A huge question looms for Susan Boehrer. And she figures she has particular insight, because mental illness plunged her daughter into more than 400 days of hospitalization and a violent conduct disorder made her son a ward of the juvenile justice system. "Do you really want to be driving down the road, looking at the car next to you, wondering if that’s one of the folks who, because of the cuts to mental health, aren’t receiving the services they need?” Boehrer said. It’s a question she said more people likely will be asking as budget cuts — about $17 million and counting — deplete the state Mental Health and Substance Abuse Services Department. Already almost half of the 400 available beds have been cut. More cuts are on the way. The impact will be wide-ranging, Boehrer, of Washington, OK, said. "If my child is in class with your child and my child isn’t receiving the mental health services that they need, then my child is still going to be in your child’s class,” she said. "Except for now, it’s going to take more resources to serve my child and more of the teacher’s time. Which means it’s going to take away from someone else’s child.” Mrs. Oklahoma 1999, Susan Boehrer, with her husband, Terry, adopted two children and completed their family by taking in two other teens. But the family picture quickly went out of focus. Their daughter, Maddy, would hear voices, jump out of moving cars or cut herself as her complex disorder wracked her mind, leading to six trips to the emergency room. Drug use became an issue with their son, Tyler, and violence caused by his conduct disorder caused his parents to call 10 times for help from police or sheriff’s deputies. Tyler, 22, is now stable, married and in the military and Maddy, 18, attends alternative school. But Maddy’s mental health care is in limbo. Boehrer waits to find Maddy’s next doctor because the family is unsure how additional budget cuts might affect doctors and programs. Terri White, Mental Health and Substance Abuse Services commissioner, said department budget cuts can affect any family. "I think anytime you are denying services to someone who needs medical care, it’s a dangerous situation,” White said. She said mentally ill or addicted people and their families may be at risk. Though she said the mentally ill aren’t usually violent, when they are, the result is often scary. "When you talk about adding drugs and alcohol to the mix, we know that increases the propensity for self-harm and violence, that’s why it’s so important for folks to have the access to treatment so they are able to stay drug- and alcohol-free,” she said. White said reductions ripple through hospital emergency rooms, police departments, jails and people’s wallets.
Collateral damageHospitals and their emergency rooms will be asked to pick up the slack for now-missing services. The Oklahoma Hospital Association ran information on mental health and substance abuse center closure issues in a recent newsletter, Executive Director Rick Snyder said. "We expect it to have a negative impact on Oklahoma’s hospitals, starting probably in the emergency room, which in many communities may be the only other place those patients can go for help. It’s unfortunately about the most expensive place to go for help,” Snyder said. He predicts more patients will crowd emergency rooms and hospitals because of drunken driving accidents, domestic violence and attempted suicides resulting from people not getting treatment. Hospitals also are losing money due to lower Medicaid payments and caring for the uninsured, he said. In Oregon, a 15 percent cut in the health plan resulted in a 20 percent increase in uninsured patients entering emergency rooms, Snyder said.
Flooding jailsStacey Puckett, executive director of the Oklahoma Association of Chiefs of Police, said cutbacks are far-reaching. "There is an immediate need for addressing this issue on a state basis. Because what’s happening is our county jails are being filled with mental health clients,” Puckett said. "And that certainly is not the intent for those to be mental health detention centers.” Of the 2,101 inmates in the Oklahoma County jail Thursday, 365 were being treated for mental health issues and 20 inmates were being observed for drug and alcohol issues, said Mark Myers, Oklahoma County sheriff’s spokesman. Puckett said problems are compounded when mentally ill or substance-abusing inmates on medication enter the jail and then have to be seen by doctors to get back on their medications. She said there’s a risk of people spiraling into poor health between the time they are booked into jail and they get to see a doctor.