Michigan saw modest, but meaningful, increases in residents’ access to behavioral health care from 2019 to 2022, though high levels of unmet need remained in some communities. Meanwhile, a much smaller percentage of those in need of treatment for substance use disorders actually received services.
Those insights and others come through clearly in the third and latest edition of the Behavioral Health Access in Michigan study, produced by Altarum and commissioned by the Health Fund.
The study uses a range of data inputs, including surveys and claims data from Medicare, Medicaid, and private insurers, to paint a comprehensive portrait of Michiganders’ access — or lack of access — to needed behavioral health care services.
The latest edition was written in 2025 using the most recent available claims data from 2022 and includes the study’s first analysis after the onset of the COVID-19 pandemic. Two previous editions examined data from 2016 and 2019 respectively.
Here are a few of our top takeaways. Be sure to also check out the full report and the accompanying one-pagers on specific populations and join our webinar with Altarum on February 24 to learn more.
2022 DATA TELLS MIXED STORY ON PROGRESS
Nationally, demand for behavioral health care surged during the pandemic with growth in the number of people reporting any mental illness (AMI) and increased substance use. In Michigan, 2,156,200 people were estimated to have a mental illness of some type in 2022, up from 1,988,200 three years earlier.
However, after major disruptions in access to care in the early months of the pandemic, the data shows behavioral health access in Michigan stabilized by 2022. In fact, the state experienced slight improvements in access, with 68.2% of those needing care for AMI able to receive mental health treatment in 2022, compared to 67.8% in 2019.
During that time provider supply in the state grew from 26,794 behavioral health providers in 2019 to 31,848 in 2022, resulting in corresponding improvements in the ratio of behavioral health providers to the overall population. With these signs of progress come some important qualifiers. First, the data measures access broadly, tracking only whether a person received care at all — even just one time — and doesn’t assess important factors like the quality, appropriateness, or duration of care.
Additionally, while the percentage of those receiving treatment increased, the state still had more people who were not able to access care (increasing by 35,000+ from 2019 to 2022) as a result of the significant overall increase in need for services.
On the workforce front, while Michigan has added behavioral health providers to its workforce since 2019, significant shortages remain (especially for psychiatrists), with 233 designated Health Professional Shortage Areas for mental health as of March 2025 and persistent high vacancy and turnover rates.
And as we’ve seen in previous reports, access to care is uneven, with differences and disparities based on geography, insurance coverage, race, age, ethnicity, and more.
SUD TREATMENT GAPS PERSIST
Despite slight improvements in treatment rates over time, the share of people with substance use disorders (SUDs) in Michigan who are untreated did not meaningfully improve from 2019 to 2022.
Overall, the number of individuals with moderate to severe SUDs increased marginally from 2019 (581,200) to 2022 (595,000) while the percentage untreated remain virtually the same (72.4%). In 2022, people with alcohol use disorder faced even larger gaps, with 81% untreated statewide.
Additionally, this latest edition of the study for the first time includes those with SUDs identified as mild, reflecting data collection changes in the National Survey on Drug Use and Health.
When accounting for this adjustment, the population of Michiganders living with an SUD jumps from 595,000 to 1,337,700, which could suggest a broader scope of overall need.
Amid the concerning data on SUD treatment access, one success story does stand out. Among individuals with Opioid Use Disorder (OUD), rates of untreated individuals stood at 23% in 2022, maintaining previous gains seen after the publication of the first study in 2016, when 33% of individuals with OUD went without treatment.
GROUP ANALYSIS REVEALS DIFFERENCES, DISPARITIES
Once again, the study includes analysis for different groups in Michigan. You can read the full report for more info, but here are a few notable data points for the Health Fund.
Among children and older adults — the populations named in our mission — the data presents a mixed picture. While access generally improved with age, children and young adults faced some of the largest gaps in treatment.
For example, boys ages 0 to 17 had the highest share of unmet need for AMI (45%) among all groups measured by age and sex in 2022. Meanwhile, young women (age 18 to 24) experienced the greatest prevalence of AMI with the largest share untreated (35%) among all age groups for women.
Young men (age 18 to 24) also had the highest prevalence of SUD, while young adults of both sexes experienced the highest gaps in treatment of any group, with just 14% of young men and young women ages 18 to 24 receiving treatment for an SUD.
Meanwhile, Michiganders aged 65 and older had lower prevalence and better access than most of the other age groups, with only 18% of women and 11% of men in this age group going untreated for AMI.
For Medicaid enrollees, where data on race and ethnicity is most comprehensive, the rate of untreated need was generally consistent across racial and ethnic groups. However, American Indian Medicaid enrollees and those classified as Other/Unknown ethnicity exhibited slightly higher unmet needs for AMI and the highest rates for SUD. Service utilization remained lower among populations of color, but their lower prevalence rates led to comparable shares of untreated individuals.
It is important to emphasize again that the study measures access to any behavioral health treatment and doesn’t assess differences in the quality or duration of care. Other research has highlighted substantial racial gaps in treatment quality within Michigan.
INSURANCE STATUS PLAYS CRITICAL ROLE IN ACCESS
The data also suggest that insurance status continues to reflect disparities, as individuals without insurance in 2022 continued to have high prevalence of AMI and SUD, with large proportions untreated for these conditions (74% untreated for AMI, 80% for SUD).
Among those with insurance, Medicaid enrollees experiencing AMI increased in population prevalence and were also the most likely to remain untreated for mental illness, with 42% not receiving care, compared to 26% of the privately insured and 8% of Medicare enrollees.
For substance use disorders, the privately insured were least likely to receive treatment, with 84% untreated, followed by 59% of Medicare recipients and 58% of Medicaid enrollees.
NOTING PAST TRENDS TO INFORM FUTURE PLANNING
The Access Study shows that a lot can change in three years. That’s why we’re planning to maintain this analysis in the future to continue deepening our understanding of long-term trends driving behavioral health access in Michigan, while informing effective policy and investment.
This will remain critical for tracking impacts from the rollout of the 2025 Budget Reconciliation Bill (H.R. 1), which is expected to reduce the number of Medicaid beneficiaries in Michigan through new work requirements and other changes to eligibility.
Maintaining access to health care coverage or alternate pathways to behavioral health services will be vital to prevent existing gaps in access from widening.
Want to learn more? Join us for a webinar with the report’s authors and an expert panel of behavioral health leaders and providers from across Michigan who will reflect on the findings and how they relate to the field today.