Public Mental Health

The public mental health system in Michigan is often a key partner in supporting families raising children and youth with Severe Emotional Disturbance (SED) because it can provide intensive home and community based support for kids with complex needs.

Each area of the state is served by a local Community Mental Health Program (CMHSP) that is funded by local, state and federal funds to provide mental health services to eligible children and adults in their local area.

All CMHSP’s are directed by the Michigan Department of Health and Human Services (MDHHS) and must follow the rules and regulations of MDHHS and the following documents:

• The CMH’s Contract with the Michigan Department of Health and Human Services
• The Michigan Mental Health Code & State Priorities
• Medicaid Waiver & Federal Guidelines (Medicaid Manual)

CMHSP’s are the local community service providers or managers of mental health services for:

• Children and adults with Medicaid,
• The uninsured, and
• The underinsured with serious mental illness, serious emotional disturbance, or addictive disorders.

The Michigan Mental Health Code says that the purpose of a CMHSP is to “…provide a comprehensive array of mental health services appropriate to conditions of individuals who are located within its geographic service area, regardless of an individual’s ability to pay.” *P.A. 254 of the Public Acts of 1974.

Who is eligible for Public Mental Health Services?

The mental health code states that CMHSP’s must give priority of services to individuals with the most severe forms of:

• serious mental illness, (adults)
• serious emotional disturbance, (children)
• developmental disability (adults & children)

What is a Serious Emotional Disturbance(SED)?

A diagnosable mental, behavioral, or emotional disorder affecting a minor that:

• Exists or has existed during the past year for a period of time sufficient to meet the diagnostic criteria specified in the most recent diagnostic statistical manual of mental disorders (DSM)
• The condition must result in a functional impairment that substantially interferes with or limits the minor’s functioning in: family, school and community activities

Is a child with SED automatically eligible for public mental health services?

• Each CMHSP sets its own eligibility criteria for each service available.
• Children and youth experiencing the most significant functional deficits in home, school, and community are prioritized for services.

Who Determines if a Child is Eligible for Public Mental Health Services?

Each CMHSP’s has an eligibility process for both Medicaid and non-Medicaid youth. They decide who is eligible to receive more extensive and intensive services and who can be served through a comprehensive health plan or fee-for-service arrangements with medical doctors or psychiatrists.

The Child and Adolescent Functioning and Assessment Scale or CAFAS is an evaluation tool that is used to identify children and youth who are likely to need more than outpatient mental health treatment.

The CAFAS looks at how children and youth function in many areas of their life or life domains, including:

• School/ Work
• Community
• Behavior Towards Others
• Mood
• Self Harmful Behaviors
• Thinking
• Substance Abuse

The CAFAS measures a child’s functioning level in all of these areas and they receive a score for each. If a child has an elevated score in two or more areas, a young person may be considered to have ‘marked’ or a severe functional impairment and qualify for enhanced services.

Each local area determines how high of a score is needed to qualify based on the number of children and adults they need to serve in your local area.

How do I Access Mental Health Services from Community Mental Health?

If you are seeking public mental health services, you will want to start by contacting your local CMHSP’s ACCESS Center to request an initial screening to see if your child is eligible for services. If you cannot find the number for ACCESS for your local Community Mental Health, call the main number or the customer service line and someone should be able to connect you.

When you call ACCESS the person on the phone will conduct a Screening Interview where they will ask you questions about your child and their mental health needs in order to determine if your child meets initial eligibility criteria.

If they feel they may be eligible for services, they will make a referral for an initial appointment or ‘intake’ meeting with a mental health professional where they will gather more information and do an initial assessment.

If ACCESS says that your child is ineligible for services it means that your child did not meet initial eligibility criteria and then the ACCESS center staff should help you to find other possible resources for services in your community. If you disagree with their determination you may ask for a second opinion.

Learn more information about what to expect when calling ACCESS.