Michigan Kids Sent Thousands of Miles for Mental Health Treatment as State Facilities Collapse

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Detroit-area teen Eleanor Middlin was 15 when her family sent her to a boarding school in Missouri, an 11-hour drive from her mid-Michigan home. It was the worst thing that ever happened to her. It also saved her life.

I'm alive because of it, and I will never be able to forget it, Middlin, now 20, told reporters.

Her experience leaving Michigan for long-term care represents an emerging crisis for the states youth in severe mental health crises. In the years following the COVID-19 pandemic, a growing number of teens and children are being sent hundreds or thousands of miles from home, often because the state lacks the resources to treat them here.

The Middlins are among an unknown number of families in Michigan who pay their own way to get the help they needed — their experience largely invisible in state data. But for other children placed in facilities through court order or child welfare, state reports show out-of-state placements have surged in recent years as a series of Michigan facilities closed.

Unprecedented Surge in Out-of-State Placements

As of September 2025, 152 youth in Michigans direct-placement program were living in out-of-state facilities — some as far away as Hawaii and Arizona, according to a recent report from the Department of Health and Human Services.

That was up from 122 children sent out of state in 2024 and more than double the 74 children in 2023.

Forcing a child to travel for care is like throwing them to the wolves, said Laura Marshall of Cedar Springs, whose son was sent to a Wyoming long-term treatment facility through court order.

We had no control over where he was going, Marshall said.

Families say the extreme distance makes it challenging to plan visits and some facilities further limit contact. The isolation can be detrimental to their childrens recovery and traumatizing for parents to endure.

Horror stories about abuse and staff misconduct dominate conversations about youth treatment facilities, adding a layer of fear for parents that their loved ones may return in a worse condition.

You're shipping your kid, in some cases, across the country, Marshall said. There really isnt any way as a parent to be able to vet what's really going on.

State Officials Cite Juvenile Justice System

State officials believe the rise in out-of-state placements is largely limited to court-supervised youth in the juvenile justice system, not children they directly oversee.

But counties that report placement data to the state are not required to share that information, a spokesperson said.

The Michigan Department of Health and Human Services believes that placement decisions for youth in foster care and those involved in the juvenile justice system must be guided by safety, stability and the best interests of each individual child to ensure they receive the care and treatment they need to thrive, spokesperson Erin Stover wrote in an email.

The confusion is a symptom of a larger problem, lawmakers contend: A massive department overseeing a sprawling landscape of juvenile facilities that could lead to kids falling through the cracks — or needing to seek care elsewhere because state offerings are not accessible at the time.

The liability question is really huge, because who is responsible? State Rep. John Roth, R-Interlochen, said.

If that kid gets seriously injured in an out-of-state facility, is it the state that they went to's problem now?

Families Pay Massive Costs for Out-of-State Care

Eleanor Middlin was hospitalized for self-harm at 12 years old. Throughout her adolescence, Eleanor had seen therapists and received medication. But her mental health issues compounded during the pandemic, a period marked by intense isolation and complete access to the internet.

Snapchat, Instagram and Yubo became social media vehicles toward a path of feeling horrible about herself, she said.

It was the perfect environment for me to get worse, she said.

She developed substance-use disorders — mainly downers like Xanax and opioids — and eating disorders. Many of her habits were unknown to her mother, Jennifer Middlin.

It felt shameful even though we tried everything that we could try, Jennifer told reporters.

Short-term stays could stabilize her daughter, Jennifer said, but Eleanor needed something more than the behavioral health centers near Holt were offering.

We didnt think we could keep her monitored the way she needed to be monitored, she said. They didnt have recommendations that we could really sink our teeth into, so we had to find it on our own.

The cost of out-of-state care came out-of-pocket for the Middlins — Jennifer estimates her family spent $90,000 on her daughters treatment. Insurance didnt cover her daughters frequent therapy sessions at the boarding school.

The loans and the toll on her savings to make payments were financially devastating, she said.

The state also carries a significant financial cost to send its youth out-of-state for treatment — it paid more than $13 million in related costs last fiscal year, with about half coming from the state.

That was up from $9.7 million the prior year. That amounted to $392 per day of care, up from $379.

Pandemic Exacerbates Youth Mental Health Crisis

Gowdy estimates about 16 youth treatment programs have shuttered since the onset of the pandemic. The Shawono Center in Grayling, Michigans only state-run residential facility for male juveniles, closed in February 2025.

The pandemic accelerated a youth mental health crisis already worsened by social media, burning out staff at treatment facilities and forcing families to seek care outside the state.

Michigan has nearly doubled its out-of-state youth mental health placements over the past decade. Costs have similarly surged.

The confusion is a symptom of a larger problem, lawmakers contend: A massive department overseeing a sprawling landscape of juvenile facilities that could lead to kids falling through the cracks — or needing to seek care elsewhere because state offerings are not accessible at the time.

The liability question is really huge, because who is responsible? State Rep. John Roth, R-Interlochen, said.

If that kid gets seriously injured in an out-of-state facility, is it the state that they went to's problem now?

State Building New Facility Amid Crisis

MDHHS Director Hertel and State Budget Director Flood recently toured a new state psychiatric hospital, discussing the importance of continued investments in behavioral health for Michigan families.

It will replace Hawthorn Center, which opened in 1965 and was demolished to make way for the new hospital, and Walter Reuther Psychiatric Hospital, which opened in 1979, and is slated to close after the new facility opens.

What This Means for Michigan Families

Parents and mental health advocates describe a system that consistently fails children with complex psychological disorders, where the needed treatment doesnt exist in Michigan and families must send their children far from home for basic care.

The crisis extends beyond finances. Parents face emotional tolls from sending children thousands of miles away, dealing with unknown facility conditions, and navigating a system that leaves families with little control over where their children receive care.

The state has a responsibility to provide mental health treatment for its youth, but the collapse of facilities has left families with no choice but to seek help elsewhere — often at tremendous cost.