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Budget controversy prompts discussion on mental health in MI

Brian Calley photo
Courtesy photo
Office of the Lieutenant Governor

Boilerplate language in Governor Snyder’s budget would change the funding structure for the state’s community mental health system. After pushback from families and advocates, those changes seem unlikely to happen. We talk to Robert Sheehan, director of the Michigan Association of Community Mental Health Boards, about what changes he thinks are necessary.

Hundreds of thousands of Michiganders, young and old, struggle with mental illness and developmental disabilities. 

For many of them, community mental health services are key in getting the help they need.

Boilerplate language in Governor Snyder’s 2017 budget would have privatized the funding for those services by giving Medicaid HMOs control over the 2.4 billion dollars budgeted for the state’s public mental health system.

After pushback from advocates, the proposal seems unlikely to move forward. 

But it has prompted a discussion about how to improve the public mental health care system in Michigan. 

Bob Sheehan, CEO of the Michigan Association of Community Health Boards, joined Current State to discuss the situation.

“This bill would have moved all the Medicaid dollars from the public system to the private health plan system,” says Sheehan.

The proposed bill would move that money to private health plans – a troubling thought for Sheehan.

“I think the impetus [of the bill] is positive, but the language is clumsy,” says Sheehan.

“The impetus was to better coordinate physical and mental health treatment – what we often call whole person orientation.”

Sheehan says he doesn’t think privatization of mental health care would aid in that coordination.

“We have a strong belief that the public health system does the best job of protecting the most vulnerable citizens in our community, and does the best job of making sure the highest risk people are served,” says Sheehan.

A little over 300,000 people are served in the public community mental health system across the state, according to Sheehan.

So how exactly do public and private mental health care differ?

“The private system tends to use office space psychotherapy and inpatient care,” says Sheehan.

“The public system can offer residential care, employment services, transportation, case management, etc. A wide range of services not available in the private system.”

Sheehan notes that the populations tend to differ as well.

Those in the public system tend to have more severe conditions and most are living in poverty, according to Sheehan.

“We live in a world where if you have a mental disability it’s harder to get a job, harder to make a sustainable income,” says Sheehan.

Despite the controversy over funding, Sheehan says the discussion happening around mental health in the state is a good thing. 

Lieutenant Governor Brian Calley is convening stakeholders, including Sheehan, to come up with strategies for improving the community mental health model. 

“The largest improvement we’re trying to make is to integrate care where the patient lives – called co-locating,” says Sheehan.

Making physical and mental health care available in the same settings could make a huge difference. 

“People with mental health conditions die 25 years earlier than anybody else. Because they live in poverty, the impact of medication - and mental health has its own detriments,” says Sheehan.

“Our goal is to make sure that lifespan is closed by providing primary care.”

Sheehan is optimistic that the current conversation about mental health will maintain its momentum.

“I’m very positive for two reasons. It’s very transparent now. All the consumers are watching. The Lt. Governor is serious about this,” says Sheehan.

“And all the right people are at the table who can fix this. We’re not taking a broken system and fixing it, we’re taking one of the best systems in the country and improving it.”

Article by Ethan Merrill, Current State Intern

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