Story Highlight
– Eleanor Middlin’s story highlights mental health care challenges.
– Increased out-of-state placements due to Michigan’s resource scarcity.
– Families face struggles with long-distance treatment options.
– Michigan has seen youth treatment facility closures post-pandemic.
– Advocates call for systemic changes in mental health services.
Full Story
Eleanor Middlin, who was just 15 years old, found herself embarking on an unforeseen journey when her family sent her to a boarding school located in Missouri, approximately an 11-hour drive from their home in mid-Michigan. This decision marked a pivotal moment in her life, one that she describes as both a profound setback and a crucial turning point. “I’m alive because of it, and I will never be able to forget it,” reflected Middlin, who is now 20, sharing her experience in an interview.
The circumstances surrounding Middlin’s departure from Michigan highlight a troubling trend affecting young individuals facing severe mental health challenges. Following the upheaval caused by the COVID-19 pandemic, a noticeable increase in the number of children and teenagers being sent away from their homes for long-term care has emerged. Families often resort to these measures due to a lack of adequate resources and services available within the state.
The journey that the Middlin family undertook is indicative of a wider phenomenon, as many Michigan families independently finance the necessary care for their children—this reality largely goes unrecorded in official state statistics. Furthermore, those youths placed in treatment facilities through the child welfare system or via court orders have seen a significant rise in out-of-state placements with facilities now operational hundreds or even thousands of miles away.
A recent report from the Michigan Department of Health and Human Services revealed that as of September, there are currently 152 youth under the state’s direct placement program residing in out-of-state facilities—a sharp increase from the 122 recorded in 2024, and more than double the 74 youths documented in 2023. The trend has raised concerns among families and advocates alike, as the distances involved complicate access to care and rehabilitation.
Laura Marshall, a mother from Cedar Springs whose son was sent to a treatment facility in Wyoming via court order, expressed her anguish over the situation. “Forcing a child to travel for care is like throwing them to the wolves,” she stated, emphasising the lack of control families have over these placements. The physical distance can severely hinder parental contact and disrupt the supportive family environment crucial for recovery. “Horror stories” about abuse and misconduct within such facilities add an additional layer of anxiety for families, who fear for the well-being of their children.
State officials assert that the increase in these out-of-state placements primarily pertains to youth under judicial supervision and not children under state care directly. However, a representative from the Department of Health and Human Services, Erin Stover, acknowledged that counties do not currently have a requirement to report placement data. “Placement decisions for youth in foster care and those involved with the juvenile justice system must ensure safety, stability, and prioritise the best interests of each child,” Stover remarked in an email.
This confusion regarding placement processes highlights a broader issue, according to certain lawmakers. Michigan is burdened by a vast department responsible for overseeing numerous juvenile facilities, leading to potential gaps in care and the necessity for families to seek help outside of state resources. “The liability question is really huge, because who is responsible if that child gets seriously injured in an out-of-state facility?” queried State Representative John Roth, R-Interlochen.
Eleanor Middlin’s mental health struggles began at a young age; she was hospitalised for self-harm at just 12. Throughout her teenage years, she sought therapy and medication, but her mental health deteriorated significantly during the pandemic, a period she describes as one of profound isolation. The prevalence of social media increased her feelings of inadequacy and despair. “It was the perfect environment for me to get worse,” Middlin explained, noting her descent into substance abuse and eating disorders—a reality previously unknown to her parents.
Jennifer Middlin, Eleanor’s mother, recounted the feelings of shame surrounding their situation. “We tried everything that we could try,” she admitted, reflecting on the silence that surrounds mental health struggles. Seeking viable options for Eleanor’s treatment proved challenging, as local facilities lacked the deeper level of care her daughter required. The family ultimately found themselves on the hook for approximately £90,000 out of pocket to cover Eleanor’s treatment, a burden that has proven financially and emotionally devastating.
The financial implications of sending youth out of state for care also weigh heavily on the state budget. Last fiscal year, Michigan spent over £13 million on out-of-state placements, with a significant portion of this cost footed by the state itself. The daily cost for care has reportedly increased, raising concerns about the affordability and accessibility of necessary mental health services.
The challenges faced by parents navigating this complex system cannot be understated, particularly as their children encounter crises that often lead to interactions with the criminal justice system instead of appropriate mental health care. Rachel Cuschieri-Murray, a cofounder of a support group for parents advocating for better mental health services in Michigan, noted that insurance companies and public mental health providers often engage in disputes over coverage, leaving families without clear guidance and feeling overwhelmed.
At present, approximately 9,200 children are documented within Michigan’s welfare system, with 468 of them residing in institutional facilities designed for residential treatment. However, the number of available beds has diminished drastically since the pandemic, which has exacerbated the crisis. Current statistics reveal that there are fewer than 400 beds across the state, down from around 1,200 prior to the health crisis.
Dan Gowdy, president of the Association of Accredited Child and Family Agencies, highlighted these challenges as resulting from a “perfect storm” of factors impacting mental health care. Issues such as social media’s role in deteriorating youth wellbeing, isolation during the pandemic, and an ongoing crisis of staffing within child care institutions are increasingly apparent. “You had smaller available beds, high-acuity youth concentrated in more intense environments,” Gowdy explained, indicating a systemic level of stress that is unsustainable.
In light of these findings, some lawmakers express skepticism about the potential for meaningful changes in the state’s mental health care systems within the current legislative term. Yet, a coalition of bipartisan lawmakers believes there will be an opportunity for impactful reform in the future.
As families like the Middlins attempt to navigate this challenging landscape, Eleanor remains hopeful about the possibility of reducing stigma surrounding mental health issues. “I’m more just hoping that maybe the one person who needs it … maybe they understand it,” she stated, as she strives to raise awareness and foster connection among those affected by similar struggles.
Our Thoughts
The article highlights numerous failures in the provision of mental health services for youth in Michigan, leading to detrimental outcomes for children such as Eleanor Middlin. To prevent similar situations, several key safety lessons can be drawn, primarily emphasizing the need for compliance with UK health and safety legislation, particularly in safeguarding well-being and ensuring appropriate care environments for vulnerable populations.
Firstly, the lack of coordinated oversight and reporting on placements breaches principles outlined in the Health and Safety at Work Act 1974, which mandates employers to ensure safety and health in the workplace. Improved mechanisms for tracking placements and outcomes of children would facilitate better oversight.
Furthermore, the evident inadequacies in facilities and staff training can be identified under regulations such as the Safeguarding Vulnerable Groups Act 2006, which emphasizes the necessity of background checks and proper staff qualifications to protect children.
Establishing local treatment options and improving accessibility to mental health resources would mitigate the need for out-of-state placements, reducing disruptions to familial support systems essential for youth recovery. Promoting a collaborative approach among healthcare providers, insurers, and state entities can foster a more reliable and responsive treatment infrastructure, ensuring that children’s needs are met more effectively within their communities.
