MHA reveals Michigan emergency rooms struggle with behavioral health patient wait times

In a recent meeting of the Michigan Legislature, significant concerns were raised regarding the state’s behavioral health services, particularly in emergency departments. With over 1.2 million emergency room visits last year linked to behavioral health issues, the need for timely access to care has become increasingly urgent. The Michigan Hospital Association (MHA) is actively addressing these challenges, having initiated an 18-month data collection process to better understand the impact of behavioral health diagnoses on emergency department stays.

The data revealed that on any given day, more than 155 patients are waiting in emergency departments across Michigan for critical behavioral health services. This figure is likely conservative, as it reflects feedback from only about 70 hospitals. Notably, pediatric and geriatric patients face the longest wait times, highlighting the difficulties in finding appropriate placements for these vulnerable populations. Furthermore, patients with Medicaid insurance are disproportionately affected, often waiting longer for care compared to those with commercial insurance.

The MHA's findings indicate that over 8,000 Medicaid patients experience extended boarding in emergency departments annually, compared to approximately 5,000 commercially insured patients. This discrepancy raises serious concerns about the adequacy of the current system, particularly as Medicaid patients must undergo a pre-admission screening assessment within three hours during a behavioral health crisis. However, hospitals report that these assessments frequently do not occur within the required timeframe, leading to delays in care.

The meeting also highlighted the bureaucratic complexities that Medicaid patients face when seeking behavioral health services. Unlike commercially insured individuals, who can be assessed and transferred to inpatient care relatively quickly, Medicaid patients must navigate a convoluted process involving community mental health agencies. This often results in prolonged waiting periods in emergency departments, where patients receive no immediate treatment while awaiting decisions about their care.

The stark contrast in processes for commercially insured versus Medicaid patients underscores systemic issues tied to payment mechanisms. Medicaid beneficiaries require approval from community mental health clinicians before receiving inpatient care, which can lead to extended delays and further complicate their access to necessary services.

As Michigan continues to grapple with these challenges, the MHA's ongoing efforts to streamline processes and improve access to behavioral health care will be crucial. The discussions from this meeting reflect a pressing need for reform in the state's approach to behavioral health services, particularly for the most vulnerable populations. Moving forward, stakeholders will need to address these disparities to ensure that all patients receive timely and effective care in their moments of need.