How bad is mental health in Tulsa? Study portrays ‘alarming’ statistics but offers hope

Tulsa Public Schools staff come across a suicide note nearly once a day from elementary or middle-school students, and Tulsans with chronic severe mental illness die 27 years earlier on average than all Oklahomans.

Those “alarming” snapshots of Tulsa, where 1 in 7 people have a mental illness, are in a new study that illustrates the dire situation in which Oklahoma is mired through disinvestment from and stigmatization of mental-health and substance-abuse care.

Together those statistics — and many others in the report — underscore the need for prevention and early intervention services to achieve better outcomes at a lower cost.

A comprehensive study of the Tulsa region’s mental health care delivery system was unveiled Wednesday by the University of Tulsa and the Anne and Henry Zarrow Foundation.

The 91-page study identifies several disconcerting trends but offers five “action areas” to serve as a 10-year blueprint on how best to improve the Tulsa area’s mental health and wellness.

The document also establishes measurable benchmarks toward achieving gains, saying Tulsa should be able to “create a culture of real and continuous mental health improvement” that builds on existing strengths.

In the report’s foreword, TU President Gerard Clancy laments that funding for prevention and early intervention of mental-health or addiction care services “does not come close” to other medical conditions. Mental health and addiction are “complex diseases of the brain,” he writes, and thus require much more than just psychopharmacology.

Clancy notes that Oklahoma jails and prisons house more people with mental illness and nonviolent drug offenders than the state’s “much less costly” inpatient- and outpatient-care facilities.

The study found that incarceration for a person suffering from a mental illness in Oklahoma costs $23,000 annually, whereas community-based treatment for that individual is $2,000.

At a news conference Wednesday, Clancy said 10,000 people per year pass through the Tulsa County jail with a mental illness and that at any given time 30 percent to 40 percent of jail inmates are on psychotropic drugs.

“I cannot think of a worse place to treat mental illness than the corrections system,” Clancy said.

Bill Major, executive director of the Zarrow Foundation, said the group will donate $3 million for a mental-health action team to operate over a three- to five-year period.

The three- to four-person team will ensure that Tulsa advances mental-health strategies outlined in the report, Major said. The team may help with capital projects or scaling up pilot projects and most certainly will track data toward goal achievement.

“This report is not meant to be a silver bullet but more of a guide,” Major said.

Three of the four metrics involve life and death:

Tulsa’s 27-year life-expectancy gap of chronic severely mentally ill vs. all Oklahomans is targeted to be to 24 years in five years and 14 years in a decade.

The suicide rate of 19.1 people per 100,000 is targeted for 16.0 in five years and 12.6 in a decade.

The drug overdose rate of 19.3 per 100,000 is targeted for 13.9 in five years and 9.5 in a decade.

Life expectancy is labeled as a “sentinel indicator of human health and well-being,” with the study citing an average life expectancy at birth in Oklahoma of 75.9 years.

That drops precipitously to 52.6 years statewide for clients of Oklahoma’s public mental health service system. In the greater Tulsa area, it’s even worse at 49.4 years — an “alarming figure” comparable to life expectancies in “some of the least developed countries in the world.”

In Tulsa, according to the study, the early deaths of people with mental illness or addiction are most often caused by accidents, suicide, homicide and drug overdoses. The deaths often are preceded by years of “poor health, social disconnection, and low economic productivity.”

“Our stark death rates are a direct result of the pernicious stigma associated with mental illness and addiction, and that is a wrong that must be made right,” Clancy writes in the report.

The Urban Institute, a Washington, D.C.-based nonprofit organization, worked with Tulsa research partners from September 2016 to February 2018 to examine Tulsans’ mental health and the community’s capacity to meet mental-health needs. The Zarrow Foundation funded the research and report.

The study looks at people younger than age 65 in seven counties that make up the Tulsa metro’s statistical area: Tulsa, Rogers, Wagoner, Creek, Osage, Okmulgee and Pawnee.

“A false belief … persists in 2018 that these individuals are personally at fault for their conditions,” Clancy writes.

“What follows is another false belief among some voters, decision makers, and people with influence over funding — that these citizens do not deserve financial support for prevention, early intervention and direct care of their brain diseases.”

The study places special emphasis on children and youth, which it found is a group in Oklahoma disproportionately affected by poor mental health.

Given that half of all mental illnesses appear by age 14 and three-quarters by age 24, early and effective intervention can have profound lifelong benefits, according to the study.

By age 19, 1 in 6 Oklahoma children experience at least four “adverse childhood experiences” such as witnessing domestic violence, substance abuse or mental illness in the household; loss of a family member due to incarceration, separation or divorce; or being a victim of abuse and neglect.

Child maltreatment has risen by almost 30 percent since 1990 in Oklahoma, coinciding with a 131 percent increase in juvenile violent crime arrests in that same period. Of children in the juvenile justice system, 70 percent have mental illness.

“This dual burden on Tulsa’s children and youth and on people living with mental illness and addiction largely explains why mental health and well-being are so low in Tulsa,” the study states. “Schools and other child- and youth-serving programs are not adequately supported to deliver prevention and early intervention services.

“The mental health system is not delivering the right care at the right time to the right people.”

Original Tulsa World Article can be found by clicking here.