For the past 10 years I have been involved with Packard Health where we treat both the physical and mental health of the patient with the physical and behavior heath professionals working side by side for the benefit of the patient. Unfortunately most insurance companies fund and view physical health and mental health as separate issues, which they are not. This has resulted in uncoordinated care for the patient since very few physical and mental health providers work in the same facility. This fragmented approach needs to change and it needs to start with our insurance companies recognizing the benefit for the patient if the Packard Health model becomes the standard of care.

I am sharing a guest editorial that was published in the Detroit News today by Jim Haveman, former director of Michigan Department of Health and Human Services under Engler and Snyder. Jim and I have had multiple conversations about this subject. He gets it. Please take the time to read his thoughts. Jim will be testifying before senate majority leader Shirkey’s committee on this subject in the next few days. This is an extremely important issue that can no longer be ignored.

Opinion: Overhaul state’s Medicaid mental health system

James HavemanView Comments

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.

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.https://4b61cfc67f584fd22a67f7f4dc42bca7.safeframe.googlesyndication.com/safeframe/1-0-38/html/container.html

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.

Being fully integrated will allow the Michigan Department of Human Services to standardize services throughout Michigan and only fund best practices. It will give the consumers of services a choice of health plans that are fully integrated. If they are unhappy or services are not as they expected, a means of appeal is in place outside of the health plans providing services. 

The integration of mental health and physical health is doable and Michigan needs to catch up with other states. Some have suggested that the system should stay the course, saying the legislation being proposed “privatizes” health care — ignoring the fact that virtually all mental and physical health coverage in Michigan is currently provided by private providers. This is a red herring, intended to derail the proposed progress towards full integration of services. Get the COVID-19 Update newsletter in your inbox.

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I believe dialogue and action by the Legislature is needed and timely. We don’t need any more study groups or research on integration. It is time to take the best of various bills and finalize a bill that points Michigan in a new direction — one that will provide better care for the patients we all want to serve well.

I am confident in those who will implement the new legislation and those who will measure the required accountability. The winners will be the citizens of our great state. 

James Haveman was director of the Michigan Department of Mental Health from 1991 to 1996. He was director of the Michigan Department of Community Health from 1996 to 2002 and from 2012 to 2014.S