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Professionals fear mental health services are at risk in budget talks

Norman Transcript - 2/13/2018

Feb. 13--NORMAN -- As lawmakers work on the state budget, lives and livelihoods hang in the balance.

Outpatient services cost less than keeping people in prison or other institutions, but outpatient services are often the first to go during budget cuts, mental health professionals said at a recent meeting of the Cleveland County Mental Health Task Force.

"We have seen that the system is fragile," said Transition House Executive Director Bonnie Peruttzi, task force chairperson. "Now we are seeing the crumbling of the system."

In Cleveland County, 13,475 people received mental health services funded by the Oklahoma Department of Mental Health and Substance Abuse Service in Fiscal Year 2017, down from 15,450 the previous fiscal year. With drops in funding, that number could decrease again.

Peruttzi said Transition House -- which provides a supervised, transitional living apartment program, counseling and outpatient services -- gets about 65 percent of its funding from ODMHSAS. The rest of the funding comes from private donations and United Way.

If funding is cut, Transition House could lose its transitional living program and would lose all outpatient services, she said.

At the Center for Children and Families Inc., CEO Brandon Brooks said mental health services are key for many of their clients.

"We provide counseling for children up to age 17," Brooks said. "We've had to make some significant cuts in some other areas. That has definitely created some financial strain. There is anxiety amongst our clients."

Statewide, 101,426 women and 95,843 men received ODMSAS funded services in FY 2017. Peruttzi fears cutting services to a segment of that population could have tragic results.

"People get blamed when things go bad," Peruttzi said. "A couple of weeks ago, we saw a prime example with people wanting to point fingers at the police and the hospital."

Peruttzi referred to the death of jail inmate Marconia Kessee, whose family said he had mental health issues and should have been taken to a mental health facility, not jail.

Peruttzi said the elimination of beds and staffing often results in people who need mental health treatment sitting in prison or released into the community, and the state's unstable funding stream makes it hard for agencies to recruit and retain quality staff.

When older children and teens don't get the help they need, they find alternative ways of managing those issues like acting out or substance abuse, Brooks said.

"Last fall, they were talking about all of the outpatient services, which is the first line," said Cathy Liedy of Red River Youth Academy. "Otherwise, people end up in the hospital or inpatient [mental health services] which is more expensive."

Red River took a cut in the reimbursement rate for Medicaid services, and she's keeping an eye on legislature.

"Our staff have shown a lot of anxiety that their jobs may not be there," she said.

Peruttzi said there is an economic bottom line that affects how the outside world sees Norman and the state.

"The face of Norman is impacted when there's a mental health crisis," she said. "We forget that we employ people. We shop in this town. We go to restaurants in this town. People are leaving the mental health sector."

Peruttzi said you know it's bad when people leave mental health jobs to go to work as educators in Oklahoma.

"Mental health makes less than many teachers with masters degrees," she said. "People in our profession do deserve compensation."

Johnny Johnson of the Oklahoma Health Care Authority said many counties throughout the state are short on nurses. The medical and mental health industry has growth potential and is important to the economy, he said.

"We pay a lot into the community, and it's my opinion that we have to communicate that health care in the state is a big business, and it does pay a lot in tax revenue," Johnson said.

Peruttzi said having people in the community who aren't stable is a safety issue, but without funding and without the ability to pay trained professionals, the problem will likely get worse before it gets better.

"What engineer would work for substandard pay? What surgeon would work for less than $30,000 a year?" Peruttzi said. "This is where our voice really has to be raised. We want to be adequately compensated."

Without funding, often the choice is sacrificing lives, especially if people who need long term treatment and have co-occurring disorders don't get the help they need, she said. In many cases, people who need mental health services end up in jail or prison where the services they need are underfunded or nonexistent.

While the Cleveland County jail has recently expanded the mental health services offered through its medical provider Turnkey Health, more is needed.

"I wish we had an unlimited budget and could have someone here all the time," Chief Deputy Jacob Wheeler said.

A psychiatric provider comes by the jail regularly and meets with inmates, putting a high priority on people who are suicidal or who have ongoing mental health needs.

"When Sheriff Gibson took over, he made it a big emphasis on mental health, and we were happy to see that," said Trent Smith of Turnkey. "We increased our hours without increasing any cost on the contract."

Previously, Turnkey had provided 8 to 10 mental health hours a week with counselors and that was increased to 14 to 16 hours. Turnkey also added two to three hours a week with a mental health clinical provider who works on medication management and deals with more acute cases.

"Anything we can, we refer out to community programs," Smith said. Because turnover is quick in county jails, those referrals give people help when they leave jail.

Peruttzi said a cure for what ails patients may not be possible, but they can improve the likelihood of survival.

"They need wrap around support," Peruttzi said. "The majority of the people that we serve have substantive childhood trauma."

Brooks said CCFI is bringing some complex trauma training to Norman in March. Traumatic experiences in childhood affect neurobiology, social, emotional and brain development, learning and relationships across a person's lifespan, he said.

"We have to continue to be in the public's face and humanize the issue," Brooks said. "This is not about numbers, this is about human faces. Mental illness, emotional illness and substance abuse are issues that can affect all of us."


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