The Community Mental Health Association of Michigan study shows that integrated care is on the rise

The Community Mental Health Association of Michigan (CMHA) is the state association that represents and supports Michigan’s public mental health system and those served by this system.

A research arm of the Michigan Community Mental Health Association (CMHA), the Center for Healthcare Integration and Innovation has released its Health Care Integration and Coordination – 2022-2023 Update: Michigan Public Mental Health System Initiatives Survey in March. Approximately 40 organizations participated in the study, submitting approximately 800 health integration initiatives operating across the state. Integrated health care brings together mental health, substance abuse and primary health care to create more effective care for people in need.

The study shows that integrated care in Michigan’s public mental health system has not only grown over the past six years, but that the initiatives are diverse and available in rural, suburban, and urban boards.

According to CMHA Executive Director Robert Sheehan, these results for the average person show that integrated care “is really great care” and that there are different ways to get integrated care. Additionally, public mental health systems are innovating to provide many integrated care initiatives that are currently not available in private sector settings where most of the public seek care.

“The average person, who is a voter and might be interested in public policy, might say, ‘Wow, I want more than that cutting-edge behavioral health system integration,” says Sheehan.

The report detailed hundreds of integration efforts underway in Michigan’s public mental health care system that have increased behavioral health consumers’ access to primary care services; improved access to behavioral health services for individuals seen in primary care settings without ready access to the full range of behavioral health services; improved prevention and interventions that reduce serious physical illness; and improved health status for general health care consumers.

St. Clair County Community Mental Health which houses an Immunization Clinic.

Of the many health integration efforts, three appear to be the most widely used.

• Coordination of care. A patient’s care activities are organized and information is shared among all providers interested in that parent’s care. The goal is to get safer and more effective treatments. The study identified 157 initiatives that use care coordination.
• High-use initiatives. These provide patients with comprehensive case management. A patient uses many services, health services and human services such as public safety or housing support. The study found 147 joint efforts in high- and super-user initiatives.
• Co-location of care. Behavioral health and intellectual/developmental disability services or protocols are provided by a behavioral health staff at a primary care site or hospital emergency department through face-to-face psychiatric consultations or via telehealth. The study identified 115 efforts to co-locate physical and mental health services.

Overcoming the challenge of integration

“[Integrated care] Sounds like a no-brainer, right? We work together,” says Sheehan. “Except record keeping is really different. Primary care is short appointments, and mental health care tends to be longer. Usually, physical health care is often based on walking into the doctor’s office and a lot of ours [mental health] the assistance is going to people’s schools and workplaces.”

To overcome these challenges, the study found that public mental health organizations are using different integrated methods of care based on patient needs, geography, the skill set of the health care provider, or even considerations such as a bus route in vicinity. Evolving integration initiatives, increasingly focused, are efficient and advanced in meeting the needs of Michigan residents.Uswa Ali Memon, policy analyst for the Community Mental Health Association of Michigan

“I was really intrigued that a lot of the things that are happening aren’t documented as much as they should be because these are important things,” says CMHAM policy analyst Uswa Ali Memon.

For this reason, it decided to include case studies in the survey report to facilitate understanding of what integrated care is, encourage CMHs to showcase their work and highlight the complexity of the cases.

Looking at the case studies, Memon says, “You actually understand how complex things are, which is not the sense you get when you go through processes. You think if you follow a, b and c, you’ll get the output, but it’s not always that simple.

“Our system gets better every year.”

Through the study, existing projects demonstrated greater maturity than previous integration initiatives and deeper involvement from health integration partners.

“Our system gets better every year,” says Sheehan. “What we’ve learned is that if you stay with it, this is a live organic process. It’s not just an initiative or project that changes the way we do behavioral and physical health care. This is the most important thing. This is a live thing that gets more sophisticated every year. We learn from our mistakes, step back and move forward. I was impressed with the results.”

Joanne Bailey-Boorsma has over 30 years of writing experience having served as a reporter and editor for several West Michigan publications covering a variety of topics from local news to the arts and entertainment.

Photo by Robert Sheehan by Roxanne Frith. Photo by Uswa Ali Memon and CMHAM logo courtesy of the Community Mental Health Association of Michigan. Additional photos courtesy of St. Clair County Community Mental Health and the Genesee Health System.

The MI Mental Health series highlights the opportunities Michigan’s children, adolescents and adults of all ages have to find the mental health help they need, when and where they need it. It is made possible thanks to funding from the Michigan Community Mental Health Association, Center for Transforming Health and Research, Genesee Health System, Western Michigan Mental Health Foundation, North Country CMH, CMH Northern Lakes Authority, On the verge, Sanilac County CMH, St. Clair County CMH, Tip of the SummitAND Washtenaw County CMH.