Across the Midwest, there are 49 state-owned psychiatric hospitals.
State-owned hospitals are funded by the state and tend to provide wider access to patients, because they take most insurance plans and have extensive emergency departments. These facilities provide inpatient care, disability rehabilitation, drug addiction services and pediatric psychiatry to Midwesterners as what’s called “last-resort” care.
Last-resort care refers to care that is a patient’s very last option after exhausting every other type of help. These facilities are inpatient hospitals where individuals go for 24/7 care.
The American Psychological Association reported that 90% of Americans believe there is a current mental health crisis in the U.S. However, the institutions that provide this “last-resort” are decreasing.
In 2009, The Gazette reported that Iowa’s mental health institutes were the final options for patients who were in danger of hurting themselves or others. At the time, Iowa had four institutions. Now it has three.
From 1997 to 2015, the Midwest saw 16 of these facilities close. The state that was hit the hardest was Michigan, which closed five locations from 1997-2009.
Now, Michigan has no psychiatric hospitals in the Upper Peninsula. To get to Caro Center, the northernmost facility in the state, residents would have to drive up to eight hours. If they decided to go to one of the northern Wisconsin facilities, either in Chippewa Falls or Oshkosh, Upper Peninsula residents might drive about five hours.
The four psychiatric facilities in Michigan are shared among about 10.1 million residents.
Minnesota’s population of 5.8 million, according to the 2025 Census, has 13 facilities to choose from. If a Minnesotan lived in the far northeast corner of the state, they would have to drive about five hours to get to a facility.
The states with the fewest state-owned psychiatric facilities are the Dakotas. While neither state has seen hospital closures in the past 30 years, South and North Dakota each have only one facility each, both located in the southeastern part of the state.
North Dakota State Hospital is located in Jamestown, a facility shared by about 799,000 of North Dakota’s population. If a North Dakotan lived in the far northwestern corner of Divide County, they would have to drive five to seven hours to receive that “last-resort” care from the hospital.
In South Dakota, the Human Services Center in Yankton is up to almost eight hours away from the far northwestern city of North Harding. The state’s population of about 935,000 shares that hospital.
If those distances were too far for a Dakotan resident and they decided to look at the western bordering states of Wyoming and Montana, they would still have to travel about 10 hours to get to a facility.
A similar story is told in Nebraska, which has two state-owned psychiatric facilities to share among about 2 million residents; the Lincoln Regional Center and the Norfolk Regional center. Both facilities are located in the eastern part of the state, meaning western Nebraskans have to journey up to seven to eight hours to reach either location.
To access this “last-resort” care in urgent situations, most Midwesterners have to drive for an entire day. If they can’t make that drive, Midwesterners have to explore other options that won’t offer the care they may need.