Witnesses tell Michigan panel shortage of psychiatric beds—especially for children—forces out‑of‑state placements, strains hospitals and jails

The Michigan House Oversight Subcommittee on Public Health and Food Security continued a multiwitness review July 1 of the state’s psychiatric bed shortage, focusing on child and adolescent services and the “continuum of care” that used to follow inpatient treatment.

The shortage matters, witnesses told the panel, because it shifts care from therapeutic settings into emergency rooms, the juvenile justice system and distant out‑of‑state facilities—placing financial, logistical and safety burdens on families, hospitals and county jails.

Mary Anne Huff, president and CEO of the Mental Health Association in Michigan, told the committee that the state no longer has the “robust level of care” that existed in the early 1990s, when two state psychiatric hospitals for children and specialized residential step‑down programs were operating. She said the state lacks licensed specialized psychiatric residential treatment programs on the commercial payer side and that “kids should not have to go into the juvenile justice system to get residential treatment.” Huff said changes in restraint and seclusion rules and shifts in Medicaid policy removed a path that previously let children step down from state hospitals to specialized residential care.

Huff described family calls she receives from parents with children whose behaviors are “extreme,” including self‑harm and violent outbursts, and said families sometimes spend weeks in emergency rooms while waiting for an appropriate bed. She told the committee Michigan currently operates two psychiatric residential treatment facilities (PRTFs)…