Michigan Association of Health Plans

Opinion: Overhaul state’s Medicaid mental health system

This opinion piece by James Haveman, former Michigan health director, appeared in The Detroit News. To read the whole article, click here

Michigan’s Medicaid mental health system needs a major overhaul. I am pleased that the Legislature will be reviewing reforms this fall that could dramatically enhance behavioral health services for those recipients and bring them more in alignment with what most Michigan residents received through employers.

When I started as a social worker in the late 1960s, services for the less affluent in the community were managed by the State of Michigan. Most were treated for psychiatric care in state institutions, and few ever left those facilities.

I am pleased that the Legislature will be reviewing reforms this fall that could dramatically enhance behavioral health services for Medicaid recipients, Haveman writes.

About that time, as part of a national movement, the Legislature started moving to create community mental health boards to provide increased services to those in the community who had not spent time in a state institution — seeking to help them overcome their issues and live a productive life.

At that time, the causes of mental illness were not well understood, and their connection to physical illnesses was not apparent. So, when the state moved Medicaid to a managed care system for physical health in the late 1990s, services to the mentally ill were not included in that system — which has worked very well to improve physical health care.

Fast forward then until today, we still have a Medicaid system where mental health is separated from physical health, even though we now know mental illness is a brain disorder and chronic disease. The current mental health system should now be part of a fully integrated health care system and managed with great state oversight by the state’s private insurers who today handle the physical health of Medicaid recipients. I believe the integration will significantly add to the numbers of those seeking and receiving mental health services in Michigan.

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