McAlester News-Capital, McAlester, OK

December 9, 2010

More suicide prevention funding requested

Mental health commissioner: State in 'crisis' level for suicides

By Trevor Brown
CNHI

OKLAHOMA CITY — Mental-health officials report 776 more people called the state's suicide hotline in the first three months of the year compared with the same period of 2009.

Experts say the 65 percent increase in calls is proof that more Oklahomans are at risk of taking their own lives largely due to the poor economy and state budget cuts to health services.

Oklahoma Department of Mental Health and Substance Abuse Services Commissioner Terri White said the state's suicide situation is at a crisis level. She said more money is needed to prevent more deaths.

“We know that the demand is growing,” White said. “We warned folks when they cut our mental health budget (last year) that it was at a time when demand is increasing and there are significant risks of an increase in the suicide rate. Unfortunately we are seeing that come to fruition.”

The 593 suicides reported in 2008's Oklahoma Medical Examiner report represented an increase from the average of 519 suicides per year for the preceding decade. Official suicide statistics typically lag by three years. But White and other experts anticipate the upward trend in Oklahoma to continue in 2009 and 2010.

White said the combination of troubles people experience during economic downturns paired with deep cuts to the mental health agency is causing the state to lose ground on its suicide-prevention efforts.

Phil Lowe, who chairs the legislature-created Oklahoma Youth Suicide Prevention Council, agreed the state is struggling to do more with less.

“People are losing their jobs and losing their health care,” he said. “So if you have someone being treated for depression and then they lose their insurance, have mental stress and possibly lose their homes, there are a lot of things that can happen.”

One mother's pain

Heather Coffey took her own life on Feb. 4, 2009. The Oklahoma City resident was 38 years old and battling alcoholism and mental health problems.

Helen Coffey, Heather's mother, said her daughter visited an emergency room 48 hours before she killed herself. Coffey said she wishes the state would provide more training and resources for professionals and others to identify and treat signs of suicidal behavior.

“I just really feel strongly it is an area, medically, that is neglected,” she said.

Coffey, who recently moved to Portland, Ore., helped start a suicide survivors' support group in Oklahoma City and worked as a suicide-prevention advocate after her daughter's death. She said better funding for mental health issues could help reduce the stigma surrounding depression and help people get help before it is too late.

“The stats say 90 percent of all (people who commit suicide) are people who have diagnosable and treatable mental illnesses,” she said. “Unfortunately these mental illnesses are not being diagnosed and not being treated for people like my daughter.”

Budget requests

Lawmakers slashed $25 million from the Department of Mental Health and Substance Abuse Services budget in the last 18 months. White said the department has been forced to close psychiatric and substance-abuse treatment beds, cut staff and eliminate programs across the board.

The cuts were not directly related to the state's suicide prevention programs. But White said its ability to reduce suicides is strongly related to services that were diminished as a result of the cuts, such as treatment for alcohol and drug abusers.

The state mental health office, which has a $183 million budget for the current year, is requesting a $130 million funding increase for fiscal year 2012. The proposal includes $15 million to maintain existing programs, $1 million to launch an anti-stigma campaign and nearly $1.2 million for recovery and peer support specialists.

The largest share of the request – $90 million to boost its Smart on Crime program – would focus on creating prevention and pre-booking programs for nonviolent drug offenders, expanding mental health courts and ensuring inmate reintegration services.

“I am hopeful (legislators) understand this is desperately needed,” White said. “Oklahoma needs to look at how we provide for mental illnesses or be ready for the consequences.”

Rep. George Faught, R-Muskogee, said ideally he would like to grant the agency its budget requests. However, he said the legislature is going to need to close a budget gap of about $600 million next session, and many funding increases are unlikely.

“I know those services reap great benefits, and we will try to minimize the losses,” he said. “But unless there is a significant increase in revenues, there will be a lot of long faces at the Capitol.”

Federal grant at risk

Oklahoma is also in danger of losing an annual $400,000 federal grant that supports programs directly targeted at preventing suicides.

The Garrett Lee Smith Memorial Act expires in late 2011, and Oklahoma would need to look elsewhere for the money if it is not renewed by federal lawmakers. Jessica Hawkins, director of prevention services for the state's mental health agency, said the money mainly provides screening and training programs throughout the state.

Hawkins said one of the programs, which works similar to a CPR training class, teaches basic suicide-prevention tips to anyone from medical professionals to community members. The more expensive and intensive program – called Applied Suicide Intervention Skill Training – is a two-day program that is targeted for caregivers, law enforcement officials and others in the medical field.

If Congress does not renew the funds for the act or if Oklahoma is not awarded a grant through the program, Hawkins said the state will have several options: It can ask lawmakers to fund the programs through state money, it can seek additional grant opportunities or it can abandon the more costly services, such as the Applied Suicide Intervention Skill Training program.

“The loss of the prevention money would be devastating, because we know that suicide is among the most preventable types of death,” Hawkins said. “These services are invaluable to the state, and the potential loss would only compound the problems we already have.”

Looking to the private sector

Oklahoma uses federal money to administer calls through the National Suicide Prevention Lifeline, which is contracted to HeartLine's 24/7 call center. HeartLine – a nonprofit suicide-prevention organization that serves the state – also staffs an additional suicide hotline and provides other outreach efforts.

Lowe, with the Oklahoma Youth Suicide Prevention Council, said assistance from the state's philanthropic community is a crucial piece to improving suicide-prevention care. With the state's own budget challenges, he said, advocates need all the help they can get.

But HeartLine Executive Director Tom Taylor said his organization is tasked to meet a higher need with less money. The organization has an operating budget of about $1 million that is funded through a combination of donations and money from the state, federal government and its United Way partnership.

“We'd be ecstatic,” to maintain the current budget, Taylor said. “But that is not what we are hearing.”



Trevor Brown covers the Oklahoma statehouse for CNHI. He can be reached at tbrown@cnhi.com.



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Need help?

The National Suicide Prevention Lifeline: 1-800-273-TALK

HeartLine's CareLine: 405-848-2273



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A state in crisis

Suicide is the 10th-leading cause of death for all Oklahomans and third-leading cause of death for youths.

More than 500 Oklahomans kill themselves each year at a rate of 1.3 per day.

Suicides in Oklahoma are rising at a rate 38 percent above the national average.

From January through March, the National Suicide Prevention Lifeline received 1,959 calls from Oklahomans. For the same period last year, that number was 1,183.

A total of 286 Oklahoma youths committed suicide during 2004-2007. Oklahoma’s youth suicide rate was 31 percent higher than the national rate.

Source: DMHSAS



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Oklahoma suicides by year:

1994: 472

1995: 512

1996: 480

1997: 505

1998: 492

1999: 529

2000: 530

2001: 523

2002: 528

2003: 480

2004: 516

2005: 534

2006: 544

2007: 539

2008: 593

Source: 2008 Oklahoma Chief of the Medical Examiner Annual Report



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Department of Mental Health and Substance Abuse Services budget request for new money

Maintain existing programs - $15. 3 million

Smart on Crime Initiative - $90 million

Children's Coordinated Budget Request - $8.9 million

95 Additional beds for Residential Sub. Abuse Tx - $4.5 million

Increase and Maintain ODMHSAS Rates at Medicaid Rates - $7.8 million

Recovery and peer support specialists - $1.2 million

Wellness Initiatives - $1million

Telemedicine system implementation - $750,000

Gambling Outreach - $250,00

Anti-stigma campaign - $1 million

Total new requests: $130.8 million

FY 2011 budget: $183.6 million

Proposed FY 2012 budget: $314.4 million

Source: DMHSAS