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MC3 in the Media

Whitmer Hosts Mental Health Roundtable in Pontiac

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  • Alyssa Wealty |

  • Apr 25, 2022
Photo of Gov. Gretchen Whitmer meeting with others at round table discussion about mental health

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.


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.

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MC3 in the Media

How can Michigan address its dire shortage of mental health professionals?

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  • Alyssa Wealty |

  • Apr 14, 2022
Photo of Michelle Schulte, the maternal infant child health division director of the Inter-Tribal Council of Michigan

The following article was written by Estelle Slootmaker and originally published by Second Wave Michigan. It mentions the MC3 program in reference to MC3’s collaboration with the Inter-Tribal Council of Michigan to improve mental health outcomes for members of Michigan’s tribal communities.


This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.

Even as mental health issues have risen worldwide, Michigan has fallen behind on having enough health professionals to address that trend. According to National Alliance on Mental Illness (NAMI) data, there were 421,000 Michiganders who did not receive needed mental health care in 2021, but only 38.4% cited cost as the reason. A Kaiser Family Foundation analysis illustrates one of the other key reasons people aren’t getting the care they need. That study finds that more than four million Michiganders live in communities with a shortage of mental health professionals, ranking fifth worst in the nation, behind Texas, California, Alaska, and Missouri.

“There’s a systemic shortage. We don’t have enough providers to meet the needs of the population. The shortage has progressively gotten worse over the last five or 10 years. And we’re feeling the impact even more due to COVID,” says Timothy Michling, research associate in health affairs at the Citizens Research Council of Michigan and author of a report entitled “Michigan Falls Short on Mental Health Services.” “When we look at projections going forward, we see the gap between demand and supply of providers widening. If we don’t address the issue now, it’s only going to get worse in the future.”

According to Michling, this shortage spans the mental health professions, from direct caregivers to master’s-level therapists to social workers to psychiatrists to psychologists. Many Michigan counties have no psychiatrists, particularly for children and adolescents.

“Mental health underpins our wellness as a society. We see much worse outcomes in a variety of health conditions when you have an untreated mental health disorder. This affects our economy and our society at large,” Michling says. “Students are not able to do as well in school if they have an undiagnosed or untreated mental health condition. And that follows children into adulthood. It affects their career readiness. It affects our rates of homelessness, our rates of unemployment and workforce participation.”

Filling the void for tribal communities

Effects of the mental health professional shortage vary by geographic region in Michigan. Six Upper Peninsula counties and nine Lower Peninsula counties have no psychiatrists, and three UP counties and seven Lower Peninsula counties have neither psychiatrists or psychologists. Michelle Schulte, maternal infant child health division director for the Inter-Tribal Council of Michigan (ITCMI), works with Northern Michigan tribal communities located in some of these areas of need.

“The shortage of mental health professionals is impacting people in our communities in a very bad way,” Schulte says. “We have long waiting lists … People who have needs can’t get in. In our rural areas, especially the UP, many people have to travel two to four hours to get the kind of care that they need. Some tribal communities have a limited contract with a local psychiatrist or psychologist that comes in maybe once a month and sees everybody on that same day. If you miss your appointment or can’t make it on that day, you’re stuck.”

Schulte and her ITCMI colleagues have collaborated with a wide range of partners to create projects and programs that shore up the lack of mental health services, especially for children and young families. MIchigan Medicine’s Michigan Child Collaborative Care program provides mental health services via telehealth. The Michigan Public Health Institute and Michigan Association for Infant Mental Health programs train early childhood teachers to address children’s mental health in Head Start programs and tribal schools, and to equip designated child behavior specialists from within the community to support families. 

“We’re seeing children who have a high influx of behaviors that our early childhood providers have never had to deal with before or feel ill-equipped to deal with,” Schulte says. “A child may have disruptions at home, … may not have slept well, may not have been bathed, or may feel run down. How do we address it in a way that the child gets what they need, as far as nurturing attention or care?”

ITCMI social media campaigns enlist aunts, uncles, and grandparents to play traditional cultural roles in raising children within extended families. An ITCMI focus group with tribal elders explored Anishinaabe words for resiliency, producing rich definitions that strengthen that concept in community. 

“Our goal is to support healthy development and resiliency in children,” Schulte says. 

NAMI Michigan a first responder for many

Kevin Fischer, executive director of NAMI’s Michigan chapter, agrees that the state is experiencing a dire shortage of mental health professionals. That may be one reason that NAMI affiliates across the country have seen requests for help increase between 80% and 100% over the last year. The nature of the calls for help has changed, as well. More people are calling with an urgent need for services. NAMI’s education and support programs also are seeing huge increases in enrollment.

“People are calling to get a better understanding of what’s going on, what a mental health diagnosis means,” Fischer says. “For example, they ask, ‘What is schizophrenia? What does bipolar mean?’ They may have a family member and want to better understand how they can help them.”

NAMI Michigan’s peer-support volunteers help the nonprofit meet this increasing need. These peers have lived experience of mental illness. That experience may be helpful to a person initially diagnosed with a mental illness, who may feel uncomfortable talking to friends or family members about it.

“They really want to talk to somebody who’s walked in their shoes already, to get an understanding of what their recovery process would look like,” Fischer says. “Peer supports have become tremendously valuable.”

Fischer notes that unless more mental health professionals enter the field, Michigan communities will be ill prepared for increasing demand for mental health services. For example, from 1999 to 2019, suicide rates have increased in the general population by 35%. Other groups have seen even more severe increases. Among Black male adolescents, suicide attempts increased by nearly 80% between 1991 and 2019.

“We’re seeing another significant uptick in needs for mental health services among young people because of social distancing and closing the schools,” Fischer says. “There’s a significant increase in mild to moderate mental illness — depression, anxiety, some self-harm like cutting. Across the board, there’s been a significant increase.”

More strategies for increasing the ranks

Fischer notes that the surge in telehealth usage has helped address the shortage of mental health professionals, especially when COVID-19 limited face-to-face health care visits. While virtual video calls are not the answer for every person living with mental illness, the modality has had surprising success. Another strategy that could help relieve the shortage is better equipping primary care providers to offer mental health services.

“We’re in this age now where we’re talking about integrated health care. Our primary care physicians really should be our first responders for behavioral health care,” Fischer says. “They are able to diagnose and prescribe medication for people who are experiencing mild to moderate mental health diagnoses, or refer them to a psychiatrist or psychologist if they think something more serious is going on, like schizophrenia or bipolar disorder. But that’s not the norm.”

Michling concurs. However, even though primary care physicians may have received mental health care training in medical school, many are not comfortable — or not willing — to tackle mental health issues during office visits. Additional options to address the shortage include policy changes that allow nurse practitioners to have a wider scope of practice, school loan forgiveness for college graduates entering behavioral health care fields, and better insurance reimbursement levels for behavioral health services.

“We also want to look at ways to incentivize people to stay in the field so we don’t have high rates of atrophy and people leaving the field for other professions. That requires research on why folks are leaving,” Michling says. “Recruitment efforts at the undergraduate or high school level could make a really clear talent pipeline and career trajectory for folks to get into various behavioral health careers. Beyond that, providing grants to help hospital emergency departments deal with psychiatric or other mental health emergencies, or supplemental training for physicians, nurses, and other emergency department personnel, could make them better equipped to deal with what we’re seeing.”

While finding ways to increase the ranks of mental health professionals is essential, Michling feels it is even more important to address the root causes of growing mental illness among Michiganders.

“Much in the way that we treat chronic disease, we want to focus our public health resources on strategies to deal with stress, improved nutrition, improved sleep, mitigating the community-level factors that we know can put people at greater risk for experiencing a mental health disorder,” Michling says. “That prevention piece, I think, is what’s really lost.”

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MC3 in the Media

Kids, teens and mental health: Parents report challenges in screening, getting care

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  • Alyssa Wealty |

  • Mar 21, 2022
illustration depicting a teen looking stressed out and sitting in front of a computer while a parent or caregiver looks at them with a concerned look on their face

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


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.”

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MC3 Consulting Psychiatrists in the Media

Michigan docs tackle youth mental health crisis with on-demand psychiatric support from U-M program

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  • Alyssa Wealty |

  • Jan 13, 2022
Photo of Dr. Sheila Marcus

Original article written by Estelle Slootmaker and published by Second Wave Michigan on Jan., 13, 2022.

This article is part of State of Health, a series about how Michigan communities are rising to address health challenges. It is made possible with funding from the Michigan Health Endowment Fund.


Across the country, more kids than ever are struggling with mental illness. 20% live with a diagnosable mental illness and 10% are experiencing a significant impairment. Over the past 10 years, twice as many teens and young adults have had major depressive episodes, and suicide is now the second leading cause of death for Americans aged 15-19. To make matters worse, more than 33% of Michigan’s littles, adolescents, and young adults with mental health issues do not have access to care.

In 2012, Dr. Sheila Marcus and her colleagues at Michigan Medicine launched a program to address this mental health epidemic: Michigan Child Collaborative Care (MC3). MC3 helps primary care providers (PCPs) address their young patients’ mental health by offering same-day phone consultations, scheduling telepsychiatry sessions with patients, connecting families to local mental health resources, and providing educational opportunities for PCPs to expand their expertise in diagnosis and treatment. In addition, MC3 has expanded its reach to women experiencing mental illness during pregnancy and postpartum.

Marcus, a clinical professor at the University of Michigan (U-M) and section chief for child and adolescent psychiatry at Michigan Medicine, says MC3 aims to improve access to mental health care, as well as PCPs’ “competence and confidence.”

In addition to drawing upon Michigan Medicine’s psychiatry department, MC3 collaborates with the Michigan State University College of Human Medicine, which provides group case consultations and educational programming, and the Michigan Department of Health and Human Services (MDHHS). Since launching in 2012, MC3 has enrolled approximately 3,500 PCPs and provided about 18,000 consultations.

“I became aware of the increasingly dire straits of mental health care for children, young adults and women in the state of Michigan,” Marcus says. ” … MC3 was designed to leverage getting mental health expertise from big academic centers into the communities. The goal is to provide diagnostic clarification to clinicians who are really puzzled by what they’re seeing in front of them and are not sure what to call it — and to improve evidence-based treatments, including advice about psycho-pharmaceutical medicines as well as psychotherapies.”

For example, Marcus notes that pediatricians may misdiagnose children who have experienced trauma as having bipolar illness or ADHD. When those pediatricians consult with an MC3 psychiatrist, they are equipped to make better diagnoses.

“We’re providing access to people who otherwise would not have access,” Marcus says. “We’re seeing high rates of trauma among the population that we serve, high rates of suicidality — patients who have been hospitalized and are coming out, or patients who have some degree of suicidality. When they went to the emergency room, they were not severe enough to be admitted. So they come back to the PCP office.”

“I was bowled over.”

One of those PCPs, Dr. Lia Gaggino, practiced as a pediatrician with Bronson Rambling Road Pediatrics – Oshtemo for 33 years. She joined the MC3 program when Marcus, whom she did not know at the time, recruited her via Facebook in 2012.

“At the time I trained, we basically learned how to manage ADHD, which I think pediatricians are really good at. I was always interested in mental health, so I took psychopharmacology courses, went to lots of conferences, did lots of reading, and worked with some other pediatricians that were really gifted,” Gaggino says. “When Dr. Marcus described that MC3 could be a support, that I could talk to a child psychiatrist on the same day [of a patient’s visit], I was bowled over. Even if she had said, ‘We can get back with you in two weeks,’ I would have been ecstatic because prior to MC3, I had to manage everything without a psychiatrist.”

Gaggino’s retirement from active practice launched her into her role with MC3, where she now consults with, educates, and recruits Michigan pediatricians, family practice doctors, and obstetricians into the program.

“Now more than ever, mental health is a significant concern for kids. Both the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry have declared a mental health crisis,” Gaggino says. “Behavioral health concerns account for well over a third of patient visits. … For most pediatricians it is a daily occurrence.”

Gaggino says those patient visits reveal that too many kids live with anxiety, depression, and suicidal ideation. Parents may bring kids in because they have chronic stomach aches, chronic headaches, or sleep disturbances. When physical causes are ruled out, their doctor can quickly consult with an MC3 psychiatrist and receive guidance the same day.

“We are finding that much of the time, PCPs are just unsure about what to call things,” Marcus says. “Children who have trauma backgrounds are often being misdiagnosed with bipolar illness or ADHD. We’re trying to rectify some of that.”

A phone conversation with a child psychiatrist helps clarify the diagnosis and sets the child on the way with the correct medication and treatment plan. That plan might include a telepsychiatry visit with one of MC3’s behavioral health consultants, referral to a local mental health resource, or simply continued follow-up with the PCP. MC3 also consults with over 75 school-based health centers and provides educational programming to PCPs as well as schools.

“The MC3 behavioral health consultants are all regionally dispersed and are very knowledgeable about which resources exist in the home community,” Marcus says. 

Mental health help for the youngest among us

With funding from the MDHHS Healthy Moms, Healthy Babies initiative, MC3 has expanded its reach to Michigan’s perinatal providers, who serve new moms in the weeks immediately before and after birth. Dr. Maria Muzik, who leads the U-M psychiatry department’s Zero to Thrive women and infant mental health programs, shared her insights in a September 2019 State of Health series story on new moms and mood disorders.

“These are natural points where moms are being seen by the medical professionals,” Muzik said. “We know this is a time when women are vulnerable for mental health issues and that preexisting conditions are exacerbated by the hormonal changes, sleep deprivation, and birth trauma.”

Through MC3, pregnant women identified as at risk for mental health issues receive brief interventions and same-day access to virtual counseling and care coordination through remote behavioral health consultants. In some cases, MC3 sets up telepsychiatry consultations with psychiatrists who focus on the perinatal period. When mothers have access to mental health services, infants and children are better poised to experience better mental health in the future as well.

Through COVID and beyond

COVID-19 has hit Michiganders’ mental health especially hard, especially in families who have lost jobs or found themselves food-insecure. And, for both rural and urban residents, the long-term mental health outlook is not bright. Delivering virtual care for years before the pandemic struck, MC3 has been a shining example of how mental health care can be expanded to meet this increasing need.

“There is no question that there is ‘a surge after the surge’ during COVID,” Marcus says. “There are increased rates of suicidality, especially among teens. There are increased rates of trauma. If you think about families who are quarantined together with their aggressor, that’s a huge issue. There are issues with children with special needs, like autism and developmental disorders, who have had their primary treatments interrupted.”

Because of MC3, Michigan communities lacking mental health services or a practicing psychiatrist have an alternative. Organizers hope that as this model of care becomes more broadly recognized, health care systems and payers will step up with funding to expand it – and reduce reliance on grant dollars.

Gaggino says MC3 made her a better clinician and “totally changed” her prescribing habits.

“You do the best you can, but you can do better when you have help,” she says. “MC3 is really brilliant in being able to amplify that support.”


Dr. Sheila Marcus photo by Doug Coombe.

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MC3 Consulting Psychiatrists in the Media

Dr. Sheila Marcus on the Paul W. Smith Show

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  • Alyssa Wealty |

  • Dec 2, 2021
Photo of radio show host Paul W. Smith

MC3 Pediatrics Director Dr. Sheila Marcus was interviewed on the Paul W. Smith radio show, commenting on the mental health implications for the November 30 Oxford High School shooting. She also explained what MC3 and how primary care providers in Michigan can sign up. Listen to the interview below:

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MC3 in the Media

A lifeline for primary care amid a crisis in youth mental health

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  • Alyssa Wealty |

  • Nov 9, 2021
decorative image

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

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