Terri White’s wish list for her agency is contained in an ambitious 10-point budget request that would cost the state an additional $144 million if everything were to be filled.

The director of the Oklahoma Department of Mental Health and Substance Abuse Services rattles off the state’s dire statistics and national standings in addiction, health and treatment.

That includes being No. 1 in illegal use of prescription painkillers, No. 21 in methamphetamine addiction, and in the top tier regionally in people who need substance abuse treatment and don’t get it.

White speaks like a physician when explaining how body chemistry varies in reaction to drugs and alcohol and how mental health and addiction are no different from heart disease or diabetes.

She ties it all to broader community issues such as child neglect, workforce readiness and education performance.

“We have to invest in prevention and education,” White said. “We underfund the system for treatment and prevention. We know the younger someone uses, the longer they are going to be dependent. There is brain science behind this.”

The agency’s budget of $289.8 million includes state, federal and all other grants to the department, and the total is down 11 percent since 2009.

The state’s portion of the budget has also decreased by 11 percent since 2009, from about $209.5 million to $187.2 million. Funding for substance abuse programs, both state and federal, has fallen by 21 percent.

The budget request holds nothing back, asking for money to expand on current programs and implement others that are needed to fill service gaps.

Just to maintain services will require an additional $16.8 million in the next fiscal year.

The rise in health insurance costs, the loss of federal stimulus money and changes in federal match formulas have led to the need for more money from elsewhere to keep the status quo.

The requests are listed in the order of priority for the agency, White said.

But she quickly adds that all are linked and that no one item will solve the problem.

“We need all of these,” she said.

The largest item is the Smart on Crime initiative, which is a comprehensive approach to lessen the prison population by offering more mental health and substance abuse treatment opportunities.

Elements are in place around the state, where outcomes have been evaluated.

Some aspects, such as drug courts, are more common, and others, such as mental health and substance abuse screenings during jail bookings, are less known.

To expand all the programs statewide would cost about $105.1 million.

Prevention includes educating youths about the dangers of using drugs and alcohol, including that one in 10 people have a trigger that leads to substance abuse, White said.

The budget request includes $500,000 to work with law enforcement on preventing alcohol sales to minors.

Agency officials say underage customers consumed 20 percent of all alcohol in the state in 2009, totaling $250 million in sales.

“We are finding the average age an addict tries alcohol for the first time is at 12 years old – 11 for boys and 13 for girls,” White said. “One in 10 will be set on a path of addiction, and we don’t know which of our children will have that reaction. How many of us are held responsible as adults for choices we made at that age?”

“At 12 years old, if I’m one of the kids with the brain reaction and the chemical cravings start, imagine what those cravings will be like at 25, 35 or 45. Drinking as a rite of passage is not OK.”

For youth who do become addicted to substances, the state has few resources.

For several years, support for a partnership to address children’s behavioral health has been in place among key agencies, but a lack of funding has prevented starting any specific programs.

The budget request includes $8.9 million to implement treatment programs for children and teenagers through a coordinated effort with the state Health Department, the Oklahoma Health Care Authority, the Department of Human Services and the Office of Juvenile Affairs.

The children’s coordinated budget includes prevention and education programs targeting suicide and underage drinking, residential treatment, expansions of local systems of care and workforce development.

Sprinkled throughout White’s discussion of budgets, science and public policy, she stresses the need for more community understanding.

“There is still a stigma of mental illness and addiction, and that is a concern to the state,” she said. “It has led people to believe it’s their fault or morally wrong and it’s a choice.

“Until we break that stigma, we are not going to make the impact we need.”

Budget Request Items

Maintenance of existing programs: $16.8 million

Smart on Crime initiative: $105.1 million

Children’s coordinated budget request: $8.9 million

Veterans treatment programs: $1 million

Screening, brief intervention and referral to treatment: $4 million

Additional residential beds for substance abuse treatment (95 beds): $4.48 million

Recovery and peer support specialists: $1.2 million

Wellness initiatives: $1 million

Law enforcement partnership to reduce illegal alcohol sales to minors: $500,000

Anti-stigma and service outreach for mental health, substance abuse and gambling addiction: $1.5 million

Source: Oklahoma Department of Mental Health and Substance Abuse Services.

The Oklahoma Legislature has boosted funding for continuing programs of the Department of Mental Health and Substance Abuse Services for two years in a row, but not enough to make up for the cuts of the three previous years. Although the fiscal year 2013 appropriation is 3% higher than the previous year’s, it remains 8% below the 2009 peak.

SOURCE: Oklahoma State Budget *The Legislature approved a total 2013 appropriation of $311.4 million. The figure includes a $118.5 million transfer to take over functions previously assigned to another state agency.

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