The following is a press release originally published on the Michigan.gov website. It features a mention of Gov. Whitmer’s proposal to fund a $5 million on-demand help of school-based clinicians initiative via the MC3 program.

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LANSING, Mich. — Today, Governor Gretchen Whitmer sat down with students, parents, educators, and mental health professionals at Pontiac High School to advocate for additional mental health investments in schools at the beginning of Student Appreciation Week. The governor’s fiscal year 2023 School Aid Fund budget recommendation would invest $361 million for school-based mental health services, including hiring and retaining mental health professionals and opening 40 new clinics for students across the state.

“Last year, I made largest education investment in Michigan history and delivered resources to hire over 560 mental health professionals, including nurses, social workers, and psychologists,” said Governor Whitmer. “In my budget for the next school year, I’m proposing another historic investment in on-campus mental health supports for our kids. We can and must work together to expand access to mental health care to help our kids thrive in and out of the classroom. My budget includes the highest per-student investment in Michigan history – I look forward to making that investment reality. Let’s get it done.”

Governor Whitmer’s Proposed Mental Health Investment

The fiscal year 2023 School Aid Fund Executive Recommendation includes $361 million for school-based mental health services. Today’s visit highlights the increased need for school-based mental health services and the Governor’s proposed response. Governor Whitmer’s proposed budget includes:  

• $150 million to offer training for teachers in partnership with TRAILS.
• $25 million to give every school free access to quality mental health screeners.
• $120 million to hire more school-based mental health professionals.
• $50 million to continue to strengthen school-based mental health supports to ensure school nurses and social workers are part of a bigger effort and not isolated resources.
• $11 million to open school-based health centers in regions with limited access to care.
• $5 million to provide on-demand help for school-based clinicians responding to unique cases in partnership with the Michigan Child Collaborative Care at the University of Michigan.

School-based health centers, also known as child and adolescent health centers, are housed in school buildings and staffed by clinicians. There are over 100 sites across Michigan, serving more than 200,000 students annually in communities where families lack access to medical services. Governor Whitmer proposes adding 40 more sites.

The following article was written by Beata Mostafavi and originally published by the Michigan Health blog. It mentions the MC3 program in reference to guidance from experts recommending that parents of adolescents reach out to primary care providers for help in finding a mental health provider and support from their communities.

Link to original article

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Amid growing concerns for children’s mental health during the pandemic era, more than a quarter of parents say their adolescent-aged child has seen a mental health specialist – with nearly 60% of those reporting a visit within the past year – a new national poll suggests.

But screening and navigating the mental health care system remains difficult for many parents. While almost all parents say they’re confident they would recognize a possible mental health issue in their child, much fewer say their child is regularly screened for mental health by their provider or that it’s easy to get the care they need once they recognize a problem.

The findings come from a nationally representative report conducted by the University of Michigan Health C.S. Mott Children’s Hospital National Poll on Children’s Health in collaboration with the Children’s Hospital Association. The report, which comes less than six months after children’s mental health was declared a national emergency in the United States, is based on responses from 1,201 parents of children ages 11-18 surveyed in October 2021.

“Even before the pandemic, mental health disorders in adolescents, such as depression and anxiety, were prevalent,” said Mott Poll co-director and Mott pediatrician Gary L. Freed, M.D., M.P.H.

“The pandemic caused significant stress and social disruption for kids that likely exacerbated these problems, as we’re seeing a growing number of young people face mental health concerns. This places a heavier burden on parents, health providers and other trusted adults in their lives to be aware of potential warning signs.”

Screening for mental health issues in children and teens

While a third of parents say their adolescent has completed a mental health screening questionnaire at their primary care office, only four in ten say their adolescent’s provider asks about mental health concerns at all well child visits. One in seven say their provider never asks about mental health concerns.

“Regular check-ups are the best time for providers to discuss potential mental health concerns,” Freed said. “If parents feel their adolescent’s provider is not being proactive in raising these issues, they should bring it up with them.”

It’s also important for adolescents themselves to feel comfortable seeking help, Freed notes.

Only a quarter of parents polled, however, thought their adolescent would definitely talk to them about a possible mental issue, and even fewer thought their adolescent would open up with their primary care provider.

There are some steps parents can take to help, Freed notes. He recommends having open conversations with kids that give them opportunities to discuss issues and emphasize that asking for help “isn’t a sign of weakness but of strength.” They can also prepare them for health visits by reinforcing the importance of sharing concerns with providers and also allow their child privacy during the visit.

“Being good listeners and initiating open, non-judgmental conversations about mental health can help reduce stigma and make kids feel more comfortable,” Freed said. “It may also be helpful for parents to share any of their own experiences with mental health challenges.”

“Before seeing a doctor, adolescents should understand that their doctor is there to help and that they should be as honest as possible about any physical or mental health problems.”

Identifying warning signs of mental health issues

Even before the added stress and disruption of the pandemic, one in five adolescents had a diagnosable mental health disorder, including depression and anxiety. Several reports indicate that these challenges may have worsened during the pandemic.

While it may be difficult for parents to tell the difference between their adolescent’s normal ups and downs and mental illness, parents polled seemed to know what to look for. Among signs that would prompt their concern were frequent comments about being worried or anxious, moodiness, decreased interaction with family, a drop in grades or changes in sleep or eating patterns.

SEE ALSO: How to Talk to Children and Teens About Suicide: A Guide for Parents

If parents notice a possible mental health issue, most say their first response would be to talk with their adolescent or keep a closer eye on them. Fewer parents’ first response would be to make an appointment with a healthcare provider, check in with their adolescent’s teacher or get advice from family or friends.

The stigma of mental illness may make parents hesitant to seek help or delay seeking care for their adolescent as they may think the symptoms will go away on their own, Freed says. But it’s important to take the next step if needed.

“Signs of struggles with mental health can look different for every child, and some may be easier to recognize than others,” Freed said. “Parents should take seriously any major changes to their baseline behavior that could be a symptom of something more concerning.

“If adolescents seem overwhelmed by trying to manage challenges, parents should seek professional help.”

Barriers in receiving mental health care

More than half of parents say they decided on their own to have their adolescent see a mental health specialist while less than one in five got a referral from their adolescent’s primary care provider or school.   

But even after recognizing a problem, some parents also have trouble navigating the health system to find a mental healthcare evaluation or treatment options for their adolescent, the poll finds.

Nearly half of parents who tried to do so, describe difficulties getting their adolescent care with a mental health specialist, including long waits for appointments, finding a provider who took their insurance or saw children. Ten percent of parents also said they simply just didn’t know where to go.

Experts say parents should reach out to their adolescent’s primary care giver for help in finding a mental health provider and support from their communities. Some programs, such as the MC3 program at University of Michigan, helps connect primary care providers with psychiatrists and behavioral specialists for consultation and training to help address mental health needs in local clinics.

“Difficulties finding and getting mental health care for youth reflects strains in our current mental health system and highlights the need for more ways to support parents and their children,” added Amy Wimpey Knight, president of CHA.

“Parents whose children need mental health help should remember they aren’t alone. But they may need to be proactive and persistent in seeking support from a provider, their school, or family or friends in caring for mental health issues.”

This article, written by Kara Gavin, originally appeared on the M Health Lab website.

Most mental health care in America doesn’t happen in psychiatrists’ offices – especially when it comes to children, teens and young adults. 

Instead, young people with depression, anxiety and more turn to the same people they already go to for all kinds of other health issues: their pediatricians, family doctors, school-based clinics and other primary care providers.

But where do those providers turn when they need more help in handling the mental health concerns of their patients – especially more serious issues that they’re not trained to handle? 

If they’re anywhere in Michigan, they can turn to the team at MC3. 

For nearly a decade, the MC3 program has helped thousands of primary care providers throughout the state care for the mental health needs of young people up to age 26. It also aids providers caring for pregnant women and new mothers of any age who have mental health needs.  

More than 16,000 times since 2012, MC3’s psychiatrists and pediatric behavior specialists from the University of Michigan have connected directly with more than 1,800 primary care providers by phone, for consultations about their patients.

Together, they’ve mapped out plans for handling ADHD in young children, suicide-prevention safety planning for teens and symptoms that might signal schizophrenia in young adults.

There’s no charge to providers or their patients, thanks to the program’s funding from state and federal grants.

For providers whose patients recently had a mental health emergency or are waiting for an appointment with a child psychiatrist or a psychiatric inpatient bed, the service can literally be a lifeline: one in five of the consults involve a patient who has expressed suicidal thoughts or harmed themselves. 

How it works

MC3 also offers video-based telehealth appointments to connect patients of participating providers with psychiatrists. U-M and Michigan State University experts have also created a wide range of training options for professionals available on the MC3 website. 

Though the demand has grown in recent years thanks to the pandemic, the program has room for more Michigan providers to join the network and get access to its services.

Each connection starts by contacting one of the trained professionals in MC3’s network of Behavioral Health Consultants, located throughout the state. MC3 also works closely with the state-funded Community Mental Health agencies across the state.

“Only about 3% of the children, teens, young adults and moms that our participating providers have consulted with us about are in treatment with a psychiatrist. We’re providing access to specialist-informed care to young people who wouldn’t otherwise have it,” said Sheila Marcus, M.D., who heads the pediatric component of MC3 and is a professor of psychiatry at Michigan Medicine, the University of Michigan’s academic medical center.

“The reality is that no matter where they live and no matter what their family’s income level, most of these patients would not have easy access to a specialist because of the critical shortage of such providers,” she added. “In some counties, there are no local providers trained to provide this level of care.”

Primary care providers inside and outside Michigan can also access MC3’s free online resources, even if they’re not enrolled in the program. 

These include prescribing guides for mental health medications and online provider education, to equip them to provide diagnosis and care that might not have been part of their formal professional training. Much of that training offers continuing education credits that can help physicians, nurse practitioners, physician assistants and certified nurse midwives keep up their license.

“For me, MC3 has been a game changer,” said Lia Gaggino, M.D., who first interacted with the MC3 team through her pediatrics practice in Portage, Michigan and now is the team’s consulting pediatrician. “Since its inception I have used their services for children and teens who presented with very complicated mental health concerns. I wished I had had a psychiatrist to help me and then MC3 appeared and offered me a lifeline. Their services changed my prescribing practices and improved my skills and I am so grateful for their advice and support. I encourage my colleagues to sign up and call –MC3 is there to help us!”

Local care amid a national emergency

As the nation grapples with a national emergency of rising mental health concerns among young people, MC3 and similar programs in other states are expanding access to critical psychiatric services at a time when demand is soaring.  

The national organizations that declared that emergency in October called for more support of mental health care in primary care settings, as well as efforts to overcome the national shortage of mental health specialists for young people, especially in rural and low-income areas. 

That shortage is what drove the creation of MC3 in the first place.

Michigan is third from the bottom among all states in supply of mental health professionals for young people. Only Washtenaw County, where the University of Michigan is located, meets national population-based criteria for having enough mental health providers specializing in children and teens.

The pandemic has made matters worse across Michigan and the United States. A national report from November 2020 showed that anxiety and depression in pregnant women have more than doubled, and emergency department visits for mental health concerns in children had risen by double digits since the pandemic began.

Joanna Quigley, M.D., another MC3 consulting psychiatrist from Michigan Medicine, recently presented data at a national meeting showing that 30% of MC3 consults during 2020 focused on pandemic-related concerns. 

The pandemic has prompted MC3’s team to plan to offer extra training to help providers identify the needs and handle the concerns of children traumatized by experiences they or their families have had during COVID-19. 

Trauma-informed care is also important for children who even before the pandemic experienced very disruptive life events. 

Terri Rosel, NP-C, a nurse practitioner at Cherry Health in northern Michigan, wrote to the MC3 team: “I work in a small student health center in Cedar Springs and am the sole provider in the office. Since starting this job four years ago I have had the pleasure of seeing so many students with mental health concerns. I felt ill-equipped at times to help them with my degree as a family practice nurse practitioner. I would utilize MC3 often to help with treatment plans for these wonderful kids who needed help but could not get into psychiatric services soon enough.”

As the program continues to grow, it will partner more with schools through a direct connection with the TRAILS program that offers mental health awareness and support services. 

Positive feedback from providers

The MC3 team has surveyed participating providers and found that 99% agreed with the statement that “following phone consultation(s) I felt more confident that I could effectively treat patients’ behavioral health problems.”

The team published other findings from its survey of providers, and responded to feedback by making changes.

The quotes they received from providers are equally compelling. 

“This service has been absolutely ‘practice- changing’,” said one. “As we have more and more patients with mental health issues and limited local resources- we are essentially the only option for these kids. Having MC3 support helps us make good treatment decisions and is also ‘on the job training’ which we can apply to future patients.” 

In fact, MC3 data show that 25% of the interactions help the patient avoid a higher-level of care that may be difficult to access, such as a psychiatric hospital bed or emergency psychiatric visit. 

One of the maternal health providers who joined MC3 recently said, “I can’t even express how this service has enhanced the care I can provide. In the past, we’d screen and diagnose and then send moms out. We’d place referrals and hope that folks could navigate the complex system. Now, with MC3, I can collaborate with psychiatry, start meds or treatment, and access community resources that I am confident they will be able to access. It’s really been invaluable.”

Paper cited: “Michigan Child Collaborative Care program (MC3): Ten years of growth, adaptation, and learning,”  American Academy of Child and Adolescent Psychiatry annual meeting. DOI: 10.1016/j.jaac.2021.07.142