TERRI White uses the following analogy to illustrate how Oklahoma deals with people who need help for substance abuse or mental health problems:
A person goes to the emergency room with chest pains and the doctor finds that the heart is 20 percent damaged. But instead of repairing the problem, the doctor tells the patient to return when the heart has worsened because limited resources dictate that only those with really bad hearts can be treated.
“You'd be like, ‘Are you kidding me? Your idea is I go away and I just wait for my heart to get more and more damaged and then I come back?'” And yet, White said, “That is literally how our mental health and substance abuse treatment works.”
As head of the state agency charged with providing resources to combat Oklahoma's mental health and substance abuse issues, that's a frustrating reality, one she has worked six years to improve.
The good news is that improvements have been made. The agency's Smart on Crime initiative, which provides treatment instead of incarceration for nonviolent offenders with mental illness or addictions, has been a success during its two years in place. At Gov. Mary Fallin's urging, it got $3 million each of those years. That's a far cry from the $100 million per year needed to really make a difference — not just in treatment, but in savings that would be realized on the back end — but White will take what she can get.
She's likely to get more for the upcoming fiscal year. Fallin in February requested an additional $16 million for mental health and substance abuse services. Her call came not long after the Newtown, Conn., school shooting, which was carried out by a man with a history of mental illness.
Oklahoma, thank goodness, hasn't experienced such an event. But, “I feel like we roll the dice every day,” White says, because so many of those who need help don't get it. Indeed, she said her agency can assist only a third of Oklahomans who need it. There are 600 to 900 people per day on the waiting list for residential substance abuse treatment.
The large number of people who need help but can't get it helps explain why our prisons and jails are so crowded (the Department of Corrections says half of all state inmates have a history of, or now exhibit, some form of mental illness), why our rates of children in foster care are so high, why our suicide rate is so high and why some of our other health outcomes are poor. In Oklahoma, mental disorders are the third-leading cause of chronic disease — when the brain doesn't function properly, the rest of the body suffers too.
Ever the optimist, White says that most days, “I'm really hopeful that we're getting toward a tipping point. But there are days when it is hard sometimes for me to carry that hope, because it just seems like still there's such a long way to go.”
Bending the curve back in the other direction will require additional funding from the Legislature — our per capita spending on mental health ranks 46th nationally. But just as important, Oklahomans must disabuse ourselves of the notion that seeking help for a loved one, or for ourselves, is a sign of weakness or an embarrassment.
And we must let our elected officials know that improving Oklahoma's mental health outcomes should be a priority. We've been rolling the dice for too long.