Both mental illness and addiction are real medical conditions, just like diabetes, cardiovascular disease and heart disease. In terms of addiction,

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1 The State of Behavioral Health The State of Behavioral Health in Oklahoma

2 Mental Illness and Addiction: Diseases of the Brain Both mental illness and addiction are real medical conditions, just like diabetes, cardiovascular disease and heart disease. In terms of addiction, although h initial iti substance use might be voluntary, drugs of abuse have been shown to alter gene expression and brain circuitry, which in turn affect human behavior. Once addiction develops, these brain changes interfere with an individual s ability to make voluntary decisions, leading to compulsive substance abuse, seeking and use. 2

3 The Science of Mental Illness The brain scan on the left reflects normal activity; the scan on the right shows a person affected with schizophrenia. Source: PBS.org 3

4 The Science of Mental Illness The brain on the right shows normal activity; the left is affected by clinical depression. 4

5 The Science of Addiction The Science of Addiction 5

6 Oklahoma: An Overview In Oklahoma, mental disorders are the third leading cause of chronic disease behind only pulmonary conditions and hypertension and more prevalent than heart disease, diabetes, cancer and stroke. Oklahoma ranks second in the nation for the number of adults who reported experiencing i serious psychological ldistress over the past year. This represents more than 380,000 Oklahomans over 14% of the adult population. More than 245,000 Oklahomans above the age of 12 abuse or are dependent on alcohol or illicit drugs; and underage buyers still account for just over 20% of all alcohol sold in Oklahoma. The most recent National Survey on Drug Use and Health (NSDUH) ranks Oklahoma #1 nationally for the nonmedical use of pain relievers in the past year for all age categories. Deaths due to suicide are increasing, jumping from 567 in 2009 to 618 in Oklahoma ranks 13 th nationally in terms of suicide rate. 6

7 Oklahomans With Mental Illness or Addiction Issues Die Too Soon As most people know, mental and addictive disorders can be deadly, but the average lifespan of Oklahomans with these diseases is far shorter than the average Oklahoman. 90 Mortality Average Age at Death by Cohort at Death Age Mental Health Substance Abuse MH & SA General Population 7

8 Treatment Options Are Excellent, If Accessible Mental illness and addiction can be diagnosed and effectively treated. In some instances they are preventable. Compare these treatment success rates: Success rates for heart disease treatments range from 41 52%. The treatment success rate for schizophrenia is 60%. More than 80% of people with depression can be treated successfully with medications, psychotherapy or both. Substance abuse treatment has similar positive outcomes if people can access appropriate treatment and follow up care. 8

9 Treatment: The Past Until the mid 1960s, the primary means to treat mental illness was institutionalization in large state institutionalization in large state hospitals. On an average day in 1960, nearly 6,400 Oklahomans were in the state's mental hospitals. p In the mid 1970s, the concept of "deinstitutionalization" prompted states to c ease e o ts to ut e outpat e t to increase efforts to utilize outpatient services through Community Mental Health Centers. This approach has proven to be an effective means of recovery and a less costly method to provide services as compared to long term inpatient care in a hospital setting. 9

10 Treatment Today In fiscal year 2011, ODMHSAS provided services to more than 70,000 Oklahomans. Approximately 54,000 received mental health servicesand 19,000 received substance abusetreatment services, with some overlap. Fewer than 3% of individuals receiving ODMHSAS services each year require hospital care. The vast majority take part in mental health and substance abuse outpatient programs, prevention and educational initiatives, and targeted community based services including telehealth. Newer medications and treatment modalities have significantly increased recovery success rates for Oklahomans with mental or addictive disorders, allowing them to stay in their communities, where they can continue to hold down jobs, maintain relationships, and fulfill their day to day obligations. 10

11 Stretching Services and Dollars Through TeleHealth Oklahoma is considered a national leader in telepsychiatry. Through the Oklahoma Telehealth Network, Oklahomans who were once unable to receive services due to geographical, economic or workforce barriers are now able to receive the care they desire. This network has also facilitated new partnerships, strengthened existing ones and contributed to the goal of merging physical and mental healthcare by providing a mechanism for physicians and behavioral health professionals to consult with each other in a more rapid fashion. As a result of this network, the landscape of the service delivery system in Oklahoma has been forever changed. Telepsychiatry: Moving Mental Health Care Closer to Rural Patients 11

12 TeleHealth Statistics ODMHSAS has been recognized by the American Telemedicine Association as having the largest telemedicine network in the nation that specializes in behavioral health. In FY12, 78,300 services were delivered via telepsychiatry nearly 20,000 more than in FY11. 21,800 Oklahomans were served through this technology 5,400 more than in FY11. $2.4 million was saved by delivering services via telemedicine up from $1.8 million in FY11. More than 13.5 million kgs of CO2 were prevented from being emitted into our atmosphere by conducting services and business processes via telemedicine more than 11x that of FY11. ODMHSAS now oversees 140 distinct telemedicine sites in Oklahoma. More than 500 instances of video conferencing in use to improve business processes. Oklahoma served as a model for 21 states that are developing telemedicine networks for behavioral health services. 12

13 ODMHSAS T l H lth Sites Sit TeleHealth 140 Distinct Locations Spanning the State 140 Distinct Locations Spanning the State Google Maps,

14 Behavioral Health Care: The Future With health care issues changing seemingly every day, it is difficult to know, for sure, what the future of behavioral health care will look like, but we can be certain of a few things: Behavioral health will become more integrated into primaryhealthsettings; newer andmoreeffective effective medications will continue to be developed; and there will never be a lack of need for services, although there may be a lack of services. Telemedicine is helping to fill some of those service gaps. It s reaching many rural Oklahomans, for whom receiving mentalhealthoraddiction related addiction related services hasoften meant taking time off work, finding child care, spending hours in travel, and other considerations. 14