What’s the Difference in Out-of-Home Care Options for Michigan’s Kids?

By Jennifer Peacock, Policy Director 

In Michigan, children and youth may interact with several different systems that provide out-of-home care and treatment. The most commonly discussed are the child welfare and the juvenile justice systems. Both of those systems are also deeply connected to the pediatric behavioral health system, which can be more commonly understood as dealing with mental health.

These systems are distinct, but they often overlap in practice. As conversations continue around residential capacity, or youth beds, in Michigan, it is important to clearly define what each system does, who it serves, and how strain in one system can affect the others.

A simplified way to think about these systems is:

• Child welfare beds → “If it’s not possible to remain at home, where can this youth live safely?”

• Mental health beds → “What medical or psychiatric treatment does this youth need?”

• Juvenile justice beds → “What placement is required because of court involvement?”

At Michigan Center for Youth Justice (MCYJ), we have seen firsthand how strain in one system can place pressure on another. Michigan is facing rising treatment needs among youth involved in both the child welfare and juvenile justice systems. At the same time, access to specialized behavioral health services remains uneven across the state.

As a result, systems often struggle to match youth with the appropriate level of care and treatment. In some cases, placement decisions are driven more by scarcity than by clinical need.

When youth cannot access appropriate behavioral health treatment, families may face difficult choices. Some seek treatment out of state. Others encounter systems involvement that may not have occurred if adequate community-based or psychiatric care had been available earlier.

In some situations, youth with significant behavioral health needs may remain in or enter juvenile justice settings because more appropriate community-based, crisis, or psychiatric treatment options are unavailable or inaccessible outside the legal system. This further strains juvenile justice capacity and can place additional pressure on staff, facilities, counties, and state oversight systems.

The result is a fragmented system that is increasingly asked to serve youth with highly complex needs while lacking adequate treatment infrastructure across multiple sectors.

Juvenile Justice 

Michigan’s juvenile justice out-of-home placement system is made up primarily of detention facilities and residential treatment facilities. These placements serve youth involved in the delinquency system, meaning youth accused of or adjudicated for offenses. Detention facilities provide short-term custody in physically restrictive settings while youth await court hearings, adjudication, disposition, or placement elsewhere.

Residential placements are longer-term and may include both secure and nonsecure facilities. These programs are intended to provide treatment, rehabilitation, structure, and supervision for youth under court jurisdiction. Facilities may be run by the state, the county, the court, or by a private organization.

Importantly, a facility’s licensed bed count does not always reflect actual capacity. Staffing ratios play a major role in whether beds can be used. If facilities do not meet required staffing levels, youth cannot legally be placed in otherwise empty beds.

In some cases,  a juvenile court commits or refers a delinquency-involved youth to MDHHS for placement and supervision, including as an Act 150 public ward. In these situations, MDHHS Juvenile Justice Specialists oversee placement, treatment coordination, and supervision from acceptance through discharge.

Child Welfare

Michigan’s child welfare system serves youth who cannot safely remain at home due to abuse, neglect, abandonment, severe family conflict, or other concerns. The welfare system includes a wide range of placement settings, including:

• Foster family homes

• Relative placements

• Emergency shelters

• Residential facilities

• Child caring institutions

• Preadoptive homes

In general, these youth are involved with the child welfare system rather than the juvenile court for delinquency matters.

Pediatric Behavioral Health 

Another important piece of this conversation is Michigan’s pediatric behavioral health treatment system. These placements are designed to provide medical and psychiatric treatment for youth experiencing significant behavioral health needs. This may include:

• Inpatient psychiatric hospitals

• Crisis stabilization programs

• Psychiatric Residential Treatment Facilities (PRTFs)

Some behavioral health facilities are licensed to serve youth who are under juvenile court jurisdiction. In other situations, families independently seek treatment for youth with acute mental health needs outside of court involvement. While these systems may interact, the purpose of placement is different in each one.

Where the Systems Overlap

In practice, these systems do not operate in isolation. A youth in foster care may also need psychiatric hospitalization. A justice-involved youth may require intensive behavioral health treatment. A youth receiving psychiatric care may also have an open child welfare case.

In Michigan, some youth become involved in multiple systems at once. For example, a “dual ward” generally refers to a youth who has both an open foster care case and involvement with the juvenile justice system through court supervision or MDHHS delinquency placement.

Because youth needs are often complex, conversations about residential “beds” can quickly become blurred. A psychiatric treatment bed is not the same as a juvenile justice placement, even if both are residential settings. Likewise, a child welfare placement may involve supervision and care, but not delinquency-related custody. These distinctions matter because the legal purpose, oversight structure, funding mechanisms, and treatment goals of each system are different. 

What Does the System Actually Need?

All children and youth deserve access to safe, high-quality, and appropriate care, whether that means acute psychiatric treatment, foster care placement, or residential treatment within the juvenile justice system. As Michigan debates expanding residential capacity, it is critical that we first understand what types of placements are actually needed.

Calls to build additional juvenile justice beds should not be conflated with the need for expanded pediatric behavioral health treatment infrastructure. These are related challenges, but they are not interchangeable.

A real-time census of youth currently placed in Michigan’s juvenile justice residential system would help policymakers better understand:

• Youth adjudications

• Risk levels

• Behavioral and mental health needs

• Lengths of stay

• Whether residential placement is the appropriate level of care

This type of assessment is essential for understanding both system capacity and treatment gaps. More kids in the general public are needing access to mental health support options, and for some parents their options are significantly limited, varying from court involvement to out-of-state care. Michigan likely does need more behavioral health treatment options for youth with higher-acuity mental health needs. However, those are not necessarily juvenile justice beds, and that distinction matters. At a macro-level, Michigan must invest in local continuums of care to ensure robust treatment options for a variety of needs. This can ensure that youth are placed out of the home as a last resort, and not as a means to access care. 

These systems are complex, and this piece only scratches the surface of the challenges and overlaps that exist. But if Michigan hopes to responsibly address youth treatment and placement needs, conversations must begin with clear definitions, accurate data, and a shared understanding of what each system is designed to do.