Michigan’s childhood psychiatry needs go unmet 

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By CAMERYN CASS
Capital News Service

LANSING — Michigan has fewer than 300 hospital beds for children under 18 needing mental health treatment, a shortage that worsens the farther you go north.

There are no juvenile mental health beds in the Upper Peninsula. Oakland County is the only county that has an adequate number of child psychiatrists for the county population, according to the American Academy of Child and Adolescent Psychiatry.

In fact, Michigan ranks third-worst in the nation in the number of child psychiatrists, said Sheila Marcus, a clinical professor at the University of Michigan who is involved with a state-funded project called Michigan Child Collaborative Care. Most psychiatric illnesses start in adolescence or younger. 

Michigan Child Collaborative Care is trying to address mental health problems before people go to the hospital through telepsychiatry support to primary care physicians, Marcus said. It offers same-day phone consultations and educational opportunities to help them think like psychiatrists.

The collaborative started in 2012 and includes the state health agency, U of M and Michigan State University.

When hospital beds run out, patients are boarded for hours, sometimes days, waiting in hallways or emergency rooms for an open bed, said Lia Gaggino, a Michigan pediatrician of 32 years and a former committee chair for the Michigan chapter of the American Academy of Pediatrics. Sometimes that means patients must seek help out of state. 

The emergence of COVID-19 flooded emergency rooms with people afflicted with mental illnesses, Marcus said. Reports of suicidal thoughts increased 124%, and there was a 158% increase in depression and anxiety cases. 

The pandemic also changed the public perspective toward physicians from being superheroes to enemies, said Gaggino, who describes them as wounded healers. 

Gaggino said mental health needs are not being met not only across Michigan, but nationwide.

 “We have to be willing to put resources into developing programs that work. It would require an enormous system change,” she said. 

High costs for adequate treatment is a concern. Patients with suicidality require strict supervision, said Gaggino. 

“We have a grossly inadequate supply and huge demand for services that really requires we rethink how we deliver mental health services,” said Marcus. 

Telepsychiatry is a bright spot of the pandemic, Gaggino said. These services can be accessed remotely in rural areas that lack access to psychiatric help, like the Upper Peninsula. 

But a good third of U.P. residents are without internet, so although telepsychiatry is a promising solution for rural areas like this, broadband issues are a concern, said Jim Haveman, a former director of the Department of Community Health. The proposed federal  infrastructure money would improve the U.P.’s internet and capacity for telepsychiatry.