Oklahoma Joins List of “Distressed” Mental Health States

Approximately 3 weeks ago I read one of the most distressing that most informative articles I have seen in over 20 years. It was published in the Oklahoma City newspaper on January 2, 2015 and written by Jaclyn Cosgrove. It was entitled “‘Epidemic ignored’: Oklahoma treats its mental health system without care.” It was described as: “a yearlong investigation into Oklahoma’s mental health system.’

It had the usual now almost obligatory saddened startling photographs of dilapidated antiquated hospital facilities with patients in threadbare clothing without shoes crowded into dining halls or sitting hopelessly in empty hallways.

Much more startling to me the reader of such articles now spanning nearly 30 years since I have made it special interest of mine, were reading quotes from legislators, treatment advocates, and mental health professionals from time periods ranging from 40 to 100 years ago. The statements that were discovered and published in this article were quite riveting and unsettling because they could have been uttered in the last few years and without there being identified in the context of the years long past when they were first uttered, I would’ve had no idea if these were statements made by people long deceased. It was like reading the history of our present dilemma in mental health care system delivery and its failures nationwide, that existed in a parallel almost identical universe of similar mistakes, failures to adequately fund mental health programs, many of whom had forms and objectives and methods similar to the “new” massive programmatic renovations proposed in almost all states in this country today

For instance in 1895 the governor at that time of Oklahoma William C Renfro began proposing a novel idea that residents should be treated for their mental illness closer to their homes. This arose out of the unbelievable practice in that time in Oklahoma when the territory was sending mentally ill residents away by train to the state of Illinois. A second example is the fact that this newspaper article reported, “almost 80 years ago, the national mental hospital survey committee published a report that noted that air Oklahoma would save money if it invested in its mental health system.’ Whatever the future may bring,’ the report concluded,’ Oklahoma cannot look on itself with pride until provision is made for adequate care of its mentally helpless citizens. The year of that statement was 1937. It was recognized even then that the few state-funded inpatient hospitals then supported by the state of Oklahoma were only the first part of the treatment continuum that had to include community placement for the chronically mentally ill
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One of the fundamental hypotheses of this newspaper article was that Oklahoma has been far behind in most other states in this country in providing mental health services. For instance the news purple article noted that in the year is surrounding World War II, Oklahoma had one of the worst doctor to patient ratios ranking it number 43 in the United States for care of the mentally ill. One other telling statistic was cited that each of the doctors at Central State Hospital in approximately 1947 had a caseload of 700 people, one of the highest psychiatric physician caseloads in the United States. It also had one nurse for every 45 patients in the hospital. The problems with safety of the psychiatric hospitals and facilities began very early in the history of treatment of the mentally ill in Oklahoma. For instance Western State Hospital at Fort Supply was overcrowded by nearly 500 patients and had building buildings which had already by the 1880s been repeatedly condemned by fire marshals as fire hazards and there were only four doctors to treat 1603 patients and no nurses or social worker

This is the historical backdrop to the looming mental health serivce crisis in Oklahoma today. This beginning examination of the mental health crisis in Oklahoma will be examined further in the coming weeks in a series of posts that will sketch the usual elements that have already beeen seen to operate in so many other states the last 20 years. These all too well known factors include: economic shortfalls in the state’s budget that suddenly jeopardize everything except football program at the state universities, poor foresight and plannnining, shortage of mental health professionals and delaying for still years the easy to have been seen to explore still further the outpatient agenices, facilities, physicial plants and staff cohorts of the world of public outpatient mental health services.

Further I will go on to document in following posts the same kind of story in another state with very unique twists and hardships of its own in meeting lesser mental health care needs in that state, Alaska which is slowly grinding toward a large crisis of its own.

 

 

 

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Author: Frank

I am a older child, adult, geriatric teaching psychiatrist with over 30 years' practice experience in North Carolina, first at Duke as clnical teaching faculty, then in Western NC as a primary child psychiatry specialist. I have taught and supervised child psychiatrists and psychiatrists in training and many other mental health professionals and taught at two medical schools. I have served in many public and private practice settings. My primary interest is in observing and documenting the ongoing mental health reform efforts in the State of North Carolina and documenting its sucessess and failures at all levels. My favorite pastime among many others is spoofing my friends and kids with my deadpan sense of humor.

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