Growing up in Kansas near the Oklahoma Panhandle, Michael Brose saw firsthand the struggles of rural residents to find quality health care.
Later, in two decades as executive director of the Mental Health Association in Tulsa, Brose observed similar problems with urban residents’ access to affordable care for mental illness and substance abuse.
Today, Brose is using his experience in those two settings to carry out a new, broader mission for his advocacy organization. In April, the Mental Health Association in Tulsa renamed itself the Mental Health Association Oklahoma. That change occurred after the Mental Health Association of Central Oklahoma in Oklahoma City closed its doors.
MHA Oklahoma, based in Tulsa, is now the state’s most prominent nonprofit to focus on mental health services beyond the local level. The need is great: Oklahoma’s rate of mental illness ranks among the highest in the nation, and funding for health services is limited.
In an interview with Oklahoma Watch, Brose discussed the association’s plans for expansion; efforts to help the homeless, teens and veterans, and how to prevent suicide. The interview has been edited and condensed.
You now lead an organization for the entire state. Does that mean you will be offering your services for the mentally ill in every part of Oklahoma?
It’s a step-by-step approach. We’ve always served the Tulsa metro area. The next step is to develop systems that will primarily be targeting Oklahoma City and central Oklahoma areas that will include Norman. I spoke and met with people in Stillwater not too long ago. Ultimately, we want to serve the whole state. Before the expansion, we consulted and worked with contacts in central Oklahoma and around the state in rural areas. We’ve become a member of the United Way of Central Oklahoma, so we’re members of both United Ways (Tulsa and Central Oklahoma).
One of the most exciting things about expanding in other parts of the state is meeting people. We’re all Oklahomans and have similar needs. We’ve had this long history of this dichotomy between Oklahoma City and Tulsa, and we’re really about doing our part to break down those barriers.
What programs developed in Tulsa are you implementing elsewhere?
We opened up a drop-in center in Tulsa, called Denver House, which is operated by people who live in recovery from mental illness. It was funded by the Oklahoma Department of Mental Health and Substance Abuse Services. It’s been so successful that the department wanted one in central Oklahoma. We decided to do that, which was a big step for us. We opened Lottie House in Oklahoma City on October 1.
Another program in both cities is SunBridge, which had a long legacy in central Oklahoma. We operated it as BrightSky in Tulsa, but now it’s SunBridge in both cities. SunBridge partners with mental health professionals who can provide pro bono clinical services.
Another program in both cities is TeenScreen, where we go into the schools and provide mental-health screening services for children, with parental permission.
The association in Tulsa has been a leader in using the “housing first” model for the homeless and mentally ill. You place them in a home and arrange for services to be offered. Will you be doing this to the same extent in Oklahoma City?
There are good housing providers in central Oklahoma, just like in Tulsa. But there are not enough. We’re talking with leaders, foundations and social-service providers about the possibility of helping them own and operate housing there like we have in Tulsa. We own and operate 850 units and 20 apartment buildings in 16 different Tulsa neighborhoods. We didn’t accomplish that overnight. It was one apartment complex at a time. We’re making footprints, building up credibility and working with these partners.
You mentioned the TeenScreen program. Oklahoma has high rates of youth and adult suicide. What are you doing to try to reduce the number of deaths?
The state department of mental health deserves a lot of credit. They have gotten very involved in suicide prevention on various levels. We’ve been about that business for a long time. The general public doesn’t seem to understand that we have twice as many suicides as we have homicides. People from every socioeconomic group, every walk of life, rural, urban – it doesn’t make any difference – they are killing themselves. They are primarily doing that because of some type of mental illness or substance abuse-related issue, and they aren’t getting the treatment they need. We know the rate of suicide among vets is extremely high, and the department of mental health is very involved with that. I have staff leaving next month for Bethesda, Maryland, to meet about suicide prevention for our vets.
The suicide of actor Robin Williams shocked people around the world. What can be done by individuals to prevent suicide?
We promote QPR, or Question Persuade Refer, a concept that is loosely based on CPR. The whole idea is that lay people can be trained to ask simple questions of someone, and if they answer affirmatively, that they’re thinking about hurting themselves, they will persuade them to get treatment and refer them to a professional.
What’s the difference between what your association does and what the state mental health department offers?
The department of mental health is the primary funder of community mental health centers. They are providers of mental health care. We’re not providers. We’re an advocacy agency. We do our housing programs. We work with them on suicide prevention for young people and all ages, including veterans.
We are all trying to address the same problems — housing needs, access to services, poverty, substance abuse, and we need to work together.
What services do you offer for veterans?
One of the big trends is that the number of vets who are homeless is declining. I don’t know about Oklahoma City, but in Tulsa we’ve got that down to under 20 homeless vets on the streets. We have two contracts with the VA. We provide housing to vets who are homeless and have mental illnesses. The number of mentally ill homeless vets is going down across the country. Funding for veterans seems like one of the few areas politicians at state and national levels are willing to support. But so far, our state lawmakers haven’t been willing to make that full investment and have even wanted to cut those programs.
What other actions do you think lawmakers should take?
They need to revisit Medicaid expansion. I think that’s a tragic mistake in Oklahoma, especially when I see uninsured rates going down in states that expanded the program, like Minnesota, where the uninsured level is down to 5 percent. The uninsured wait until they are very sick and go to the emergency room, the most inefficient way to get health care. States that expanded Medicaid are allowed to be more innovative in finding cost-efficient ways to provide care, health education and better access through health homes. We’re doing pockets of it, but we’re short on resources.
Are you doing anything for the many inmates in Oklahoma prisons who are mentally ill?
We want them to have access to care. If they are arrested, let’s divert them out of incarceration, get them back in the community and link them with services. We’ve started working with the Tulsa Municipal Court. When individuals are arrested for petty crimes like public intoxication and vagrancy, and they have substance abuse or untreated mental illnesses, we help connect them with services. If they seek treatment and do what they’re supposed to do, they can have the court costs and charges dropped.
We’re willing to house people who have been incarcerated. Many private landlords in this state will not rent to people who have felony convictions and incarceration, so where do they turn? They often are homeless.
What do you think is the primary factor contributing to Oklahoma’s high rate of mental illness?
I just hate it, but it’s lack of money — that’s really what it comes down to. The association is interested in the economic wellbeing of people in our state. If they’re economically stable, it’s beneficial to everyone. They’ll have a chance to have job skills training, live in recovery and have access to appropriate mental health care.
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