Michigan, the Great Lakes State and birthplace of the US automotive industry. When people think of Michigan they think of its mitten shape, beautiful freshwater shorelines, outdoor recreation, Motown Records, college football rivalries and the Mackinac Bridge connecting the Upper and Lower Peninsulas. What people don’t think of is the mental health crisis happening in the state and throughout the nation.
Mental Health in Michigan
Michigan, the ninth most populated state in the United States, has a population of almost 10 million people.[1] According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 19.8% of adults in Michigan have a mental health condition and only 43.7% of them receive any form of treatment from either the public system or private providers. The remaining 56.3% receive no mental health treatment.[2] When it comes to adolescents, 11% have had a major depressive episode, but 57% did not receive any form of treatment.[3]
Shortage of Providers in Michigan
Further compounding the problem, there is a significant nationwide shortage of mental health professionals, so many individuals are not receiving the treatment they need, even when they seek it out. In Michigan, more than 4.1 million residents live in a mental health professional shortage area. There are 279 federally designated mental health professional shortage areas in the state. This means, only 24% of the state need for mental health services is met.[4] The shortage of child and adolescent psychiatrists is even more dramatic, with only 239 licensed in the state of Michigan, which equates to 11 per 100,000 children and adolescents. Further, 65 counties in Michigan have zero child and adolescent psychiatrists.[5]
The Impact on Rural and Urban Communities in Michigan
Access to mental health care providers is especially problematic in rural counties across the state, with residents having lengthy waits for an appointment or forced to drive long distances to see a specialist for care. For example, in 2017 in Presque Isle County and Ontonagon County, there were an average of 6,000 or more residents for every mental health provider. The statewide average for Michigan was 430 individuals per provider.[6]
Rural communities in Michigan saw the highest suicide rate from 2000-2017, with some counties reporting suicide rates double the state average. For example, Alcona County and Oscoda County reported the highest and second highest cumulative suicide rates in the state with 26.6 and 25.5 suicides per 100,000 people, respectively.[7] This could, in part, be related to the lack of access to mental health care providers in these regions.
However, these concerns are not limited to rural communities in Michigan; urban areas of the state also face rising demand for mental health services coupled with a significant shortage of mental health providers. A 2017 report on Wayne County states that there were 390 residents for every mental health provider, nearly 20,000 individuals with Major Depressive Disorder (MDD) and 14% of county residents reported suffering from frequent mental distress (characterized by 14-day period of emotional instability, stress, depression). In fact, out of 182 US cities, Detroit was ranked first as the most stressed out based on factors such as career, finance, health, family dynamic, etc.[8]
How Telepsychiatry Can Help
One way to meet the state need is through the use of telepsychiatry. Telepsychiatry is an increasingly popular and clinically effective way to provide mental health care to individuals through real-time videoconferencing. Telepsychiatry can be used to provide psychiatric evaluations, consultations and treatment to individuals in various settings including outpatient offices, correctional facilities, hospitals, emergency departments, crisis centers, schools or even in homes.
The focus of telepsychiatry should always be on the “psychiatry” portion of the word, not the “tele.” Technology is merely a medium for connecting individuals with psychiatric providers like nurse practitioners and psychiatrists.
Years of clinical research studies have found that telepsychiatry is an effective means of care for essentially all populations and within all settings, and is an excellent tool for supplementing in-person treatment, especially when psychiatric providers are scarce. Additionally, anecdotal evidence and research show high rates of satisfaction among consumers and providers with telepsychiatry.
Benefits of Telepsychiatry
Telepsychiatry can benefit individuals, providers, healthcare organizations and communities as it allows more people than ever to access mental health care. Timely access to mental health services—whether emergent or ongoing—improves continuity of care and mitigates the need for higher cost interventions.
Telepsychiatry meets individuals’ needs for convenient, flexible and accessible mental health services, helping to improve patient outcomes. The convenience of online appointments makes individuals more likely to attend their mental health sessions than if they were seeing a provider in person — and when people are consistent in managing their mental health, their physical health also improves. It also gives individuals more options to find the right provider for them and the care that meets their specific needs, and allows typically underserved groups to access care. This combined with less travel time, less time off work and shorter wait times for services means people get the care they need sooner, are more engaged in their health and happier with their experience of care. Receiving mental health treatment sooner can help to prevent potentially costly hospitalizations later on.
For people concerned about the stigma of seeking mental health services, telepsychiatry allows them to access care in a comfortable, private environment. Much like Skype or FaceTime, direct-to-consumer telepsychiatry allows individuals who had not sought care before to have options.
Who is Appropriate for Telepsychiatry?
Research shows that telepsychiatry is clinically appropriate for nearly all patient populations, but it is important for individuals receiving care to be educated on telepsychiatry and consent to treatment through this medium. Direct-to-consumer telepsychiatry is not the right medium for individuals who are in a mental health crisis, but is ideal for mild or moderate concerns or those looking to maintain their mental wellness.
About InSight Telepsychiatry
InSight (now Array Behavioral Care) is the leading national telepsychiatry service provider organization with a mission to increase access to quality behavioral health care through innovative applications of technology. InSight has over two decades of telepsychiatry experience and serves hundreds of organizations across the country with its on-demand, scheduled services and Inpathy divisions. InSight is uniquely positioned to offer scalable telepsychiatry services in settings across the continuum of care. InSight has a diverse team of psychiatry providers, a robust internal infrastructure and a history of adapting its programs to fit the needs of a variety of different settings and populations. InSight has led the growth of the telepsychiatry industry and remains an industry thought leader and advocate.
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[1] Mental Health Resources in Michigan. (2019). Rtor.org. Retrieved 18 July 2019, from https://www.rtor.org/directory/mental-health-michigan/
[2] The NSDUH Report: State Estimates of Adult Mental Illness from the 2011 and 2012 National Surveys on Drug Use and Health. (2014). Samhsa.gov. Retrieved 18 July 2019, from https://www.samhsa.gov/data/sites/default/files/sr170-mental-illness-state-estimates-2014/sr170-mental-illness-state-estimates-2014/sr170-mental-illness-state-estimates-2014.htm
[3] Behavioral Health Barometer: Michigan. (2017). Retrieved from https://www.samhsa.gov/data/sites/default/files/Michigan_BHBarometer_Volume_4.pdf
[4] Mental Health Care Health Professional Shortage Areas (HPSAs). (2019). The Henry J. Kaiser Family Foundation. Retrieved 19 July 2019, from https://www.kff.org/other/state-indicator/mental-health-care-health-professional-shortage-areas-hpsas/?currentTimeframe=0&selectedRows=%7B%22states%22:%7B%22michigan%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
[5] (2019). Aacap.org. Retrieved 19 July 2019, from http://www.aacap.org/app_themes/aacap/docs/Advocacy/federal_and_state_initiatives/workforce/individual_state_maps/Michigan%20workforce%20map.pdf
[6] Suicides, opioid overdoses spike in rural Michigan. (2019). Grand Haven Tribune. Retrieved 19 July 2019, from https://www.grandhaventribune.com/Law-Enforcement/2019/03/17/Suicides-often-linked-to-opioids-spike-in-rural-Michigan-and-among-young.html?ci=stream&lp=2&p=1
[7] Suicides, opioid overdoses spike in rural Michigan. (2019). Grand Haven Tribune. Retrieved 19 July 2019, from https://www.grandhaventribune.com/Law-Enforcement/2019/03/17/Suicides-often-linked-to-opioids-spike-in-rural-Michigan-and-among-young.html?ci=stream&lp=2&p=1
[8] Hafke, T. (2018). Mental Notes – Hour Detroit Magazine. Hour Detroit Magazine. Retrieved 19 July 2019, from https://www.hourdetroit.com/health/mental-notes/
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