The Tulsa World’s most recent town hall event — Let’s Talk: Mental Health Forum — was a big success.
About 250 people filled a room at the University of Tulsa’s Allen Chapman Activity Center.
Psychiatric professionals, clients, family members and law enforcement came to hear a stellar panel, including TU President Gerard Clancy, a practicing psychiatrist who was a leading force in last year’s comprehensive study of mental health challenges in the Tulsa area; state Mental Health Commissioner Terri White and Dr. Martin Paulus, president and scientific director of the Laureate Institute for Brain Research. Mike Brose of Mental Health Association Oklahoma and Oklahoma first lady Sarah Stitt were special guests for the evening.
To me, Stitt was the big surprise of the night. I won’t soon forget her moving, first-person description to the challenges of dealing with her parents’ mental health issues. When Kevin Stitt was elected governor, she was told she would need to come up with an issue she would want to champion publicly, and she said she knew the answer immediately — mental health. She’s a good ally in a high place for Oklahoma’s mental health advocates.
The program’s 90 minutes flew, and I honestly didn’t get a chance to ask many of the excellent questions that members of the audience had submitted. So, I thought I’d circle around now and get some answers.
• Several submitted questions concerned the frustrations of families of mentally ill people with the treatment system. Mentally ill people can only be held against their will if they are a threat to themselves or others. That standard relies somewhat on the honesty of the patient, two questioners said. Psychiatrists seem hesitant to take input from family members, who want to protect their loved ones and themselves.
“It’s like catch-and-release medicine and families are frustrated beyond reason,” one person wrote.
I put the questions to Clancy, who said that the threat to self or others standard was a reaction to mass, involuntary commitment processes in place until the 1960s. They were inhumane and ineffective.
Mentally ill patients can be cagey, and a good clinician will make decisions based on as much other information as possible, he said. While federal medical privacy laws limit how much information clinicians can release, there is no limitation of their ability to receive information and doctors should welcome it.
“Patients’ families can tell us anything they want,” he said “Good clinicians listen.”
Privacy laws don’t release doctors from their obligation to warn people who are in danger, he added.
• “How can we get rid of the stigma and mystification that surrounds mental illness,” another audience member asked.
Brose said the question identifies a very real, deeply embedded social problem: If a person is physically ill, we think they need treatment; but when a person is mentally ill — when they have a disease of the brain instead of the heart or liver — we see a character flaw. It’s a cultural issue that is largely driven by fear, he said.
Social leaders can (and are) changing that.
“You’re seeing professional athletes, iconic entertainers and others talking openly and on social media about their own struggles, and that’s so important,” Brose said. “Open discussion in public space — people owning it — that’s what’ll bring it down and reverse the stigma.”
Stitt’s comments at the forum were a perfect example of the open discussion of mental health issues that are critical to more progress, he added.
• “Do you think the current culture and atmosphere of state government is open to improving and increasing services,” another participant asked. “If so, what areas should legislation focus on?”
White said she sees progress.
“The progress that has been made along with increased attention to the importance of these issues is creating positive change and support for access to services that work,” she said. “I believe that this is absolutely a priority concern in our state, as evidenced by the additional investment in treatment and prevention services made this year through efforts from the governor and Legislature.”
Mental health appropriations were up 4.2% in the budget approved by the Legislature last month. The department’s $348.5 million appropriation includes $10 million in new money for smart-on-crime diversion programs.
White said continued expansion of evidence-based services is key to addressing appropriately the state’s enormous unmet need.
“Policy, without additional resources, will not adequately address the problem when the crux issue is that the door to get into help is too narrow,” she said. “We need to continue community engagement and increase prevention services, address barriers to treatment and find innovative ways to efficiently and effectively get the best possible care for our fellow Oklahomans.
• Finally, we got this question: “How do we get involved with funding in mental health care in Oklahoma?”
I’ll answer that one.
There are excellent advocacy groups that can help amplify your voice, including the Mental Health Association Oklahoma and National Association on Mental Illness Oklahoma, but don’t underestimate the power of the individual, motivated voter to get lawmakers’ attention.
The Oklahoma Legislature sets the state’s funding priorities every year. In the current year’s budget, a little over 4% of state appropriations go to mental health. If you want it to be 5%, there are four things you need to communicate to your legislator:
• I am your constituent.
• I am registered to vote.
• I care deeply about mental health funding.
• I will be watching how you act.