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Michigan's mental health care shame

Patients at the Eloise Psychiatric Hospital in the early 1950s.
Friends of Eloise

When I was a child growing up in the Detroit area in the 1960s, all the kids knew what happened if you became mentally ill, or as we so nicely put it, went nuts. You would be taken to Eloise, which we vaguely knew of as a huge mental institution somewhere.

Indeed, there was a mental hospital with the quaint name Eloise in western Wayne County, part of a sprawling complex that once housed thousands of patients.

Michigan has very few government mental facilities now; instead, our mentally ill are either living homeless on the streets or are housed at huge expense in our prisons.

This is a public health disaster. Last week, my attention was drawn to a story Michigan Radio reported that said the state was taking new steps to rebuild inpatient psychiatric care in Michigan. That would be an excellent idea, but I didn’t believe it for a minute. Rebuilding a state psychiatric care system would be expensive, and we have a legislature which won’t even raise taxes to properly fix the roads, even though that would have overwhelming public approval.

Tom Watkins is about as well positioned as anyone to assess the situation. “You are right to be skeptical,” he told me. Watkins was director of what was the state mental health department thirty years ago, and just finished a four-year stint as president and CEO of the Detroit Wayne Mental Health Authority.

Watkins told me that the idea that there was a mental health “system” in Michigan, or the nation, was a joke. 

“We have a disjointed collection of too few state hospitals and private hospitals that are seeking to profit off public patients and hence don’t want those that are too sick, aggressive, and non-compliant.”

Additionally, there are too few state or local resources directed at developing community-based programs. Cuts to the Affordable Care Act, which did provide some resources to fill in mental health gaps, are adding to the chaos.

The bottom line is that there is no one agency that can hold the multiple fragments of our mental health care network responsible. The result is that too often it is next to impossible to find a psychiatric hospital bed for a patient who clearly needs hospitalization.

Those angry at this often blame John Engler, who closed a number of state psychiatric facilities soon after he became governor in 1991. But the problem started long before, longtime Wayne County Probate Judge Milton Mack told me.

Mack, now Michigan’s state court administrator, said the problem began when Congress passed the Community Mental Health Act of 1963. It provided an incentive for states to close state-funded mental hospitals while promising to fund community-based mental health centers and programs to provide outpatient treatment.

The facilities were closed. But the funds for the mental health centers never materialized, leaving us with our current mess, which Watkins believes is also a ticking time bomb. He thinks our mental health crisis is “unlikely to truly be addressed until a sensational tragedy erupts.”

“Public policy by tragedy, as we are once again witnessing in Parkland, Florida, is not a sensible way to govern,” he said. But as he noted, the real tragedy is already with us, in the thousands of people with serious mental illness who are not properly being served.

Jack Lessenberry is Michigan Radio’s Senior Political Analyst. Views expressed in his essays are his own and do not necessarily reflect those of Michigan Radio, its management, or the station licensee, the University of Michigan.

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