The voices of Urban Institute's researchers and staff
May 30, 2018

How Tulsa, Oklahoma, is making mental health a priority

May 30, 2018

Before Mental Health Awareness Month (May) ends, let’s pause to remember that mental health problems and illnesses are as real as any physical ailments, and, if addressed early and effectively, mental health can be improved for everyone. And for many, mental illness can be prevented from progressing or from occurring in the first place.

To these ends, an influential and dedicated group of concerned citizens and stakeholders from across health care, government, the nonprofit and philanthropy sectors, education, and the courts and criminal justice system in Oklahoma’s “Beta City” recently partnered with the Urban Institute to produce the new report Prevention, Treatment, and Recovery: Toward a 10-Year Plan for Improving Mental Health and Wellness in Tulsa, which was funded by the Tulsa-based Zarrow Foundation.

Already, Tulsa opinionmakers, like the editorial board of Tulsa World, are rallying around the report’s findings and five action areas because Tulsa is dealing with a challenging state of mental health. Tulsa’s suicide rate ranks 15th in the nation, and people living with mental illness die 27 years earlier than all Oklahomans.

Of the 30,000 people treated at the David L. Moss Criminal Justice Center in 2016, more than a third received treatment for mental illness. This was a waste of public resources, considering the $23,000-per-year cost of incarcerating a person with mental illness versus $2,000 per year for community-based treatment. Says Gerard Clancy, University of Tulsa president and chair of the planning group that has championed the plan, “I cannot think of a worse place to treat mental illness than the corrections system.”

To change this picture, Tulsans will pursue four goals, as recommended in the report:

  1. Close the gap in life expectancy between Tulsans living with mental illness and all Oklahomans.
  2. Lower the rates of suicide attempts and overdoses, and deaths from both causes.
  3. Lower the share of Tulsans who experience poor mental health.
  4. Reduce criminal justice system, first responder, and hospital emergency room costs caused by untreated or poorly treated mental illness.

Prioritize children and youth

The report underscores how children and youth must be a priority if long-term and sustainable gains in the Tulsa community’s mental health are to be achieved. According to the American Psychiatric Association, half of cases of mental illness begin by age 14, and three-quarters begin by age 24. In Tulsa, 7.7 percent of children and youth, or 19,000, have a serious emotional disturbance.

Addressing this need as early as possible promotes lifelong mental health and lowers the chances of entering an emergency room or a prison cell because of a mental illness.

Tulsa has notable strengths to draw on as well as daunting challenges to surmount. The city boasts an innovative early childhood education sector that is positioned to show how to address the region’s challenges with mental health early on, but Tulsa-area schools are not adequately funded or staffed to address students’ mental health needs.

Uniting around evidence

Damaging stigma and misinformation can shape perceptions about people with mental illnesses and their treatment. Clancy laments in his preface, “A false belief…persists in 2018 that these individuals are personally at fault for their conditions.” And stigma is not limited to the public—it persists among doctors, teachers, and law enforcement.

Perhaps the most critical characteristic of Tulsa’s planning process, and the most valuable lesson for other localities to apply, is its reliance on research supported by abundant data. This research can counteract stigma while revealing the most effective approach for addressing mental health challenges in different areas.

Tulsa’s commitment to evidence is encouraging. The data that Oklahoma mental health department officials and other Tulsa stakeholders provided for our report were impressively detailed, so much so that benchmarking it against similar data from other areas made for a unique, but welcome, challenge.

With these data, concerned Tulsans can demonstrate the region’s need for a comprehensive mental health plan that addressed every area affected by mental illness: the juvenile justice system, hospitals, prisons, law enforcement, schools, philanthropy, and more. Representatives from all these fields were present at the public release of our report last month.

Now, the real work begins for Tulsa as leaders begin crafting and implementing the final 10-year plan. They are off to a good start by demonstrating how everyone can agree that addressing mental illness is vital to the health of their entire community and that the way forward will involve everyone.

Downtown Tulsa. Photo by Barry Lenard via Flickr.

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As an organization, the Urban Institute does not take positions on issues. Experts are independent and empowered to share their evidence-based views and recommendations shaped by research.