New report identifies Oklahoma City’s most urgent mental health challenges

An in-depth assessment of Oklahoma City’s needs around mental health and substance use found serious challenges in the community’s behavioral health system, including a lack of intensive services for people with serious mental illness, inadequate supports for children and youth, and an overreliance on inappropriate settings of care like emergency rooms for mental health crises.

Now, Oklahoma City’s mental health leadership team will use these findings as a guide to select and implement the evidence-based interventions Oklahoma City needs to add to its array of mental health and substance use services to better meet residents’ needs across the lifespan.

Download the full assessment (6.6 MB PDF)

Download a one-page overview (1.4 MB PDF)

The assessment, conducted by Healthy Minds Policy Initiative and funded by Inasmuch Foundation and the City of Oklahoma City, calls for strategic investments and planning in five core areas:

Removing structural and systemic barriers to care

• In parts of Oklahoma City where risk for mental health problems is highest, we see some of the worst access to safety-net mental health providers.

• The city isn’t designed around equitable access to safe, communal spaces: 38% of schools are located within two-thirds of a mile from places that sell alcohol, but about a third are more than two miles from the nearest public park.

Diverting residents to appropriate settings of care

• More people go to the ER for mental health crises than to urgent recovery or crisis centers, despite promising new resources for a community-based crisis response.

• Behavioral health-related ER visits among people in the safety-net mental health system rose by about 56%, while visits to urgent recovery or crisis centers remained steady.

Addressing missing community-based intensive services

• Without access to community-based care, people with complex behavioral health needs often cycle between homelessness, emergency rooms, and the criminal legal system.

• Only about 31% of Oklahoma City residents estimated to have serious mental illness were served in the state-funded behavioral health system in 2024.  

• Only about 4% of the estimated 15,000 Oklahoma City residents with opioid use disorder received medications for opioid use disorder, the evidence-based standard of care, through OKC’s core providers.

Investing in children and youth to strengthen community wellbeing

• Oklahoma City needs to shift to proactive, upstream mental health care for its youngest residents. But the number of children in the state-funded system who received outpatient care — where most care should be delivered in a functioning system — dropped by about 25% from 2019 to 2024. Youth ER visits climbed by about 19% during the same time.

• Only two of Oklahoma City’s five school districts receive state funding for programs designed to prevent young people from developing mental health and substance use challenges later in life.

Meeting residents’ basic needs

• Underpinning all of Oklahoma City’s challenges is that too many residents struggle to meet basic needs, like making a living wage, getting enough to eat, and having a safe place to live.

• Nearly half of renters spend over 30% of their income on rent, and about 18% of the city’s population lives in areas with inadequate food access.

“Oklahoma City is doing something remarkable here,” said Jessica Hawkins, Healthy Minds Policy Initiative’s director of community initiatives and facilitator of the OKC mental health leadership team. “It’s impressive and rare to see a city take ownership of the issues of mental health and substance use in the way Oklahoma City is. This is a long-term investment in the people of Oklahoma City, and I’m optimistic about how this work is going to pay off in the years ahead.”

In addition to the leadership team, which serves as a steering committee for the Oklahoma City mental health initiative, Healthy Minds has convened several smaller work groups to craft goals around several areas identified in the assessment. Those include: neighborhood-level mental health needs, the mental health of young residents, and access to intensive community-based care.

“Just as important as understanding Oklahoma City’s mental health and substance use needs is developing a thoughtful plan to make strategic improvements where they are most needed,” said Sarah Roberts, vice president of programs at Inasmuch Foundation. "We are proud to be part of this collaborative with state and city leaders, nonprofit providers, and philanthropic organizations. Inasmuch Foundation is excited and ready to support the implementation phase to move Oklahoma City forward on behavioral health.”

About Oklahoma City’s mental health initiative

Healthy Minds was awarded a WayFinder Innovation Grant from the United Way of Central Oklahoma in 2023 to launch a multi-year, cross-sector change initiative around mental health in Oklahoma City. Throughout 2024 and 2025, Healthy Minds gathered leaders from across Oklahoma City — representing schools, public safety agencies, community behavioral health providers, and philanthropic organizations — to orient them to the city’s behavioral health strengths and challenges.

Meanwhile, Inasmuch Foundation and the City of Oklahoma City generously funded an in-depth assessment of Oklahoma City’s needs around mental health and substance use. Healthy Minds delivered the resulting report to the leadership team and participating stakeholders in August 2025. The Oklahoma City Community Foundation recently awarded a grant to support the next phase of the city's mental health initiative.

The leadership team is committed to including input from a diverse array of stakeholders throughout the initiative.

Additional quotes from the leadership team

Trisha Finnegan, president and CEO of the Oklahoma City Community Foundation

“So much is possible when communities work together to assess needs and align around a vision, which is why our participation in the OKC Mental Health Leadership team is important. Through data and partnership, we are forming a clear path for how we can all help meaningfully address these issues, strengthen resources, and provide lasting support for our neighbors moving forward.”

Verna Foust, CEO of Red Rock Behavioral Health  

“I am very proud to be a member of the Oklahoma City mental health leadership team. This team has collaborated in a way I have not seen in my 37 years of working in community mental health. We have a much better understanding of the system of care in Oklahoma City and have taken steps to improve the timeliness and quality of treatment while working to not duplicate services and fill gaps in services.

“Healthy Minds’ Oklahoma City community needs assessment provides a valuable roadmap for improved coordination among service providers and data to effectively target gaps in services and address needs that have been overlooked. It is alarming that this assessment showed that almost 80% of youth age 12-17 experience moderate to high depressive symptoms, and that despite improved access to medications for opioid use disorder (MOUD) services, only a fraction of those in Oklahoma City that need MOUD treatment are getting treatment. We must continue to advocate for funding needed to provide timely, cost-effective and evidence-based treatment for our fellow Oklahomans.”

Andrea Grayson, implementation program manager at the City of Oklahoma City

“While the prevalence of mental health challenges among youth in Oklahoma City was surprising, it is encouraging that Healthy Minds has assembled community and youth-based program leaders, mental health service providers, public school administrators, and public safety officials to work together to remove barriers to programs that can connect young people to the resources and services that will help them achieve better outcomes."

Heather Helberg, CEO of HOPE Community Services

“I was surprised to learn that even with three new urgent recovery centers added in recent years, Oklahoma City continues to see exceptionally high emergency room visits related to mental health. This underscores how significant the need remains for sustained mental health funding and accessible resources in our community. HOPE is fully committed to contributing to the continued expansion of services that Oklahoma City residents deserve.”

Rachel C. Holt, president and CEO of the United Way of Central Oklahoma

“I am honored to be a part of the mental health leadership team for Healthy Minds Policy Initiative’s community needs assessment of OKC. The planning and assessment phase was thorough and robust. The data was well researched and presented in a sobering yet informative approach, illustrating the true challenges and needs faced in OKC. It’s also a call to action: the subtitle of the report is ‘strategies to address and prevent behavioral health challenges.’ United Way of Central Oklahoma is grateful to be a part of this conversation, and we look forward to being a part of data-driven, impactful strategies to improve the wellbeing of our whole community.”