Michigan teens and children in severe mental health crises are increasingly being sent hundreds or thousands of miles from home as local treatment facilities close and capacity shrinks.

The trend, which accelerated during the COVID-19 pandemic, leaves parents scrambling to find care for their children in facilities as far away as Hawaii, Arizona, Texas, and even Wyoming.

Eleanor Middlin, now 20, 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 me," Middlin told Bridge Michigan. "It also saved my life."

Her experience represents an emerging pattern for Michigan families struggling with youth mental health care.

Out-of-State Placements Surge

According to a recent report from the Department of Health and Human Services, 152 youth in Michigan's direct-placement program were living in out-of-state facilities as of September 2025. That number more than doubled from the 74 children sent out of state in 2023.

The report, however, does not capture the full extent of the trend because courts sending youth out of state through court orders are not required to share that information with the state.

"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," State Rep. John Roth, R-Interlochen, said.

Families Pay Out of Pocket

For the Middlins, out-of-state care came out of pocket. Jennifer Middlin estimates her family spent $90,000 on her daughter's treatment.

"It was financially devastating," Jennifer said. "The loans and the toll on our savings to make payments."

Insurance did not cover her daughter's frequent therapy sessions at the boarding school.

Laura Marshall of Cedar Springs faces a different reality. Her son was sent to a Wyoming long-term treatment facility through court order, and she had no control over where he was going.

"You're shipping your kid, in some cases, across the country," Marshall said. "There really isn't any way as a parent to be able to vet what's really going on."

Perfect Storm of Factors

Dan Gowdy, president of the Association of Accredited Child and Family Agencies and CEO of the Grand Rapids-based Wedgewood Christian Services, describes a "perfect storm" that enabled the current capacity crisis in Michigan.

The COVID-19 pandemic accelerated the crisis already worsened by social media, which burned out staff at treatment facilities during the emergency orders and quarantines.

"If you could figure out a job that wasn't in a congregate setting like that with a difficult population to deal with," said Bridge Michigan reporter Eli Newman. "We're talking about kids that are having an acute mental health crisis. That's not an easy field to work in, so there was a lot of staff that dropped off at that time."

Distance Creates Isolation

Forcing a child to travel for care creates challenges in planning visits and can be detrimental to recovery.

"It was the worst thing that ever happened to me. It also saved my life," Middlin said.

Some facilities further limit contact, which can be traumatizing for parents to endure while their loved ones are in the midst of a severe mental health crisis.

State Response

Michigan Department of Health and Human Services spokesperson Erin Stover wrote that the department believes placement decisions for youth in foster care and those involved with 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.

"The state also carries a significant financial cost to send its youth out-of-state for treatment," Bridge Michigan reported. The state paid more than $13 million in related costs over the past year.

Families Navigating the System

The Middlins struggled to find appropriate teen residential treatment facilities for Eleanor during her adolescence. She was hospitalized for self-harm at 12 years old and developed substance-use disorders and eating disorders during the pandemic.

"We didn't think we could keep her monitored the way she needed to be monitored," Jennifer said. "They didn't have recommendations that we could really sink our teeth into, so we had to find it on our own."

Short-term stays at behavioral health centers near Holt could stabilize her daughter, but Eleanor needed something more than what local facilities were offering.

Liability Concerns

The liability question is huge, because who is responsible, State Rep. John Roth said.

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

The trend highlights a crisis of care at home that is driving families to seek help elsewhere, often at great emotional and financial cost.

Sources: Bridge Michigan, WJR-AM, Associated Press, AP News