A primer on Michigan’s community mental health system: A report for the Ethel and James Flinn Foundation

September 2, 2019

Three profiles with a network in the background symbolizing community mental health.Michigan’s community mental health (CMH) system serves more than 300,000 people: Approximately 155,000 adults with serious mental illness, 51,000 children with serious emotional disturbance, 50,000 people with intellectual or developmental disabilities, and 73,000 people with substance use disorder.

These community mental health services are funded by Medicaid, state general funds, block grants, and local funds. Approximately half (49 percent) of all spending in the state’s public mental health system is for the intellectually and developmentally disabled population, which makes up approximately 15 percent of the service population. The other half of the spending is for adults with serious mental illness (36 percent), children with severe emotional disturbance (9 percent) and people with substance use disorders (6 percent).

The services offered by Michigan’s community mental health system include: applied behavioral analysis, occupational therapy, physical therapy, crisis interventions, child therapy, home-based services, medication review, treatment planning, and mental health monitoring. The system also offers specialty services and recovery-oriented services for individuals with substance use disorders.

Medicaid is the major source of funding for Michigan’s publicly funded mental health system as care through CMHs is an entitled benefit under Medicaid. As such, individuals with Medicaid coverage are more likely to receive care through CMHs than uninsured and insured individuals. CMHs providing care for individuals who do not qualify for Medicaid coverage must use limited state general fund dollars to cover that care.

Workforce shortages are expected for Michigan’s community mental health system as the state’s needs grow. According to the Health Resources and Services Administration, by 2030 Michigan is projected to have a shortage of over 700 psychiatrists, 1,220 clinical, counseling, and school psychologists, 1,790 addiction counselors, and 2,780 mental health counselors if demand  continues to outgrow supply.