Skip navigation
Mental health in Michigan

Confronting Michigan’s mental health challenges

CMU faculty provide services and education beyond the classroom and lab

Contact: Heather Smith


COVID-19 isn't the only pandemic of the past year and a half. Isolation and anxiety driven by the disease have worsened some mental health challenges and created new ones.

And while some Central Michigan University physicians and faculty members fight coronavirus in hospitals and research labs, others fight for those in need of mental health care and resources. Read below for a closer look at some of these efforts:

  • Trauma training for child care workers.
  • Evaluation of court-ordered treatment.
  • Virtual psychiatry outreach and support.
  • New tools to help rural children and their families.
  • Education to fight social stigma of mental illness.
  • Expanding counseling services through telehealth.

Trauma training for child care workers

When the Inter-Tribal Council of Michigan wanted to improve early childhood programs by addressing the effects of trauma, it reached out to the College of Medicine's Alison Arnold, director of CMU's Interdisciplinary Center for Community Health and Wellness.

Arnold put together a four-person planning team of CMU experts in adverse childhood experiences and Brazelton Touchpoints training: herself and Department of Human Development and Family Studies faculty members Cheryl Geisthardt, Holly Hoffman and Amy Bond.

The six-hour educational program they developed has reached 90 child care workers at six tribal locations around Michigan in the past year — all through remote meetings that expanded CMU's reach.

"Through that virtual lens, we were able to make so many more connections than we ordinarily would have," Hoffman said.

The program explores the effects of trauma and how to work with affected students and their families, all of whom meet low-income qualifications for federal Head Start programs. It also encourages child care workers to take care of themselves amid the stress from the pandemic.

"They're dealing with their own trauma and also taking on whatever the children and families are," Hoffman said.

Geisthardt likened the need for self-care to the airline safety instruction to put on your own oxygen mask before helping children with theirs.

"We're all doing the best we can, and we're making a difference," she said.

Evaluating court-ordered treatment

In 2019, the U.S. Substance Abuse and Mental Health Services Administration awarded CMU and Calhoun County $2.5 million for a four-year program to conduct and evaluate Assisted Outpatient Treatment, where seriously mentally ill individuals receive court-ordered treatment while continuing to live in the community.

Dr. Jeff Inungu, director of CMU's Master of Public Health degree program, is principal investigator for the evaluation, working with Imad Haidar and Joe Pomerville. Haidar is senior research and data scientist and director of CMU's Institute for Health and Business Insight, and Pomerville is a data scientist with the institute.

Inungu said independent living is the goal and challenge for those in the program. Many have felony records, and many don't keep appointments or take their prescribed medication.

"How can we help them live an independent kind of life?" he asked. "Instead of putting them in a hospital, is it possible these people can be managed by a social worker?"

Inungu's team is evaluating the work of Summit Pointe in Battle Creek, which administers mental health services in economically disadvantaged Calhoun County. Calhoun ranks in the lowest 10% of Michigan counties for healthy behaviors and overall health outcomes. Bronson Healthcare reports that hospitalization rates for psychoses in Calhoun County are 41% higher than in other Michigan counties.

Assisted Outpatient Treatment already has proven successful in other states, with social workers motivating clients through interviews and interventions.

"It's primarily about educating them so they can avoid going back into the justice system," said Inungu, whose team is working to enroll 75 patients for the early stages of evaluation.

Inungu said their work aligns with CMU's objective to partner with Michigan communities.

"As a university, we have to contribute to improving the health of our communities," he said. "We're hoping this can lead us to other partnership opportunities."

It's already making a difference: Inungu said at least one Summit Pointe staffer is considering CMU's public health master's degree program.

Virtual growth for psychiatry residency

CMU's psychiatry residency program is not new, but running it during a pandemic certainly is.

Residents quickly pivoted last year from in-person appointments to virtual meetings with patients, said Dr. Furhut Janssen, residency program director and faculty member psychiatry. It was a challenge, but it also expanded the residents' reach beyond the local community.

"We were seeing patients from (Michigan's) northern rural counties," she said.

Seventeen CMU residents saw adult clients this spring. Third-year medical students spend four weeks in the psychiatry residency, which is also a fourth-year elective. A CMU child and adolescent psychiatry fellowship begun two years ago also has four fellows.

Janssen, who also is director of behavioral health for the College of Medicine and CMU Medical Education Partners, said increases last year in cases of abuse, neglect, domestic violence and suicidal thoughts as a result of the pandemic showed the critical need for more mental health care providers in a crisis.

Janssen is focused on expanding where CMU residents and faculty practice and creating referral networks so patients in crisis can be seen more quickly.

"Our mission continues to be to increase access and provide the best standard of evidence-based psychiatric care," she said. "We focus on our region, but what we're doing is certainly going to improve care in rural regions to the north and west of us."

New tools to help rural families

In eight years of delivering mental health services to children and families around Michigan, CMU's Center for Children, Families and Communities has never seen a year like the past one.

"As the pandemic shut down our in-person services, we pivoted to be able to provide telehealth services," said center director Larissa Niec, a faculty member in the Department of Psychology. "The families and children we work with are coping with a range of traumatic experiences, as well as child conduct problems, anxiety, depression and child abuse."

The pandemic, she said, has only made those problems worse.

Niec works mainly with preschool and early school-age children. Her colleague Sarah Domoff — clinical program supervisor and director of CMU's Family Health Lab, in addition to having a clinic in the CCFC — works mainly with adolescents.

Under their supervision, CMU doctoral clinical psychology students assist families from southern Michigan to the Upper Peninsula. Domoff and Niec also train Michigan therapists and teachers in mental health interventions that can help families cope with pandemic-related stress.

And Domoff leads a partnership with U.P. schools to help students build healthy social media habits — another challenge during pandemic isolation.

"Sarah goes virtually to the U.P., and she's teaching 20 teachers who each have 20-25 students in their class," Niec said. Through those and other efforts, "without exaggerating, we're reaching thousands of kids."

Telehealth reaches not only farther but deeper. Instead of seeing clients at clinics, caregivers see them on camera in their homes and can, for example, coach parents through a family meal in real time.

In-person services will return, Niec said, but telehealth — with its advantages in delivering care to rural Michigan — is here to stay.

"Now that we've got here, I wouldn't want to go back," she said.

Fighting stigma with education

Social stigma feeds prejudice against the mentally ill and keeps many people from caring for their own mental health, and that's a growing problem, according to Neli Ragina.

Where one person in 10 experienced anxiety or depression before the COVID-19 pandemic, the number is now four in 10 — "and maybe it's underreported," she said. "The suicide rate is higher; depression and anxiety disorders are up now — especially because of COVID — and intervention is needed."

For Ragina, that intervention takes the form of an educational research project that began in 2019. Researchers survey participants' attitudes about the role of people with mental illness in the community, followed by an educational presentation and then more questions. CMU medical students present the lessons, and graduate students administer the before-and-after surveys.

Group sessions met in person prior to March 2020, and the project resumed online this year.

Ragina, an associate professor and director of students and residents clinical research in the College of Medicine, now is recruiting participants in their 40s and older to participate.

"The older population is the one that has more prejudices about mental health," she said. "When they grew up, there was no talk about mental health. For example, many refuse to accept that they're depressed."

Ragina needs to gather more data before making plans to expand the educational effort, but she's encouraged by what she sees already.

"Many of the questions we ask in the pre-survey about mental health, after the educational intervention, they change their mind," she said.

The upshot of the educational message? There's nothing unusual or shameful about struggling with mental health: "This is a normal part of life."

Counseling services expand reach

In two weeks in March 2020, CMU's Center for Community Counseling and Development pivoted from 100% in-person visits to 100% telehealth.

It was a good thing the center had been awarded a grant just a month earlier to study telehealth, said Michael Verona, faculty member in the Department of Counseling and Special Education and the center's director. The plan had been to phase in telehealth in the fall, but "everything got fast-forwarded."

The CCCD offers mental health counseling by clinically supervised CMU graduate students studying to become addiction, clinical mental health, and school counselors, at no cost to clients. Before the pandemic, it served mainly CMU and Mount Pleasant. Now it's reaching statewide.

"This transition has definitely increased access," Verona said, especially for rural residents and those without transportation. In fact, so many new people have signed up for services — more than 500 since last May — that the CCCD is struggling to meet the demand. Verona said the center is selectively accepting clients and providing referrals.

The latest challenge is to resume in-person treatment this summer. Verona said the CCCD is modifying larger rooms to provide individual counseling while socially distancing. He expects it will help clients who were not easily served by virtual meetings, such as young children and people on the autism spectrum. But the days of meeting only in person are past.

"Telemental health is here to stay," he said, adding that it's for the best.

"We can continue to serve the entire state of Michigan," he said. "Anytime we can expand the scope of individuals we can help, it sounds promising to me."


Photo Associator

Article Photo Title

Photo Title required.

Photo for News Home

Select File
{{vm.homeFile.fileName}}
Upload
Use This One

Photo for News Feeds

Select File
{{vm.feedFile.fileName}}
Upload
Use This One