The Oklahoma Department of Mental Health and Substance Abuse Services is responsible for providing services to Oklahomans who are affected by mental illness and substance abuse. In FY13, ODMHSAS provided services to approximately 187,000 individuals.
The impact of untreated mental health and substance abuse is one of the most pressing concerns, health or otherwise, facing our state today. Last year, an estimated 700,000 to 950,000 Oklahomans experienced a substance abuse or mental health issue that required treatment, yet the vast majority probably will never receive the care they need to appropriately treat their illness. Despite the enormity of its negative effects and the sizable number of people directly and indirectly influenced, mental illness and addiction remain a largely unaddressed problem in Oklahoma as a whole; the problem is even greater in specific geographic areas of the state, such as rural areas outside the I-44 corridor where the majority of available services are located.
Our state ranks 48th nationally for overall health and the number of “poor mental health days” (America’s Health Rankings, 2011, United Health Foundation), and is 46th in per capita funding for state-sponsored behavioral health services (State Health Facts, Kaiser Family Foundation). Not coincidentally, Oklahoma ranks above the national average and is among the worst for incarceration rates (USDOJ, Bureau of Justice Statistics), emergency room visits and the number of inpatient hospital days (State Health Facts, Kaiser Family Foundation). In fact, mental disorders are the third leading cause of chronic disease in our state– behind only pulmonary conditions and hypertension – and more prevalent than heart disease, diabetes, cancer and stroke.
The consequences of an insufficiently funded public service system include economic loss, homelessness, increased juvenile and adult criminal justice system involvement, and about a 25-year decrease in life expectancy. These are costs borne by the individual, their families and future generations, our communities and the State. Marriages, families, schools, jobs and businesses are all negatively impacted. Untreated, it disrupts our daily lives and our social, economic and healthcare systems.
Fortunately, effective treatments exist. These treatments restore well-being and productivity. They aid in preserving lives, families and businesses. Treatment saves lives, maintains close nurturing families, and promotes productivity and expanding businesses.
The challenge for all state agencies – particularly for the Oklahoma Department of Mental Health and Substance Abuse Services, where documented need for services has dramatically outpaced available resources – is the need to maximize the investment of tax dollars for programs that work, and address the problem so that implemented solutions may more positively impact future outcomes.
In recent years, targeted investments have been made in programs designed to not only provide services to Oklahomans negatively affected by untreated mental illness and addiction, but also to expand availability to achieve more far-reaching effects – especially related to priority issues such as incarceration, public safety, child neglect and family fragmentation. These investments have proven their worth by establishing the department’s ability not only to deliver effective services in the present, but also to save state taxpayer dollars in the future.
The ODMHSAS was established through the Mental Health Law of 1953, although publicly supported services to Oklahomans with mental illness date back to early statehood. Until the mid-1960s, the primary means to treat mental illness was institutionalization in large state hospitals. On an average day in 1960, nearly 6,400 Oklahomans were in the state's mental hospitals.
Yet, also during much of that period, Dr. Hayden Donahue, long-time Oklahoma mental health director and Central State Hospital superintendent, was one of about a dozen American psychiatrists actively involved in promoting a burgeoning “community mental health movement.” His grant proposal to the National Institute of Mental Health, written while he was superintendent of Central State Hospital, resulted in the nation’s first federally-funded community mental health center being built in Norman in 1968. In the mid-1970s, the concept of "deinstitutionalization" prompted states to increase efforts to utilize outpatient services through these facilities. This approach has proven to be an effective means of recovery and a less costly method to provide services as compared to long-term inpatient care in a hospital setting.
Today, of the approximately 187,000 individuals receiving ODMHSAS services, fewer than 5 percent require hospital care. The majority take part in mental health and substance abuse outpatient programs, targeted community based services, prevention efforts and educational initiatives.
Oklahoma has become a national leader in several areas of community based services including the implementation of programs for assertive community treatment, alternative criminal justice initiatives such as drug and mental health courts, and comprehensive services for children and families.
In many ways, Oklahoma already is “ahead of the curve” in terms of treatment success for people with mental illness or substance abuse problems. ODMHSAS programs are helping people: reunite with their families; increase employment prospects and monthly income; stay out of jail or reduce involvement with the criminal justice system; reduce homelessness; break the cycle of addiction; achieve numerous other successful outcomes, such as obtaining higher education, increasing productivity on the job, stopping tobacco use, etc.
Suffering from a mental or addictive disorder can be as frightening and debilitating as any major physical health disorder. The good news is that treatment works. There is hope, and there is help.