Substance abuse, prison systems and education have one thing in common in Oklahoma: they are leading factors in Oklahoma’s poor mental health status.
Oklahoma ranks 45th nationally in behavioral mental health — adults nearly leading at 49th nationally and children at 43rd, according to the Oklahoma Department of Mental Health and Substance Abuse Services.
“We’ve been a state that basically funds downstream,” Mental Health Association of Oklahoma Executive Director Mike Brose said.
“What I mean by that is, it’s been said many times, many ways, that our mental health treatment and institutions have become our jails and prisons here in Oklahoma,” he said.
According to the Oklahoma Department of Mental Health and Substance Abuse Services' fiscal year 2016 budget request, $10,214,447 is required to maintain existing programs, and overall $141,104,999 to implement several programs like saving lives and families through suicide prevention, improving behavioral health access for Oklahoma’s health and safety as well as screening, brief intervention and referral to treatment private/public partnership.
“Everybody says to me, ‘Mike, we just need more money in the system.’ Well we may and we probably do, but we also need to reformulate, retool and rethink,” Brose said.
Oklahoma Director of Health and Substance Abuse Services Public Information Director Jeff Dismukes said the state’s mental health problem isn’t something that has happened over night.
“We’re looking at decades of underfunding related to mental health and substance abuse issues," Dismukes said. "It’s really unfair to point toward all of these fixes that have to happen immediately."
The public system has greater need than available resources, he said.
“Some things have happened in the last few years where we funded some programs that provide services to very specific at-risk populations, and those are making a difference,” he said.
Oklahoma State Rep. Bobby Cleveland, R-Cleveland County, said the legislature hasn’t put mental health as one of its priorities over the years.
“We’ve really got a problem that needs to be addressed, and we can’t keep kicking the can down the road,” he said.
“It’s not a party-line situation, it’s just over in-general," Cleveland said. "There hasn’t been discussion. Our mental health in Oklahoma is not good, and we’ve got to do a better job."
He said Oklahoma’s record for mental health is not great, but he believes people are becoming more aware of it.
“I see that the attitude in the House is changing," Cleveland said. "I see we’re changing with our prisons, and it’s changing on mental health."
“That’s one of the problems we’ve had — it just wasn’t being talked about enough,” he said.
Mark Britzman, assistant professor of educational psychology, said it’s not all about funding, though the state is 46th in mental health funding.
“If it’s true that it takes a village to raise a child, what is going awry?” Britzman said.
He said there needs to be a change in dealing with Oklahoma children in education or in the child's environment.
“Every behavior is neuro-chemical," Britzman said. "What happens is, there’s a high rate of trauma in Oklahoma for whatever reason. It could be sexual trauma. It could be child abuse, neglect, those types of things, (or) poverty or lack of education."
Trauma at early stages in life can lead to bad decision making directly caused by cortisol, a chemical released when an individual is distressed or traumatized, physiologically affecting parts of the brain, he said.
“Make sure all the kids have warm, emotional attachment," Britzman said. "Make sure that they’re nourished, that they don’t have trauma and abuse that releases cortisol, which begins to contaminate parts of the brain and the prefrontal cortex."
He said poor decision making can naturally lead to incarceration.
Brose said Oklahoma has a strong incarceration punishment mentality, which is counterintuitive to improving mental health.
“We’ve incarcerated a lot of people, who have committed nonviolent acts in some shape or form, that are tied to either untreated mental illness or the use and abuse of substances,” Brose said.
Cleveland said most of these people who have been incarcerated were either robbing to get drugs, self-medicating or buying drugs.
"It’s all around drugs," he said.
“Some of the people who we have incarcerated have never committed a violent crime, at all, and we’re putting them in prison. As a society, that is just wrong,” Cleveland said.
Something that can help the substance abuse problem is a drug called Vivitrol, which is new on the Oklahoma market and does not allow individuals to feel drunk or high for 30 days, Cleveland said.
“I’m trying to get private funding for this to get started in Cleveland County, because I believe in it so much,” he said.
Another factor weighing in on the problem, Brose said, is the various state agencies like the department of education, department of health, department of labor, law enforcement, treatment providers and political leadership.
“No one entity can be able to move us or transform us to move from (45th in national behavioral mental health) up to where the people of this state need and deserve,” Brose said.
There isn’t an easy resolution, but there is a need for a blue-ribbon panel in Oklahoma to study the issues, he said.
“We need our governor to really put together a blue-ribbon panel, and to really study this, and bring (Fallin’s) recommendations about how we move upstream,” Brose said. “(Fallin) said we need to reduce incarceration. You want to reduce incarceration? Take this on.”
This article was corrected at 10:17 a.m. on Nov. 25, 2015 to reflect that Mike Brose is the Executive Director of the Mental Health Association of Oklahoma, not the Oklahoma Department of Mental Health and Substance Abuse Services.
