Oklahoma's mental health transformation

In ways big and small, mental health systems across our state are working better for Oklahomans than they did five years ago.

Our impact, from 2019 to 2024

862,456

People directly impacted by Healthy Minds since 2019

$77.5 million

Mental health system resources secured in our first five years

$209.3 million

Additional projected funding and savings over the next five years

Overcoming Oklahoma's mental health challenges

An estimated 768,000 Oklahoma adults — one in four — experience mental illness, and 584,000 have a substance use disorder. Too many of these Oklahomans go without treatment, and the consequences are felt in our families, businesses, schools, and the criminal justice system.

Healthy Minds Policy Initiative was formed to create a culture of problem-solving on mental health issues. Since its inception, Healthy Minds has published over 60 pieces of original research and analysis, helped secure tens of millions of dollars in competitive funding for Oklahoma’s behavioral health care system, and initiated more than a dozen community-based partnerships committed to ending untreated mental illness and substance use. Healthy Minds provides data, consultation, and education on best practices to Oklahoma leaders committed to improving the mental health of all Oklahomans.

The foundation of our work

In 2018, the Urban Institute and The University of Tulsa revealed sobering findings from their assessment of Tulsa’s behavioral health landscape: on average, Tulsans living with mental illness and substance use disorders didn’t reach age 50.

These Tulsans were dying 27 years earlier than other Oklahomans, often living in poverty and poor physical health before their early deaths.

The assessment described a fragmented, uncoordinated system of care for mental health and substance use that left Tulsans struggling to get help. Identifying a need for sustainable, long-term policy change in Oklahoma, the report called for establishing a “backbone” organization to convene partners and create a culture of problem-solving on mental health issues.

To that end, The Anne and Henry Zarrow Foundation provided a founding investment to launch Healthy Minds Policy Initiative in 2019 with a mission to end untreated mental illness in Oklahoma.

Since 2015, the Foundation has invested more than $33 million in mental health giving. The Foundation’s continued investment in Healthy Minds has allowed us to grow from a one-employee, Tulsa-focused operation to a team of 16 full-time staff with two offices and projects across Oklahoma.

Through extensive research and data analyses, we have identified four high-impact focus areas that our state can address to make a generational change in the wellbeing of all Oklahomans.

Where we focus

Affordable, accessible treatment

Ensuring mental illness and substance use disorders are treated like any other health condition.

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Children, youth, and families

Leading collaboration that helps Oklahoma’s children and families thrive.

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Mental health workforce

Expanding and empowering Oklahoma’s behavioral health workforce.

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Diversion to appropriate care

Ensuring Oklahomans receive mental health care in the least restrictive, least costly settings.

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The next five years

Oklahoma has a better understanding of its mental health challenges — and the solutions to overcome them — than ever before. We are optimistic that bold change is possible. On many critical fronts, this change is already underway.

Our vision for healthier, thriving communities across the state is made possible with the sustained partnership of leaders committed to elevating mental health as essential to every Oklahoman’s wellbeing. Building on a half-decade of progress, we will make a generational impact on Oklahoma’s mental health and substance use outcomes.

Methodology and sources

How we assessed our impact

To assemble this report and assess the impact of our first five years, Healthy Minds conducted interviews with key stakeholders, gathered national and Oklahoma data, and reviewed the financial impact of Healthy Minds’ initiatives as well as the increases in service access and capacity they produced.

To estimate the number of Oklahomans directly affected by Healthy Minds’ work, we took a conservative approach to avoid overstating our impact. However, this total includes potential duplication that could not be reconciled. For example, it was not always possible to calculate and remove overlap for people who may have benefited from multiple Healthy Minds initiatives.

Much of the taxpayer benefits generated by initiatives laid out in this report can be attributed to the fact that when people are mentally well, they can stay in the workforce longer and work more productively.  

As an example, Healthy Minds championed a bill in 2023, Senate Bill 444, that required Medicaid and commercial insurers in Oklahoma to activate medical billing codes that support the use of the Collaborative Care Model. This model greatly extends the reach of psychiatrists by allowing them to work as “consultants” to primary care providers on patients’ behavioral health needs.

Looking at other states where these billing codes have been activated, we project that in the next five years, more than 9,000 Oklahomans will be served through the Collaborative Care Model. Given the rigorously researched cost-effectiveness of this model, we can expect that those 9,000-plus people will generate for the state more than $40 million in taxpayer dollars over their lifetimes.  

As another example, Healthy Minds worked with lawmakers to pass House Bill 4106 in 2022, ensuring that the state’s public school districts will collaborate with community mental health providers to establish suicide and mental health crisis response protocols. This law impacts hundreds of thousands of Oklahoma students, even though many students will never need a suicide or crisis response. But when schools use carefully developed protocols, far fewer students will have to cope with the trauma of losing classmates and friends to suicide.

Sources and details for selected initiatives

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An estimated 768,000 Oklahoma adults: 2024 State of Mental Health Report, Mental Health America

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nearly 8 to 1 return on investment: $77.5 million in mental health system resources secured through Healthy Minds’ work, including federal, state, and local investments, compared to a little more than $10 million in philanthropic support since 2019

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$20,646,627 Estimated annual revenue to providers: Senate Bill 674 (2021) required insurers to reimburse health care providers at the same rates for services delivered through telehealth as they do for in-person services. Based on national estimates for the percentage of people who received their behavioral health care services through telehealth, we estimated that, in only a 12-month period, over 105,252 Oklahomans received behavioral health services that they either would not otherwise have received or would only have received if the provider was willing to deliver it at no cost.

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$52,776,589 Estimated taxpayer savings: A $5 million appropriation to behavioral health development funds at the University of Oklahoma and Oklahoma State University will support eight new psychiatry residency positions, which we estimate will support 14.5 new psychiatrists in Oklahoma over six years.  

To determine the taxpayer savings from more Oklahomans being treated through evidence-based models like the Collaborative Care Model, we drew on analyses of controlled cost-effectiveness studies of evidence-based practices, conducted by the Washington State Institute for Public Policy. These analyses found significant cost savings per person treated, finding that when people are treated in evidence-based models by psychiatrists, they can participate in the workforce longer and more effectively. This estimate refers to the taxpayer savings that will accrue over the course of the psychiatrists’ first five years of practices.  

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524,803 Number of students in schools implementing the OPNA: Across Oklahoma, 410 school districts use the Oklahoma Prevention Needs Assessment (OPNA), about 80.6% of the 509 districts in the state. In the 2023-2024 school year, there were 651,120 students enrolled across the state’s 509 school districts. We therefore estimated that there were 524,803 students in the schools that implemented the OPNA during the school year. We believe this is a conservative estimate because the state mental health and education departments have found that rural districts, which have smaller numbers of students, are less likely to implement the OPNA.

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1,000 more people expected to receive services: As a result of NorthCare’s expansion, 1,000 people are projected to receive services through the grant’s 4-year period

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$2,899,810 New and improved use of funds for youth mental health through OKCAPMAP: This includes $2,215,445 in new funds (from a Health Resources and Services Administration grant) and $684,365 in improved use of existing funds.