Report: Hundreds of thousands of substance abuse, mental health patients go untreated in Michigan

Highest percentage of untreated for mental illness are uninsured; for substance use, percentages are higher for privately insured Strategies to improve treatment include recruiting more providers, expanding school access Report prepared by Altarum Institute and funded by the Michigan Health Endowment Fund
Altarum
This map shows the number of untreated individuals with mental illness and substance use disorder and the percent of those who are untreated.

More than 650,000 people in Michigan with a mental illness and over 500,000 with a substance use disorder fail to receive any treatment for their conditions, according to a new study by Altarum, an Ann Arbor-based nonprofit health care consulting institute.

Altarum found that the highest percentage of people who go untreated for mental illness are the uninsured (65 percent) and Medicaid enrollees (49 percent). But for a substance use disorder, the percentages are higher for the privately insured (87 percent) and Medicare Advantage enrollees (80 percent).

“Substance use disorders and mental illness have been on the rise in the United States and Michigan and policymakers are looking for practical solutions. This research characterizes the unmet need and provides insight into strategies likely to be effective in closing the gap in behavioral health care,” Emily Ehrlich, director of Altarum’s Center for Behavioral Health, said in a statement.

The study was commissioned and funded by the Michigan Health Endowment Fund, a foundation set up when Blue Cross Blue Shield of Michigan converted into a nonprofit mutual insurer in 2013.

Altarum officials said the purpose of the study is to better understand the current state of access in order to address gaps in care amid rising rates of behavioral health-related conditions in Michigan and across the United States, especially among young adults.

“This report provides a critical baseline for understanding and improving behavioral health care access in Michigan,” Health Fund Program Director Becky Cienki said in a statement. “We now have a clearer picture of the gaps and barriers to treatment, and we’ll use the insights and recommendations from this study to guide the Health Fund’s grantmaking strategy.”

Following are some key findings:

  • 46 percent of people with anxiety disorders, 53 percent of people with depressive episodes, and 85 percent of people with alcohol use disorders are not treated for their conditions.
  • A shortage of psychiatrists and other behavioral health providers limits access to services. The shortage is especially acute in the northern half of the Lower Peninsula and parts of the Upper Peninsula.
  • Michigan has 11 child and adolescent psychiatrists per 100,000 people, far short of the recommended ratio of 47 to 100,000.
  • Central Michigan has the largest share of untreated individuals with a mental illness (41 percent) and West Central Michigan the largest share of untreated individuals with a substance use disorder (83 percent).

The study also includes analysis of data from the 2016 National Survey on Drug Use and Health, which shows that cost of care, lack of transportation and public awareness and perceptions about behavioral health care are also barriers to access.

Recommendations include:

  • increasing retention of behavioral health providers in Michigan
  • removing restrictions on the scope of practice to fully leverage all members of the health care team
  • using lay providers such as peer support specialists
  • using telemedicine to reach people in rural areas those unable to travel
  • expanding access to services in schools
  • integrating primary care and behavioral health care delivery.

Altarum plans a webinar Aug. 8 to present the findings of this study and to answer questions. Click here to register.

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