As mental health crises continue to strain resources nationwide, the University of Michigan Center for Health and Research Transformation (CHRT) is taking a bold step forward with the ADAPTS (A Dynamic Approach to Psychiatric Treatment Systems) project, a data-driven initiative designed to optimize the allocation of psychiatric beds. Built on the foundation of the Anytown, U.S. model, the project utilizes system dynamics modeling to reshape how communities address mental health needs by offering a comprehensive framework for resource planning and crisis intervention.

Understanding the ADAPTS model

At its core, the ADAPTS project relies on historical, aggregate patient data to assess the patterns of psychiatric bed demands in the community. Unlike traditional approaches that rely on historical data and population ratios, ADAPTS incorporates critical variables such as outpatient service availability, crisis service capacity, and population characteristics to deliver tailored insights into mental health resource needs.

The Anytown, U.S. model was a prototype model that different communities around the country could plug their own data into and measure what the impact would look like.

"In Washtenaw County, our principal investigator Dr. Gregory Dallack understood that our county had existing hospitals and health departments. He then began to develop a Behavioral Health Consortium consisting of partners like hospitals in the Trinity Health System and Washtenaw County Community Mental Health that started working together on some of the issues in Washtenaw County's behavioral health system and had established working groups needed to roll out this project with buy-in from different stakeholders,” says Nailah Henry, ADAPTS project manager and health policy analyst at CHRT.


Washtenaw County residents can call 734-544-3050 to access Washtenaw County Community Mental Health's crisis services. Pictured, crisis team member Paige Marchese.

Localized solutions for Washtenaw County

To ensure the ADAPTS project is responsive to the specific needs of Washtenaw County, the ADAPTS project team is carefully tailoring local implementation based on data collected both from Washtenaw County Community Mental Health, University of Michigan Psychiatric Emergency Services, Trinity Health Systems Emergency Department, and addiction treatment facilities like Dawn Farm and Home of New Vision. This includes gathering data on outpatient care access and community support systems, with a focus on reducing bottlenecks in emergency departments and improving care for individuals in crisis.

“To ensure the ADAPTS project is tailored to Washtenaw County, we prioritized getting to know all the different players in our behavioral health system. For our project team, this meant interviewing a lot of organizations that are part of our crisis care system to figure out what are their barriers and facilitators for taking care of the people that they do. From there we created a map of how Washtenaw County’s crisis care system works, how patients flow from one organization to another. And while we were doing those interviews, we were also able to get estimates of the volume of patients that flow from these different organizations, providing expert estimates for this model to inform impactful decisions,” says Henry.

ADAPTS' innovative use of system dynamics modeling allows for a better understanding of feedback loops and interdependencies in the mental health system. For instance, longer wait times for psychiatric beds often result in cascading effects, such as increased arrests or extended hospital boarding, which exacerbate systemic pressures. The model’s simulations help decision-makers predict and mitigate these challenges.

“System dynamics is really focused on consensus building, and that requires people to come together and talk to truly understand the system as best as possible. From there, dynamic modeling is basically a decision-support tool to help people figure out how to navigate and make decisions for a complex system such as our crisis support system. This project uses simulation modeling to figure out how we can best support the unique crisis care needs of Washtenaw County,” says Henry.

The model will soon prove its value in guiding resource allocation decisions. 

“For example, if we look at a crisis stabilization unit, this modeling system helps us understand that if we increase the capacity of this crisis stabilization unit, how will that impact the emergency department wait times? How will that impact the patient flow from this hospital system to this hospital system? Does it make it better? Does it free up more inpatient beds? Does it make the wait time to get into the inpatient department less? And so, they use this method to figure out what parts of the system can we enhance and support to make it more effective and with the most cost and time efficiency,” says Henry.

"This project uses simulation modeling to figure out how we can best support the unique crisis care needs of Washtenaw County." Nailah Henry

Collaboration as a catalyst for change

The ADAPTS framework adoption has benefited significantly from Washtenaw County’s existing Behavioral Health Consortium, which has fostered collaboration across the county’s mental health crisis organizations. This unified approach has been crucial to the project’s success.

“When adopting this project, many communities have challenges breaking down silos and bringing people together, but in Washtenaw County, this project launch was met with collaboration and communication between all the stakeholders in our crisis mental health system, especially those in our Behavioral Health Consortium,” says Henry.

Stakeholder contributions from existing partners have also been vital to refining the model. 

“Without the support of mental health crisis organizations in Washtenaw County, we wouldn't have been able to make this unified approach happen. Our stakeholders are volunteering their time to help us understand their organizations and give feedback on the model to make sure it's working properly and make sense for them,” says Henry.

Looking ahead: goals and impact

The ADAPTS project has set ambitious goals, including reducing emergency department wait times, improving patient flow, and optimizing resource allocation. Ultimately, the initiative aspires to serve as a blueprint for other communities tackling similar challenges.

“My vision for this program is that because we're all working together in the public mental health system, we’re able to create better flow. I think the last outcome I hope for is that by us piloting this program, other communities will adopt the Anytown, U.S. model,” Henry says.

By leveraging innovative modeling techniques and prioritizing community-specific solutions, Washtenaw County is pioneering a more responsive and equitable mental health system. As the ADAPTS project continues to evolve, its lessons and successes are poised to influence mental health care planning nationwide.

Brianna Nargiso, a graduate of Howard University and Mercer University, specializes in media, journalism, and public health. Her work has appeared in The Root, 101 Magazine, and Howard University News Service, covering profiles, politics, and breaking news. A Hearst journalism award nominee and active member of the National Association for Black Journalists, she has also worked with Teach for America and the Peace Corps. Now a doctoral candidate at American University, Brianna is dedicated to advancing social justice, public health and education on a global scale.

Photos by Doug Coombe.

The MI Mental Health series highlights the opportunities that Michigan's children, teens, and adults of all ages have to find the mental health help they need, when and where they need it. It is made possible with funding from the Community Mental Health Association of Michigan, Center for Health and Research Transformation, LifeWays, Michigan Health and Hospital Association, Northern Lakes CMH Authority, OnPoint, Sanilac County CMH, Summit Pointe, and Washtenaw County CMH.