Oklahoma’s costly lack of foresight in not funding mental health care (Guest post: Tiara Blue)

Tiara Blue is an instructor at Murray State College in Tishomingo and a contributing writer for NonDoc.

Foresight. I underlined this word twice in my notes for the late Professor J. Rufus Fears’ “Ancient Rome” course. I was just a sophomore at the University of Oklahoma, but in that lecture, Fears said something that has resonated with me all my life: The difference between a mediocre leader and a leader of true greatness is not money, prestige, or charisma. It’s foresight, the ability to recognize problems on the horizon and create solutions that are good, not only in the short term, but in the long term as well.

In the midst of Oklahoma’s budgetary crisis, it seems that Professor Fears’ hallmark of leadership is lacking at our state capitol.

This was never more clear to me then March 25, when the Oklahoma Department of Mental Health announced that its already anemic budget had been reduced by $22.8 million, or figuring in the loss of federally matched funds, a total of $40 million. Overnight, 73,000 Oklahomans found their access to mental health service reduced or eliminated.

Oklahoma has a long history of not caring enough to invest in mental health treatment. Mentally ill people are lower on the totem pole because politicians don’t view mental health as a politically expedient cause. Politicians do not care because they believe the public does not care.

I am here to tell you why you should.

From an economic perspective, cutting resources and treatment to mentally ill men and women simply costs a lot more than providing treatment in the first place. My family is in the rare position to know this firsthand. We’ve seen what happens when a state bureaucrat makes a myopic decision to save a buck. Our anecdote is quite possibly a small preview of what’s to come.

In 2013, my mother was informed that the state of Oklahoma would no longer cover her medicine, Abilify, a psychotropic drug that kept her paranoia and delusions under control. The news shocked my family to the core.

The road to Mom’s recovery had been laborious at best. Fifteen years of paranoia, hallucinations and manic breakdowns, followed by repeated arrests and mental hospital stays that were too short to do any good.  (This is not the fault of Oklahoma’s mental health professionals. There is simply too little funding, too few beds, and too many mentally ill individuals languishing on waiting lists.)

For nearly two decades, Mom was a statistic, one of the many who fall through the cracks of Oklahoma’s mental health system. But that all changed when a judge intervened with a court order, requiring her to take medicine and receive the treatment she needed. After a one-month stay at Griffin Memorial Hospital with kind and conscientious professionals, my mom began the two-year process of community treatment. She visited local counselors, saw her psychiatrist once of month via Skype, and worked with her doctors each month to adjust her medicine little by little, in order to find that perfect combination that leveled her brain chemistry without side effects like lethargy or memory loss. 

For all the failures in Oklahoma’s mental health system, Mom was an emerging success story. Mom returned to the loving woman I remembered from my childhood. And now she was an adoring grandma, taking odd jobs, junking iron with her husband Chad, and cleaning houses to splurge on little Dollar General toys for my sons.

Then someone we’ve never met decided it would be cheaper for the state of Oklahoma to not pay for Abilify. My grandmother and I crunched numbers to see if we could absorb the costs for the Abilify ourselves, but at $700 a month, we couldn’t afford it. After a mere two weeks without medicine, Mom noticed a difference.

“Supernatural things were going on,” Mom said. “I guess that should have been my cue that something wasn’t right. I would be walking down the street and hear voices. At home, pictures on the wall… were talking. And I talked back, and they would answer. I thought it was Christ’s reawakening. It was that bad.”  

Amidst all this, my grandmother worked tirelessly on my mother’s behalf. She submitted and resubmitted the necessary paperwork to the state Capitol, filled out by my mother’s doctors, verifying that Mom needed Abilify to function properly.

By the time the state renewed its coverage of Mom’s prescription, she was too far gone. Mom heeded the voices in her head when they told her the medicine was poison. She tossed the Abilify into the trash, and along with it, a two-year recovery process.

[pullquote]“It’s disturbing to think they care so little for human life,” Mom said. “You feel like garbage. You feel disenfranchised.”[/pullquote]

A short time later, during a manic episode, Mom was arrested for harassing her neighbor, a police officer. 

The arrest led to a 30-day commitment in the Red Rock Norman Crisis Stabilization Unit. According to Steve Norwood, Chief Operating Officer for Red Rock, the crisis unit in Norman cost approximately $19.50 an hour or $468 a day. A 30-day stay at Red Rock Norman Crisis Stabilization Unit costs approximately $14,040. Compare that to $700 for Abilify.

That is what you call a lack of foresight. Mom has already received notification that some of the services she counts on might be reduced or eliminated, and so we brace for the rollercoaster ride that was 2013.

“It’s disturbing to think they care so little for human life,” Mom said. “You feel like garbage. You feel disenfranchised.”

It doesn’t have to be this way. The Oklahoma Policy Institute has compiled a succinct list of ways the state can immediately work toward closing the budgetary gap. But more importantly, if Oklahoma simply accepted Medicaid expansion, which is almost entirely federally funded and has been linked to economic booms in local economies, Oklahoma’s mental health system could lift itself from underfunded and struggling to one that is comprehensive and effective.

The opinions stated above are not necessarily those of OK Policy, its staff, or its board. This blog is a venue to help promote the discussion of ideas from various points of view and we invite your comments and contributions. To see our guidelines for blog submissions, click here.