Improving mental health in Oklahoma 

A report on mental health care by the National Alliance on Mental Illness, or NAMI, gave the state a grade of B, citing innovations such as mental health and drug courts, collaboration with the state Departments of Corrections and Health and peer recovery support specialist certification.

Oklahoma is making progress.

Much more needs to be done, however, to make appropriate services available to all who need them.

The NAMI report card highlights the following needs:

—reduce the high rate of incarceration of people with mental illnesses;
—address the shortage of inpatient beds;
—increase supportive housing;
—address Medicaid’s restrictive medication policies that utilize a tiered approach for psychiatric medications;
—provide culturally competent services to Oklahoma’s diverse population;
—expand PACT (Program of Assertive Community Treatment) and other evidence-based practices; and —invest in the state’s comprehensive plan for substance abuse and mental health service.

For adults with severe psychiatric illnesses, two of Oklahoma’s greatest needs are crisis and inpatient treatment.

According to the Treatment Advocacy Center, experts estimate a need for at least 50 public psychiatric beds per 100,000 population.

That assumes the availability of good outpatient programs and outpatient involuntary commitment, which prevent the need for hospitalization.

In 2010, Oklahoma had 11 beds per 100,000 — 23 percent of target beds per capita. Today, it isn’t uncommon to have no available beds for a person in crisis or in need of inpatient treatment.

The consequences of the bed shortage could be improved with the widespread utilization of PACT programs and involuntary outpatient treatment. Oklahoma’s PACT program needs to be expanded statewide. Likewise, both inpatient and outpatient involuntary commitment to treatment need to be appropriately and consistently implemented.

While civil liberties must be protected, the pendulum has swung too far in restricting access to care for individuals who, because of their illness, are incapable of seeking help voluntarily.

Involuntary treatment is compassionate care for persons whose ill brains do not recognize that they are ill.

Increased public education about mental illnesses and treatment services is also essential. Too often, ill individuals and their families do not recognize the symptoms and do not seek help until a crisis occurs. The state could do more to promote public awareness of mental illnesses and services.

The NAMI report card concludes:

“If Oklahoma can successfully implement its state plan, it could become a national leader in comprehensive, recovery-oriented mental health care. But, the state has one of the lowest per capita rates of mental health funding in the nation … the Legislature needs to give high priority to mental health care reform.”

Jones is a board member of NAMI- Oklahoma.

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Mary Ellen Jones

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