Michigan's mental health care providers are already stretched far beyond capacity, according to an Ann Arbor research agency.
A report released Thursday by the Center for Healthcare Research & Transformation says the state's mental health system "is broken."
And if it's bad now, care providers will be overwhelmed when the Affordable Care Act takes effect next month.
CHRT director Marianne Udow-Phillips says one in five Michiganders surveyed reported being diagnosed with depression at some point in their lives.
Udow-Phillips says that's higher than the U.S. average of 18%.
"The families of many people who have mental illness are trying to get care, and a very high percentage of people with mental illness are uninsured," Udow-Phillips says.
That will change under Obamacare, but that doesn't mean getting help will be any easier.
The CHRT report finds mental health care services are limited most profoundly in rural areas including Petoskey in northern Michigan. But there's a shortage of care providers in cities, as well.
"Even in Grand Rapids we saw significant access problems," Udow-Phillips says. "Saginaw, Flint, Detroit -- it's not just rural areas."
Udow-Phillips says providers need to look for creative solutions. One option may be telemedicine.
"It could be physicians calling psychiatrists or primary-care physicians who are not trained in mental issues," Udow-Phillips says. "They can help in medication. They can consult with them on how to treat a particular patient who might be in their office at that moment.
"We also need more social workers, more technology to help expand the adequacy of psychiatrists we have in the state."
Inpatient facilities are also lacking, according to CHRT.
"Michigan has very few inpatient beds. We rank 42nd out of 50 states in terms of the number of psychiatric beds per population," Udow-Phillips says. "If you talk to psychiatrists, they will tell you that they have patients sitting in their emergency rooms for 24, 36 hours or longer, looking for a bed where this patient can be admitted.
Expanded services will, of course, require more funding. Udow-Phillips says Gov. Rick Snyder is expected to propose a $50 million supplemental budget increase next week to fund more mental health services.
The governor's proposal includes bringing substance use treatment into the community mental health system, Udow-Phillips says. "Physicians are telling us they have extreme difficulty in finding access to those services. We see individuals being sent out of state to get residential substance abuse treatment."
CHRT's report finds that survey respondents with depression and/or anxiety reported an average of five days per month in which poor health limited their activities of daily living, including work.
The report says it's estimated that nationwide, depression results in a direct loss of $31 billion in productivity annually.
For more information, see the report "Access to mental health Care in Michigan."