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How mental health treatment works in Michigan

How mental health treatment works in Michigan

April 01, 2016

How mental health treatment works in Michigan

Changes could be possible

By Nicholas Grenke

Posted Apr. 1, 2016 at 9:20 PM


The history of how mental health treatment works at a local level, and how statewide budgets could impact the future for people suffering from mental illness issues in Ionia County is often a misunderstood topic.

Misconceptions at a local level

Men in white coats do not decide on who is admitted involuntarily to receive mental health treatment.

Instead, the person who often has the final say is Ionia County Probate Judge Robert Sykes, an elected official.

The Right Door for Hope Recovery and Wellness, formerly the Ionia County Mental Health Department Chief Executive Officer Bob Lathers said 95 percent of people who seek treatment voluntarily come to The Right Door in search of help.

However, the other five percent of cases are handled in accordance with many civil rights laws.

“There are some people who refuse treatment,” Lathers said. “In those cases, often a family member petitions the probate court because someone is a danger to themselves or the community.”

Sykes determines if the petition offers valid reasoning. If so, the person is then given an evaluation by doctors. The Ionia County Probate Court office handles approximately 100 of these cases a year on average, according to Sykes.

“We want to keep people in the community, in their residence if possible,” Sykes said.

The person in question can also ask for a jury hearing. Sykes said that only occurs in extreme cases, and added that most often people are thankful for the treatment once they're able to recover from their mental health trauma.

“It’s not wearing,” Sykes said. “This is one area of the law I’m very comfortable with. I feel I’m helping people.”

Sykes is also in charge of the Ionia County Mental Health Court. The program, which is similar to a sobriety court, veteran court or drug court, works to treat people who have committed crimes, instead of simply throwing them in jail.

There are three people in the Ionia County Mental Health Court right now. They are not allowed to have a violent or sexual crime history and must be professionally diagnosed with a mental illness such as bi-polar disorder, schizophrenia or attention deficit hyperactivity disorder to qualify for the program.

"Locking people up may make (members of the public) feel good, but won't solve the problems if it's not necessary to protect the community," Sykes said.

The program was started in 2015, and he admitted he is still learning about the process. Ionia County was the fourth county in Michigan to implement the system.

Lathers said The Right Door has a great working relationship with the probate court judge.

“Bob Sykes is not just a good guy, he’s a great judge,” Lathers said. “He cares about the people of Ionia County and makes the tough decisions.”

He added that most people are hospitalized in a facility for only three to five days. The Right Door does not have involuntary treatment facilities, patients have to travel to Kent County or other areas for treatment and observation.

He went on to say the process to incarcerate people is much preferable to how it was in prior to the 1970s, when thousands of people were involuntarily incarcerated in mental institutions. He said the closing of the institutions was good, however the facilities, which were sometimes poorly managed and inhumane, left generations of people unable to cope with society.

“It’s one of the greatest shames in recent American history,” Lathers said.

Funding at the state level

Gov. Rick Snyder recently proposed changes to the state’s $2.4 billion mental health care system in that state's budget. The proposal called for turning some of the money from regional administrations to Medicaid HMO insurance plans. The largest of these are for-profit businesses.

Lathers said the plan was met with some pushback from people in the mental health services community.

“The plan was taken off the budget,” Lathers said. “Basically, they said ‘You come up with an idea.’ There must be a better way to manage the money.”

There was some talk in the 1990s of combining community health programs with mental health programs. Ionia County Health Officer Ken Bowen said the two organizations are too complex to conjoin.

“I don’t think it would be beneficial to the community,” Bowen said. “There are too many moving parts.”

So the situation is currently influx, according to Lathers. He said there were critics of the for-profit plan because the insurance companies would have been able to keep money left over when not used for service. Lathers and the National Alliance on Mental Michigan organization said there are concerns about running mental health program as a business.

Lathers met with Lt. Gov. Brian Calley as part of work group to come up with solutions to better manage the system. Lathers admitted any solutions are not easy.

He said the funding changes are not a cost savings issue, but are meant to ensure money is spent more appropriately.

“Mental health funding is very complicated,” Lathers said. “What we want to do is spend more money at the local level and less on regional overseers.”

His view is money used for the state’s 10 regional mental health departments would be better used at a local level, the way it was before a program that started in the late 1990s under former Michigan Gov. John Engler.

“We have the (ability) to do it, we’ve done it before,” Lathers said.