OKLAHOMA City (KOKH) — It is an epidemic that is killing Oklahomans and it is one that the state has largely ignored until recently.
Fox 25 Investigates is exploring the topic of mental health and how it is impacting Oklahoma. When it comes to recognizing the enormity of the problem, 2015 provided a high-profile turning point in Oklahoma.
"I loved being a parent. I loved being a mother," Cathy said, "'Christian was probably, of my five children, the most obedient, gentle sweetest, most tender hearted, introspective of the five children."
There were no real warning signs anything was wrong with Christian until his late teen years, when his illness manifested.
"It was scary," Cathy remembers of the early days of the illness, "But I thought we have to do everything we can to help him feel good feel balanced have a normal life."
Christian's illness was in his brain; schizophrenia.
"We were very quiet about our son's mental illness because we didn't know how people would take that" Cathy said.
The Costellos did not stay silent though. Mark would go on to become an advocate for mental health awareness and the Costellos joined support groups for families affected by mental illness.
Even with all the help they tried to provide, Christian's illness was winning. It became worse when he turned away from the medication that helped regulate his brain chemicals.
"Mark had been meeting with Christian every two weeks to visit with him," Cathy said. It was just such a meeting on August 23, 2015 when Mark and Cathy went to dinner with their son. They were dropping him off at a Braums restaurant when Christian asked to speak with his father alone.
"It was probably not more than a minute later that Mark was at my window and he had slammed his hands on the side of the window where the passenger seat was and I looked up and he was covered in blood."
There was blood, begging, chasing; and then as Cathy held her husband in her arm, he died.
"I said the Hail Mary because at the end of the Hail Mary it says pray for us now at the hour of our death."
Mark Costello's death became a rallying cry. As his body lay in the state capitol the reality of mental illness hit home to policy makers. This was no longer a topic to be discussed as some distant problem, mental illness had taken a colleague and friend.
"Because of these tragic reasons the dialogue has really shifted," said Mental Health Commissioner Terri White, "People are really understanding, hey we have to treat these things."
White says Costello's death, and the crash at the OSU Homecoming parade which is also being blamed on mental illness, have been high-profile wake up calls about the need to address mental health issues in Oklahoma.
"None of us want to lose one more Oklahoman as a result of these issues," White said.
For Cathy Costell, the last few months have meant taking her very personal tragedy public. She has turned to advocacy for new laws and more support for the mental health system. She says in some ways the advocacy work and making Mark's death matter helps with the healing, but it does not take away the emptiness she feels.
"I cry every day, I still do," Cathy said, "I would say that I am in more pain now than I was in earlier."
In some ways, Cathy sees her husband as a martyr and as she speaks out she hears other stories. They are stories from other Oklahomans who are trying to find ways to cope with mental illness in their own families. As they all work together to remove the stigma and secrecy of diseases that are treatable before it's too late.
What happens when mental health funds are cut and does it really save the state money?
Fox 25 Investigates is exploring the topic of mental health and how it is impacting Oklahoma. To find out more about the issues affecting Oklahoma, Fox 25 went to the people who have become the first responders to mental health emergencies.
"We don't want to put people who have mental health problems in jail, but right now that's all we can do," said Sequoyah County Sheriff Ron Lockhart, "What i see, and it is sad, the legislatures are not funding mental health with the right funding to get the job done.
Sheriff Lockhart says when deputies have to take a call about mental health it can mean hours stuck at a hospital and hours more transporting someone to a long-term care bed. The sheriff's office only gets reimbursed for mileage and not for the hourly wages of the deputy or the overtime needed to fill the gaps in patrols while that deputy is at the hospital.
"I've seen where my deputies have had to wait for 20 hours, waiting for them to be evaluated, waiting for them to be transported," Sheriff Lockhart said.
Even if someone ends up on a 72-hour hold, the maximum involuntary hold, Lockhart says cuts to reimbursements for care providers mean those providers often can't afford to keep people brought in because they are a threat to themselves or others.
Recently Lockhart told Fox his deputies had to take in a suicidal man and after they found a treatment bed for him, he was released almost exactly 72 hours later. That man killed himself after being cleared for release by the treatment center.
"You can't tell me the system is working when we have people like that who we know need help but we turn them loose because there is no funding and five hours later he's dead," Lockhart said.
"I know that is negatively going to impact law enforcement, because I know we're going to have to pick up a bigger role in that," said Captain Jeff Pierce of the Oklahoma City Police Department of cuts to mental health funding. Captain Pierce is the Crisis Intervention Team Commander for OCPD and says mental health calls have steadily increased over the years.
"Last year," Pierce said, "We had over 13,000 mental health related calls that our officers responded to." Those calls range from parents who have trouble getting their children to take medication, to mentally ill people who fear they are in danger, to complaints of full-blown psychotic episodes.
In 2015, Oklahoma City Police had to make 144 trips out of the metro to find treatment beds for the mentally ill. These transports require two officers, often those specially trained to handle mental health situations. That means 144 times in 2015 at least two police officers were taken off the streets and were unavailable to help out on other calls for several hours while they transported patients.
"It significantly impacts the manpower of the Oklahoma City Police Department," Captain Pierce said, "Without a doubt."
Both Pierce and Lockhart say every time the state cuts funding to mental health their agencies pick up the costs through transports or increased crime. In essence, taxpayers are still paying for mental health. However instead of paying for less treatment, they are paying through the courts, jails and sometimes through innocent lives.
"To have good working community mental health treatment options in a community saves so much money to taxpayers in the long run," Pierce said.
If you're looking for the good news here, there isn't much. Maybe it will get better, but maybe it won't. Either way the thin blue line of law enforcement will still be there as the last line of defense in the battle against mental illness.
Oklahomans are dying and the reason why is one we don't like to talk about. Suicide is the leading cause of violent deaths in Oklahoma and our state is experiencing a higher rate than the national average.
Fox 25 Investigates is exploring the topic of mental health and how it is impacting Oklahoma. One, often uncomfortable subject, when it comes to mental health is when someone decides to take their own life.
To understand where the biggest issues related to suicide are we traveled to the part of the state where Oklahoma's red dirt touches the Lone Star state. Those border counties of Oklahoma rate highest in per-capita suicide deaths compared to any other county in Oklahoma.
"Whenever we interview people we like to say we're 45 minutes from the nearest Walmart," said Rick Garrison, about the location of Cheyenne, Oklahoma in the heart of Rogers Mills County.
"We still take care of our own," Garrison, the district superintendent, said of the rural community. However, even with neighbors helping neighbors, sometimes there is a need for professional help. "When you are this far out there is not a lot of those type of resources available for our patrons and our community," Garrison said.
In these sparsely populated communities every death is felt by nearly every one.
"It has an incredible impact on our school," said Cheyenne Middle and High School Principal Whitney Moore, "Our students they have family members in the school in the community, even if you didn't know them personally you felt like you knew them."
Moore has helped implement Cheyenne's new wellness calendar. The school now teaches students, not just about physical health, but also about mental health. It is one way school districts in rural communities are working to bridge the gap in crucial health and mental health services lacking in rural communities.
"When I did have cases where I did need someone to come in and talk to my kids and do counseling it was incredibly difficult," Moore said.
"I do think there is a very strong fear of being known or being exposed in a small town," said Savannah Kalman, the prevention program manager for the Oklahoma Department of Mental Health and Substance Abuse Services. Kalman says there has historically been a stigma surrounding mental health which keeps many from treatment, but that stigma is beginning to fade with education.
"When Oklahomans are kind of educated about the similarities between brain diseases and the physical illnesses that we are more familiar with they jump right on board," Kalman told Fox 25.
What makes suicide prevention difficult is there's no one real cause for why people choose it.
"We can't just have one solution because there are many things that cause people to become hopeless." Kalman relies on research to help direct the limited state resources to counties and cities where it can do the most good.
A new reporting program with emergency rooms is aimed at collecting data on attempted suicides which Kalman hopes will help the targeted response even more
"We can save lives," Kalman insists, "If we can join together to face some of these very serious concerns that we have facing us."
If you, or someone you know, is thinking about suicide there is help, no matter where you are. The national suicide prevention lifeline is available by calling 1-800-273-TALK (8255), or you can call 211 to get information about where mental health services are available in your area.
The numbers say Oklahoma has one of the highest rates of mental illness in the nation, and lack of funding means Oklahomans may be suffering more than communities in most other states.
Even with limited funding the Oklahoma Department of Mental Health and Substance Abuse services has managed to make some gains, but there are still hundreds of thousands of people not getting help. The reason is simple; there is no money to help them.
This year the mental health and substance abuse budget was slashed by 22.8 million dollars, and these dollars could turn into lost lives.
"It is talked about all the time, and i don't understand why there's not more people listening to that. I just don't get it," said Verna Foust, Red Rock Behavioral Health CEO.
The company contracts with the state to offer mental illness treatment. Funding's been historically low for mental health services, but the state did manage to build a safety net for those most in need. However, advocates have said that what is coming is terrifying.
"What is coming is that if something doesn't happen the whole safety net is going to collapse," said Foust.
Mardel King-Hawkins told Fox 25 News that state sponsored programs at Red Rock Behavior Health and the National Alliance on Mental Illness saved her life.
"The things that I needed to become who I am today, they paid for and I couldn't be here today if it wasn't for them," said King-Hawkins.
King-Hawkins had a difficult start in life. She was abused as a girl, and said she was often left alone to care for her siblings. As an adult, a doctor told her she suffered from depression, panic attacks, anxiety disorder, and post traumatic stress disorder. Surprisingly, her diagnosis felt like relief.
"It is not what I am doing on purpose. It is not what I am doing intentionally. I have a mental disorder. So I was so happy," said King-Hawkins.
Now she works at a clinic helping others like her, but seeing the programs that saved her life cut because of budget shortfalls has been painful.
"I am afraidPeople are going to suffer," said King-Hawkins.
All state agencies have been dealing with cuts to fill a billion dollar budget hole, but the mental health cuts may feel especially deep in rural communities like Altus where finding help could mean an hours long drive.
"If we don't help people, if we don't give them access to the services they need for mental health or substance abuse treatment we see that show up in the criminal justice system," said Brian Bush, the president and CEO of the Altus Chamber of Commerce.
This year 73,000 Oklahoma families have had their services limited as a result of recent cuts.
"We are running out of time. Something needs to be done, and this has got to be figured out. If it is not figured out, it is going to be catastrophic for our system," said Foust.
Advocates point out that limiting service does not stop people from getting sick, and more cuts will mean more people suffering, more people in jail, and an increase in suicides.
It's important to know that you can and should still reach out for help. Often organizations will help you find another program if they can't help you themselves. If you would like to ask questions about getting mental health services for yourself or a loved one, calling 211 is a good first step.
Oklahoma's mental health epidemic is coming out of the shadows. Tragedy and advocacy have pushed it into the light. Advocates told Fox 25 they will continue to fight for funding, but keeping hope alive is important for them and the people they are trying to help in treatment.
One in four people in Oklahoma are suffering. Mental illness is taking over their minds and not everyone is getting help, but it doesn't have to be that way.
"For those who do develop the disease, treatment works if you can get in the door," said Terri White.
Mental illness is preventable, and in the face of services being cut, White said people should still reach out for help.
"The system that exists in Oklahoma to treat mental illness and addiction, we can be incredibly proud off. If people can get in the door, the outcomes are fantastic. The dilemma is when we only let one out of every three people in the door. That is where the trouble is," said White.
Mental health services have been underfunded in Oklahoma for nearly 100 years. However, in the last few years the state has made some slow but important progress, like fewer suicides and more people asking for help. Now there is the potential for taking steps back because of current financial shortfalls.
"My fear is that not only is it devastating to families and devastating to our economy and devastating to our culture, I think that you could have another tragedy," said Cathy Costello, mental health advocate.
Tragedy is still fresh in Costello's mind. Devastation catapulted the wife and mother into mental health advocacy. Cathy's son, Christian, suffers from mental illness, and during a time he was refusing treatment, he attacked his father. Cathy was there and held her husband, Mark Costello, as he died.
"I am just one person that can share my story. So, when I look at it, all I can think is lift the stigma, educate people, and advocate," said Costello.
The pain is may never go away, but neither will her hope for a stronger Oklahoma that can help everyone suffering from mental illness.
"My husband had hope. I am going to carry that hope on," said Costello.
So, you will find people like Costello and White walking the halls of the capitol reminding legislators that mental health services matter.
"There is hope if we choose to go after this. You know anything worthwhile in life doesn't come easily," said Costello.
Currently there is a push for Medicaid re-balancing in Oklahoma. The Oklahoma Health Care Authority said it is a way to stop ongoing cuts to Medicaid. Many people who suffer from mental illness often find themselves in economic need, and this plan is a proposed solution to help those in need to get health services.