Michigan's Department of Corrections (MDOC) operates 26 correctional facilities across the state and delivers mental health care through the Bureau of Health Care Services (BHCS) and the Corrections Mental Health Program (CMHP), which is established by the Michigan Mental Health Code.
MDOC's approach to mental health care includes an unusual structural feature found in few other states in this series: a dedicated Office of Recipient Rights (ORR), which protects the rights of mentally ill and developmentally disabled prisoners, investigates allegations of rights violations, and provides consultation and training across the mental health services system.
Michigan also charges prisoners fees for health care services under PD 03.04.101 -- a policy that can create access barriers for prisoners without funds. This is distinct from states like Maine and Idaho where all mental health services are explicitly free.
Michigan does not have active federal court oversight of its prison mental health system at this time.
What Michigan Prisoners Are Entitled To
Under Estelle v. Gamble (1976) and the Michigan Mental Health Code (MCL 330.1100b et seq.):
- Mental health screening at intake.
- Access to the Corrections Mental Health Program (CMHP) if they have developmental disabilities or mental illness requiring treatment.
- Acute, residential, or outpatient mental health treatment as clinically indicated.
- Transfer to a facility where their mental health needs can be met if the current facility cannot accommodate them.
- Recipient Rights protections through the Office of Recipient Rights.
Mental Health Screening at Intake
All incoming MDOC prisoners receive health screening at intake, which includes mental health assessment. The screening identifies prisoners who need mental health services and initiates classification into the appropriate CMHP level of care.
If your person has a psychiatric history, provide documentation at intake -- prior hospitalizations, diagnoses, and active medications -- to support accurate initial classification.
The Corrections Mental Health Program (CMHP)
The CMHP is the framework for all MDOC mental health services, established by the Michigan Mental Health Code (MCL 330.1100b) to provide mental health treatment for prisoners who have developmental disabilities or mental illness and require it.
The CMHP defines mental illness as a substantial disorder of thought or mood that significantly impairs judgment, behavior, capacity to recognize reality, or ability to cope with the ordinary demands of life.
CMHP services are provided across three levels of care: Acute, Residential, and Outpatient.
All mental health treatment and services to Michigan prisoners are provided under the direction of BHCS's Mental Health Services division.
Acute Level of Care
Acute mental health treatment is the most intensive level within the CMHP -- the equivalent of inpatient psychiatric care within the corrections setting. It serves prisoners experiencing acute psychiatric crises that cannot be managed in residential or outpatient settings.
Acute mental health treatment at MDOC is provided at designated facilities. Prisoners who require acute care may be transferred from their assigned facility to a facility that can provide that level of treatment, consistent with PD 03.04.100 (Health Services) which requires transfer when a prisoner's health care needs cannot be met where they are housed.
Residential Level of Care
The Residential level of care provides structured mental health programming and housing for prisoners with significant mental health needs who cannot safely or effectively function in general population but do not require the intensity of acute psychiatric treatment.
Residential mental health programs are housed at designated MDOC facilities and provide structured therapeutic environments, more intensive psychiatric contact, and programming designed to stabilize functioning.
The Outpatient Treatment Program (OPT)
The Outpatient Treatment Program (OPT) is the primary point of entry into the CMHP for most prisoners. The OPT serves three distinct functions:
Entry point: The OPT is the initial entry into the CMHP for general population prisoners identified as having mental health needs.
Psychiatric services for SMI in general population: OPT provides psychiatric services to prisoners residing in general population who have a severe mental illness or disability. These are people who have enough functional capacity to live in general population settings but require ongoing psychiatric care.
Continuity of care after discharge: OPT ensures continuity, quality, and accessibility of care for prisoners discharged from a higher level of care (Residential or Acute), providing the ongoing support needed to prevent relapse.
The OPT treats prisoners with moderate functional impairment due to a mental disability who can care for their basic needs and live in general population. Treatment emphasizes correcting thought and mood disorders, interpersonal interactions, and bio-psychosocial rehabilitation. The goal is helping prisoners cope with long-lasting mental illness and develop relapse prevention plans.
Counseling Services and Interventions (CSI)
The Counseling Services and Interventions (CSI) program is available to prisoners who exhibit psychological signs or symptoms that negatively affect ordinary demands of life. CSI is intended to provide short-term counseling and support -- it is a lower level of intervention than OPT, intended for people who need some psychological support but do not meet the criteria for CMHP enrollment.
The START Program
The Structured Treatment, Accountability, Responsibility, and Transition (START) program is a specialized MDOC program designed for high-security prisoners with mental health issues, serving as an alternative to administrative segregation. START has been offered at specific high-security facilities (identified as ICF, ECF, and MBP in MDOC documentation). The average 8-to-12 week treatment cost per participant was documented as approximately $17,745.
START represents MDOC's recognition that high-security prisoners with mental illness who would otherwise be placed in administrative segregation need a therapeutic alternative -- one of the few documented administrative-segregation diversion programs for the mentally ill in the series.
The Office of Recipient Rights (ORR)
The Office of Recipient Rights is one of the most distinctive features of Michigan's prison mental health system. The ORR is established under the Michigan Mental Health Code and protects the rights of mentally ill and developmentally disabled prisoners by:
- Setting forth a system to investigate allegations of rights violations.
- Providing consultation to prisoners regarding their rights.
- Providing training and consultation to mental health services staff.
This system exists because the Michigan Mental Health Code grants specific rights to recipients of public mental health services -- and Michigan prisoners in the CMHP are "recipients" of public mental health services under that law.
Scope limitation: ORR does not affect the regulations and policies of MDOC relating to the operation of a correctional facility. Where a right under the ORR system conflicts with MDOC security policy, the MDOC policy supersedes. The ORR is a rights consultation and investigation mechanism, not an enforcement authority over security decisions.
Health Care Fees
Michigan charges prisoners fees for health care services under MDOC Policy Directive PD 03.04.101 (Prisoner Health Care Copayments). This fee policy applies to health services generally and may affect access to mental health services for prisoners without account funds.
This fee structure distinguishes Michigan from states like Maine and Idaho, where all mental health services are explicitly provided at no cost. Families should be aware that if their person does not have funds in their MDOC account, fee policies could create barriers to accessing sick calls or initial mental health contacts.
If your person is being denied mental health services because of inability to pay, contact Disability Rights Michigan.
MDOC Policy PD 03.04.100 (Health Services, Effective March 10, 2025)
MDOC Policy Directive PD 03.04.100, updated effective March 10, 2025, is the current governing health services policy for MDOC. Key provisions:
- All prisoners have access to health services regardless of custody level or security classification.
- A prisoner whose health care needs cannot be met at their current facility shall be transferred to a facility where those needs can be met.
- Prisoners charged fees per PD 03.04.101.
The mandatory transfer provision is important: if your person's mental health needs cannot be accommodated at their assigned facility, MDOC is required to transfer them.
Michigan Mental Health Code and Reentry
Upon release, Michigan prisoners with mental health needs are intended to connect with community mental health services through the Michigan Department of Health and Human Services (MDHHS) and its network of Community Mental Health Service Programs (CMHSPs) across Michigan's regions.
Governor Whitmer's FY 2025 budget significantly expanded Certified Community Behavioral Health Clinics (CCBHCs) in Michigan, expanding access to mental health and substance use disorder services for Medicaid recipients including those leaving incarceration.
For prisoners approaching release, ask MDOC what CMHSP or CCBHC has been identified in their release county, whether Medicaid reinstatement has been initiated, and whether medication continuity has been arranged.
What Families Can Do
If your person is in MDOC custody and has a mental illness:
Provide psychiatric history at intake. Supply documentation of prior hospitalizations, diagnoses, and active medications. The intake screening determines whether your person is enrolled in the CMHP and at what level.
Know the CMHP three levels. Ask what CMHP level your person is assigned to: OPT (outpatient general population), Residential, or Acute. If they have serious mental illness and are not enrolled in CMHP at all, ask why and document the response.
Know the mandatory transfer policy. Under PD 03.04.100, if your person's mental health needs cannot be met at their current facility, MDOC must transfer them to a facility that can meet those needs. If transfer is needed and not happening, document this and file a grievance.
Know the START program. If your person is high-security and has mental illness, ask whether START program placement has been considered as an alternative to administrative segregation.
Know the Recipient Rights system. If your person's rights as a CMHP recipient have been violated, they can contact the Office of Recipient Rights for consultation and to report the violation. This is an additional channel beyond MDOC's standard grievance process.
Know the fee issue. If your person has no funds and is being denied mental health services because of fee requirements, document this and file a grievance. Contact Disability Rights Michigan.
Ask about reentry planning. Ask what CMHSP or CCBHC has been identified in the release county, whether Medicaid reinstatement is underway, and whether medication continuity has been arranged.
File a grievance. MDOC has an administrative grievance process. File formal grievances for: failure to enroll in CMHP when warranted, inappropriate level of care assignment, denial of transfer when facility cannot meet needs, fee-based denial of mental health services, and failure to initiate reentry mental health planning.
Contact Disability Rights Michigan. DRM (drmich.org) is the federally mandated Protection and Advocacy organization for Michigan and monitors conditions for people with mental illness and disabilities in MDOC facilities.
Seek legal help. If your person has serious mental illness and is not receiving appropriate CMHP services, if transfer has been denied when clinically warranted, or if fee policies are blocking mental health access, consult a prisoner rights attorney with experience in Michigan's federal courts (Eastern and Western Districts of Michigan).
Frequently asked questions
How does Michigan screen prisoners for mental illness?
All incoming MDOC prisoners receive health screening at intake, including mental health assessment by BHCS staff. The screening identifies prisoners with developmental disabilities or mental illness requiring treatment and initiates enrollment in the Corrections Mental Health Program (CMHP) at the appropriate level. Provide psychiatric documentation at intake -- prior hospitalizations, diagnoses, and active medications.
What is the Corrections Mental Health Program in Michigan?
The CMHP is the framework for all MDOC mental health services, established by the Michigan Mental Health Code (MCL 330.1100b) to provide mental health treatment for prisoners who have developmental disabilities or mental illness and require it. CMHP defines mental illness as a substantial disorder of thought or mood that significantly impairs judgment, behavior, capacity to recognize reality, or ability to cope with the ordinary demands of life. CMHP provides Acute, Residential, and Outpatient (OPT) levels of care, plus Counseling Services and Interventions (CSI) for lower-level needs.
What are the CMHP levels of care in Michigan prisons?
CMHP provides three main levels: Acute (most intensive inpatient-level psychiatric care for crisis situations); Residential (structured therapeutic housing for those unable to function in general population but not requiring acute care); and Outpatient Treatment Program (OPT, for general population prisoners with SMI or moderate impairment). Below CMHP, the Counseling Services and Interventions (CSI) program provides short-term counseling for prisoners with psychological symptoms that do not meet CMHP enrollment criteria.
What is the Outpatient Treatment Program in MDOC?
OPT is the primary entry point into the CMHP and the most commonly used level. It: serves as the CMHP's entry door for general population prisoners; provides ongoing psychiatric services to those with severe mental illness who live in general population; and ensures continuity after discharge from higher (Residential or Acute) care. OPT treats moderate functional impairment, emphasizes correcting thought and mood disorders and bio-psychosocial rehabilitation, and focuses on relapse prevention. It is available at MDOC facilities system-wide.
What is the Office of Recipient Rights in Michigan prisons?
The Office of Recipient Rights (ORR) is a unique Michigan mechanism established under the Michigan Mental Health Code. It protects the rights of mentally ill and developmentally disabled prisoners by investigating rights violation allegations, providing consultation to prisoners on their rights, and providing training to mental health staff. MDOC prisoners enrolled in the CMHP are "recipients" of public mental health services under Michigan law and have ORR protections. Note: ORR does not supersede MDOC security policies -- where rights conflict with security requirements, MDOC policy prevails.
Does Michigan charge prisoners for mental health care?
Yes. MDOC charges prisoners fees for health care services under Policy Directive PD 03.04.101. This fee policy applies generally to health services and may include mental health contacts initiated through sick call. This is a significant access concern for prisoners without funds in their MDOC accounts. If your person is being denied mental health services because of inability to pay, document this and file a grievance. Contact Disability Rights Michigan (drmich.org) if fee policies are blocking care access.
What is the START program in Michigan prisons?
The START (Structured Treatment, Accountability, Responsibility, and Transition) program is a specialized MDOC program at high-security facilities (historically ICF, ECF, and MBP) designed for prisoners with mental health issues who would otherwise be placed in administrative segregation. START provides mental health programming as an alternative to administrative segregation for high-security mentally ill prisoners. The 8-12 week program had a documented per-participant cost of approximately $17,745. Ask whether START is available at your person's facility and whether they have been considered for placement.
How does Michigan handle mental health care at release?
Upon release, Michigan prisoners with mental health needs are connected with community mental health services through the MDHHS-administered network of Community Mental Health Service Programs (CMHSPs) and, increasingly, Certified Community Behavioral Health Clinics (CCBHCs) expanded under Governor Whitmer's FY 2025 budget. Ask what CMHSP or CCBHC has been identified in the release county, whether Medicaid has been reinstated, and whether psychiatric medication continuity has been arranged.
What can families do if mental health care is denied in MI?
Provide psychiatric documentation at intake. Know the three CMHP levels -- ask what level your person is enrolled at or why they are not enrolled. Know the mandatory transfer right (PD 03.04.100) -- if their facility can't meet their needs, MDOC must transfer them. Know the Recipient Rights system as an additional advocacy channel. Know the fee policy -- document any fee-based denial. Ask about START for high-security mentally ill prisoners. File MDOC grievances for enrollment failures, level-of-care issues, transfer denials, and fee-based access problems. Contact Disability Rights Michigan (drmich.org) for advocacy.
Who oversees mental health care in Michigan prisons?
MDOC's Bureau of Health Care Services (BHCS), Mental Health Services division manages the CMHP system-wide. The Office of Recipient Rights (ORR) investigates rights violations within the CMHP. No federal court exercises active oversight of MDOC mental health. Disability Rights Michigan (DRM, drmich.org) is the federally mandated P&A organization monitoring conditions for people with mental illness and disabilities in MDOC. MDHHS oversees community mental health services through CMHSPs and CCBHCs. ---
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