Rising medication, food and fuel costs are placing new financial pressure on state mental health providers.
With a last-minute $2 million infusion, the budget for the Oklahoma Department of Mental Health and Substance Abuse Services for the coming year is the same as last year's — roughly $209 million in state-appropriated dollars. Almost 96 percent goes directly to services.
"They have just over the years been stripped down to absolute bare bones," state Rep. Wallace Collins, D-Norman, said of the state-run Griffin Memorial Hospital in Norman and other mental health providers.
"It's not that they were fat or inefficient before. They literally kind of live hand to mouth," Collins said.
"A standstill budget, in many ways, means a step back in providing services in the face of increasing demands for these services, as well as inflationary pressures such as those experienced in the areas of transportation and energy costs," agency spokesman Jeff Dismukes said.
Costs for Integris Mental Health's 102-bed psychiatric hospital continue to increase. And when state funding isn't increased, it has a "tremendous impact," said Jim Igo, vice president of Integris Mental Health.
"The profit margin for mental health services is already very small, and a standstill budget means having to do the same service with a standstill rate but having to pay for the increased operating costs," he said. "Standstill budget, in reality, is a misnomer because the additional costs are passed on to the provider."
Karina Forrest, executive director of the state chapter of the National Alliance on Mental Illness, noted almost two-thirds of those who need mental health treatment don't receive it.
Legislators, she said, don't recognize that the state will pay for services one way or another.
"They will end up in the emergency room. They will end up in prison. They will end up homeless on the street," she said. "If we just put money on the other side of the fence, we might just see that the state doesn't have to be (ranked) 50 in everything."
The Oklahoma Department of Mental Health and Substance Abuse Services is "woefully underfunded" compared to others nationwide, she said.
Nationally, state mental health agencies' per-capita spending in 2004 averaged $93.04, according to the nonprofit Kaiser Family Foundation of Menlo Park, Calif. Oklahoma's spending was $39.79.
Also, according to the Agency for Healthcare Research and Quality, about one-fourth of community hospital stays among adults in 2004 involved mental health or substance abuse.
"There is an across-the-lifespan need, and we're not addressing it," Forrest said, citing medical and lost-work costs from those who aren't chronically mentally ill.
With many mental health providers in the state operating at a deficit, "to continue to operate, what ultimately happens is the care is cut back," she said.
Al Friedman, chief executive of Red Rock Behavioral Health Services, said the percentage of money in the state budget going to mental health from 1990 to 2000 dropped every year even as agencies such as the Department of Corrections grew.
"So you can see that we got very, very far behind," he said.
Copyright 2008 The Associated Press.
