Summer 2025 Issue

Public Health: Homelessness and Mental Health in Michigan
By Joey Colby Bernert, LLMSW
Social Work Today
Vol. 25 No. 3 P. 9

Michigan’s Mental Health Code runs 191 pages. It defines responsibilities, sets procedures, and governs how behavioral health care is structured. The word “homeless” appears once.

Not once per section. Once in the entire code.

Social workers are trained to see how systems shape outcomes. We know that mental illness does not exist apart from housing, poverty, or legal status. Yet Michigan’s legal framework for mental health acts as if it does. The code gives no meaningful place to housing. It assumes that treatment can be delivered in isolation from shelter, safety, and basic stability. That assumption fails in practice.

The relationship between housing and psychiatric disability is well known. Serious mental illness increases the risk of homelessness. Homelessness makes treatment harder to access and symptoms more severe. People move through shelters, jails, and emergency departments. These are not temporary stops. They become the default settings for care.

People without housing also face much higher rates of recidivism. Research shows that individuals released from jail without stable housing are more likely to be rearrested. A national study found they are up to 11 times more likely to return to jail than people with housing. In Michigan, this pattern repeats. Jails are filled with people who need treatment and cannot find it elsewhere.

Section 330.1207f of the Mental Health Code tries to break that cycle. It created the Community Crisis Response Grant Program. It funds mobile teams made up of clinicians and peers to respond to behavioral health crises. The goal is to reduce jail admissions and increase access to care. These teams are often co-located with law enforcement and required to submit detailed reports on their work.

The statute includes metrics for success. These include the number of calls that result in de-escalation, the number of people referred to housing shelters, and the number who receive outpatient services. Programs must also report racial and gender data, time spent on calls, and cost per case. These metrics are utilized to assess how the program impacts long-term outcomes and to identify gaps in service delivery.

The law also encourages coordination between agencies. Local units of government must submit memorandums of understanding between community partners and law enforcement. These agreements are meant to facilitate collaboration across systems that often operate in silos. The intent is clear: Get professionals working together to stabilize people before the justice system takes over.

The Problem
This program exists within a system that still refuses to name housing as essential. The broader Mental Health Code does not treat homelessness as a clinical concern. It does not prioritize outreach to unhoused people. It does not require coordination with shelter systems. One section tries to build a solution, while the rest of the code ignores the problem.

A person may receive a crisis response from a trained team. That team may de-escalate the situation and make a referral. But if there is nowhere to sleep that night, the cycle will repeat. Stabilization without housing is short-lived. Recovery without housing is not sustainable.

Michigan’s Community Mental Health agencies are required to serve people with the most serious mental illnesses. In practice, this often excludes people who are unhoused. Lack of an address or phone number becomes a reason to deny services. Risk is defined in narrow terms. Those most in need are the least likely to be served.

Social workers see these failures every day. We know what happens when a hospital discharges someone to the street. We know that jail is not a treatment setting. We know that shelters are not safe spaces for recovery. These outcomes are not rare. They are routine.

But social workers are also positioned to act. We work in hospitals, jails, shelters, and clinics. We write notes that shape access to care. We design discharge plans and manage referrals. Our Code of Ethics calls on us to promote the dignity of each person and to challenge injustice. That includes systems that exclude the people we serve.

For new social workers, this means pushing for coordinated housing referrals. It means tracking how often people return to jail or lose contact with care. It means naming homelessness as part of a clinical assessment. It also means advocating for policy change when the current framework causes harm.

The Community Crisis Response Grant Program is a useful tool. It gives social workers a way to respond quickly and connect people to services. But it does not fix the code itself. Until the state rewrites its core laws to reflect the reality of homelessness, the system will keep failing the people who need it most.

Policy is not just background. It is the structure we practice within. If that structure leaves people without shelter or care, then it is part of the problem.

— Joey Colby Bernert, LLMSW, is a licensed social worker, statistician, and Master of Public Health student. Their work focuses on the intersections of structural violence, incarceration, and behavioral health policy.