MDHHS outlines crisis units, PRTF expansion and state hospital capacity shortfalls

Megan Groen, senior chief deputy director for behavioral health at the Michigan Department of Health and Human Services, and Dr. George Mellos, senior deputy director for state hospital administration, briefed the House Oversight Subcommittee on the state’s behavioral health landscape and inpatient‑care capacity on Oct. 26, 2025.

“Our mission is definitely to provide access to behavioral health care where and when people need it,” Groen said, summarizing MDHHS priorities that range from prevention and outpatient services to residential and inpatient care. She told the panel MDHHS serves roughly 300,000 Michiganders annually through the specialty behavioral health system, operates or funds crisis lines and peer warm supports receiving over 200,000 contacts a year, and is expanding several initiatives intended to reduce emergency department boarding and unnecessary inpatient stays.

Nut Graf: MDHHS described three policy areas intended to reduce inpatient pressure: crisis stabilization units (CSUs) created by a 2020 public act, which offer short (up to 72‑hour) stabilization; Certified Community Behavioral Health Clinics that provide 24/7 access and serve broad populations; and Medicaid‑funded psychiatric residential treatment facility (PRTF) benefits for children, added in December 2023. MDHHS said some progress has been made but state psychiatric beds remain a small fraction of statewide inpatient capacity, and forensic waitlists have grown.

MDHHS reported two CSUs open in Wayne and Kent counties that together saw nearly 2,900 people in the current year; MDHHS said about 80% of patients who might otherwise have needed inpatient care at one Kent County CSU were stabilized and connected to community supports. Groen said MDHHS is also developing transition/step‑down facilities to avoid long inpatient stays when patients are medically ready for discharge but lack community placements.

Dr. Mellos described state hospital operations and differences from private inpatient facilities: the state operates about 660 beds across multiple hospitals (Carroll Psychiatric Hospital, Kalamazoo Psychiatric Hospital, Walter Reuther, and the Center for Forensic Psychiatry). He said state hospitals treat people with the highest‑severity behaviors and that admissions follow either a forensic (Chapter 10) or probate (Chapter 4) process under the Michigan Mental Health Code. “We treat people ... with the highest and severest behaviors,” Dr. Mellos said.

MDHHS told lawmakers the forensic evaluation and admission demand has increased substantially; the department reported roughly 269 people on a forensic admission waitlist and about 480 defendants awaiting forensic competency evaluation. The department said it has reduced evaluation backlogs by triaging and using video evaluations from jails, and it has shortened average lengths of stay for some forensic populations compared with prior years.

Committee members asked whether the state has a role in addressing private‑sector bed shortages and what policy changes could increase access. Groen and Mellos said the state’s strategy emphasizes community‑based services, targeted transition placements and a possible new Medicaid benefit for adults with intellectual and developmental disabilities who need step‑down care; they also said some issues — for example, hospital licensing and certificate‑of‑need decisions for private facilities — fall outside MDHHS’s direct authority.

Ending: MDHHS officials offered to update the committee as new transition and Medicaid benefit work proceeds. Lawmakers asked for additional data mapping bed locations and capacity across the private and public systems.