safety net that ensures every Michigan resident can access medical care in times of need.

As a result, the serious challenges facing many hospitals in Michigan and across the country could have major ramifications for mental healthcare. A series of factors have put many hospitals in a crunch where the costs they face keep climbing, yet the reimbursements they receive have not kept up. Between 2019 and 2022, the rate at which Medicare reimburses hospitals grew less than half as quickly as the costs that hospitals front in order to provide care. Believe it or not, across the country, a majority of hospitals are operating in the red. The nation has seen almost 150 rural hospitals close their doors in just the last 12 years. Just here in Michigan, as I write this, 13 rural hospitals are at serious risk of closing. 

Our administration is working to get ahead of this problem and create solutions. One major issue is the runaway labor costs facing hospitals in light of workforce shortages. So last year, Governor Whitmer signed a bill to provide more than $75 million to recruit, retain, and train healthcare workers. And back in 2021, at the height of the COVID pandemic, our administration worked with state lawmakers to allocate nearly $385 million of funding to support hospitals. Because all Michiganders rely on our hospitals, and we stand by them.

Sadly, our hospitals’ challenges — and, therefore, our residents’ access to mental healthcare — could be further compounded by misguided legislation out of Washington. Some in Congress are putting forward legislation that would dramatically cut patient care, slashing billions of dollars more from the already-low reimbursements that hospitals need to care for patients. I urge Michigan’s members of Congress to oppose these bills. With other players in the healthcare sector enjoying huge profits, shrinking our citizens’ access to healthcare — including mental health services — is not the right way to approach tackling healthcare costs.

Finally, Governor Whitmer and I are committed to removing racial disparities in our healthcare system and systemic barriers to mental health services. At the outset of the pandemic, black people were dying in Michigan at a rate of five times our white counterparts. I was honored to chair Michigan’s pioneering COVID-19 Racial Disparities Task Force. We helped flatten racial disparities and bring our state’s mortality rates below national averages by improving access to care, testing, vaccines, and protective equipment.

Continuing that work, last year, I announced nearly $50 million of funding to address racial disparities under the “Make It in Michigan” budget. The investment will improve access to care, especially in underserved communities, through innovative programs like mobile health units and the conversion of COVID testing sites into community wellness centers.

There is still a lot of work to address disparities in mental health. More than one in five African Americans experience mental health concerns, but less than 40 percent of them receive help, according to a 2021 national survey. Suicide rates among people of color increased 58 percent between 2011 and 2021, and suicide is the third leading cause of death for young black people. And even as our culture comes to realize that representation matters, only four percent of psychologists in the U.S. are African American. 

I am confident we can and will root out these systemic problems. We can apply the same approach that helped Michigan through the pandemic: Prioritizing access to care and resources, investing in making high-quality care attainable for all residents, and building awareness about the support that’s available. As mental and behavioral health needs continue to grow, Michigan’s leadership offers a model for the country to tackle this issue head-on. I look forward to working with policymakers around the state and the nation to create the meaningful change our citizens need.