Once considered out of the purview of public health and prevention, mental and addictive disorders now must be considered as significant contributors to population-based disease, disability and death. A recent report specific to Oklahoma, the State of the State's Health 2003 Interim Report, Mental and Addictive Disorders, points to mental and addictive disorders as imposing an alarming burden of disability on our citizenry. In addition to the direct affects of the disease process, these illnesses also significantly increase the risk for several chronic health conditions and unintentional injuries; and, these illnesses can play a key role in suicide, child neglect and abuse, homelessness, divorce, unemployment, school drop out, unwanted pregnancies, and incarceration. In fact, a 2003 report by the U.S. Department of Health and Human Services shows Oklahoma, in comparison with other States, as having the highest rate of serious mental illness among adults (18 years and older). The impact on the overall health status of Oklahomans, and the disproportionate burden of these disorders on the public health and the State's health care systems, is clearly evident.

According to the U.S. Surgeon General's 1999 Report on Mental Health, mental illnesses strike one in five Americans. In fact, mental disorders together account for more than 15 percent of the overall burden of disease from all causes--even more than for all forms of cancer. In the United States and other economically developed countries, mental illness is the second leading cause of disability and premature mortality, according to a World Health Organization study. Mental illnesses have an immense impact on individuals and families, but less than half of those who suffer these disorders seek care. In large measure because of the stigma that surrounds mental illness, many people suffer needlessly and are denied full participation in society.

In a child, some key causes for parents' concern are speech or language difficulties, temper tantrums, hyperactivity, delayed development, poor peer interaction, aggressive behavior, or sleep disturbances. The roots of these problems can be early childhood trauma; depression; autism; fetal alcohol syndrome; parent-child problems; and attachment, anxiety, adjustment, or attention deficit disorders.

Among adults, the type of disease and its severity can produce a wide variety of symptoms. A person with depression, a very common brain disorder, will likely seem withdrawn and tired, and will lose interest in social or recreational activities he or she formerly enjoyed. He or she may experience changes in sleep patterns, eating habits, and other behaviors. Severe depression can lead to despair so overwhelming that thoughts of suicide emerge.

A person with bi-polar disorder, sometimes called manic-depression, experiences cycles in which his or her mood changes from deep depression to high levels of animation and activity, and back again. During the "manic" stage, the person rarely sleeps and may start a multitude of new projects but finish few or none of them.

A person with schizophrenia, one of the most disabling mental illnesses, may have visual hallucinations or hear voices, and have difficulty thinking and expressing thoughts clearly, making decisions, or interacting successfully with other people. Extreme fearfulness, watchfulness, and withdrawn behavior are other signs of schizophrenia.

Find out more by visiting our resources page for more information.

The amount a client pays for services in Oklahoma Department of Mental Health and Substance Abuse Services -supported programs depends upon his or her income, family size, and insurance status. A representative of the service provider discusses these factors with the client and determines the extent to which fees may be applicable. Clients may use the behavioral health coverage in their private insurance policies to help pay for treatment. The Medicaid program also covers the cost of some services for those who are eligible. Clients who are not eligible for Medicaid benefits, those who have no insurance, or those who have used all the benefits allowed by their insurance policies may qualify for fully state-supported services.

There are scores of mental health related programs in Oklahoma supported, at least in part, by funding from Oklahoma Department of Mental Health and Substance Abuse Services. They offer a range of services, including inpatient treatment, outpatient counseling, psychosocial rehabilitation programs, case management, and residential services. Feel free to visit our resources page or one easy way to find a program near you is to call ReachOut (800-522-9054), a statewide toll free number that's answered 24 hours a day. The ReachOut staff member can help you find the right services for you or your family member. If you are deaf or hard-of-hearing, you can use a TDD to call ReachOut. If you prefer, you can look at a listing of community mental health centers, or psychiatric hospitals, or residential care facilities, or other community-based programs on this website. Each list is arranged alphabetically by city to make it easy to find a program near you.

The Oklahoma Department of Mental Health and Substance Abuse Services ReachOut hotline, 800-522-9054, has information on support groups across the state. ReachOut is toll free and available 24 hours a day. In addition to voice calls, it can receive calls from deaf or hard-of-hearing persons who use a telecommunications device for the deaf (TDD). Other organizations that can provide support group information are the Oklahoma Mental Health Consumer Council, 888-424-1305 (toll free) and the National Alliance for the Mentally Ill-Oklahoma headquarters: 800-583-1264 (toll free).

Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening.

Anyone who has gone through a life-threatening event can develop PTSD. These events can include:
* Combat or military exposure
* Child sexual or physical abuse
* Terrorist attacks
* Sexual or physical assault
* Violent Crimes, like robbery or shooting
* Serious accidents, such as a car accident or plane crash.
* Natural disasters, such as a fire, tornado, hurricane, flood, or earthquake.
* The death or serious illness of a loved one

After the event, you may feel scared, confused, or angry. If these feelings don't go away or they get worse, you may have PTSD. These symptoms may disrupt your life, making it hard to continue with your daily activities.

All people with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD.

Most people who go through a traumatic event have some symptoms at the beginning. Yet only some will develop PTSD. It isn't clear why some people develop PTSD and others don't. How likely you are to get PTSD depends on many things. These include:
* How intense the trauma was or how long it lasted
* If you lost someone you were close to or were hurt
* How close you were to the event
* How strong your reaction was
* How much you felt in control of events
* How much help and support you got after the event

Your doctor can help you find out. Call your doctor if you have any of these problems:
* Bad dreams
* Flashbacks, or feeling like the scary event is happening again
* Scary thoughts you can't control
* Staying away from places and things that remind you of what happened
* Feeling worried, guilty, or sad
* Feeling alone
* Trouble sleeping
* Feeling on edge
* Angry outbursts
* Thoughts of hurting yourself or others.

Many people who develop PTSD get better at some time. But about 1 out of 3 people with PTSD may continue to have some symptoms. Even if you continue to have symptoms, treatment can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships.

A doctor or mental health professional who has experience in treating people with PTSD can help you. Treatment may include "talk" therapy, medication, or both.

Treatment might take 6 to 12 weeks. For some people, it takes longer. Treatment is not the same for everyone. What works for you might not work for someone else.

Drinking alcohol or using other drugs will not help PTSD go away and may even make it worse.

* PTSD can affect anyone at any age.
* Millions of Americans get PTSD every year.
* Many war veterans have had PTSD.
* Women tend to get PTSD more often than men.
* PTSD can be treated. You can feel better.

Symptoms of posttraumatic stress disorder (PTSD) can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day.

PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you probably have PTSD.

There are four types of symptoms: reliving the event, avoidance, numbing, and feeling keyed up.

Reliving the event (also called re-experiencing symptoms):
Bad memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. You may have nightmares. You even may feel like you're going through the event again. This is called a flashback. Sometimes there is a trigger: a sound or sight that causes you to relive the event. Triggers might include:
* Hearing a car backfire, which can bring back memories of gunfire and war for a combat veteran
* Seeing a car accident, which can remind a crash survivor of his or her own accident
* Seeing a news report of a sexual assault, which may bring back memories of assault for a woman who was raped

Avoiding situations that remind you of the event:
You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event.

* A person who was in an earthquake may avoid watching television shows or movies in which there are earthquakes
* A person who was robbed at gunpoint while ordering at a hamburger drive-in may avoid fast-food restaurants
* Some people may keep very busy or avoid seeking help. This keeps them from having to think or talk about the event.

Feeling numb:
You may find it hard to express your feelings. This is another way to avoid memories.

* You may not have positive or loving feelings toward other people and may stay away from relationships
* You may not be interested in activities you used to enjoy
* You may forget about parts of the traumatic event or not be able to talk about them.

Feeling keyed up (also called hyperarousal):
You may be jittery, or always alert and on the lookout for danger. This is known as hyperarousal. It can cause you to:
* Suddenly become angry or irritable
* Have a hard time sleeping
* Have trouble concentrating
* Fear for your safety and always feel on guard
* Be very startled when someone surprises you

People with PTSD may also have other problems. These include:
* Drinking or drug problems
* Feelings of hopelessness, shame, or despair
* Employment problems
* Relationships problems including divorce and violence
* Physical symptoms

Children can have PTSD too. They may have the symptoms described above or other symptoms depending on how old they are. As children get older their symptoms are more like those of adults.

* Young children may become upset if their parents are not close by, have trouble sleeping, or suddenly have trouble with toilet training or going to the bathroom
* Children who are in the first few years of elementary school (ages 6 to 9) may act out the trauma through play, drawings, or stories. They may complain of physical problems or become more irritable or aggressive. They also may develop fears and anxiety that don't seem to be caused by the traumatic event.

Children who have PTSD may show other types of problems. These can include:
* Behaving like they did when they were younger
* Being unable to talk
* Complaining of stomach problems or headaches a lot
* Refusing to go places or play with friends.

When you have PTSD, dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But treatment can help you get better.

There are good treatments available for PTSD. Cognitive-behavioral therapy (CBT) is one type of counseling. It appears to be the most effective type of counseling for PTSD. There are different types of cognitive behavioral therapies such as cognitive therapy and exposure therapy. A similar kind of therapy called EMDR, or eye movement desensitization and reprocessing, is also used for PTSD. Medications can be effective too. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD.

PTSD starts at different times for different people. Signs of PTSD may start soon after a frightening event and then continue. Other people develop new or more severe signs months or even years later.

Substance abuse is considered by many as the nation's number one public health concern. The economic cost to the US economy is staggering, estimated at nearly $414 billion annually.

In Oklahoma alone, the cost is nearly $6 billion a year including $1.4 billion in direct expenditures -- costs related to health care, public safety, social services, business and property loss -- and $4.4 billion in indirect costs.

In Oklahoma, drug and alcohol addiction contributes to 85 percent of all homicides, 80 percent of all prison incarcerations, 75 percent of all divorces, 65 percent of all child abuse cases, 55 percent of all domestic assaults, 50 percent of all traffic fatalities, 35 percent of all rapes, and 33 percent of all suicides.

The Oklahoma Department of Mental Health and Substance Abuse Services estimates that nearly 140,000 Oklahomans over age 18--about 5 percent of the population--need treatment for alcohol addiction. Another 1 percent--about 21,000 people--need treatment for other types of drug addiction. Nearly 6 percent of the state's 323,000 adolescents--approximately 20,000 teenagers--need treatment for alcohol and drug addiction. Statewide, alcohol addiction surpasses drug addiction by an average of 7.5 to one, meaning that for every person needing drug treatment, more than seven people need alcohol treatment.

A person in need of treatment will likely exhibit some of the following symptoms: 1) the substance (drugs or alcohol) is often taken in larger amounts or over a longer period of time than intended; 2) persistent desire, or one or more unsuccessful efforts to cut down or control substance use; 3) excessive time spent getting, taking, or recovering from the substance; 4) frequent intoxication or withdrawal symptoms when expected to fulfill major role obligations at work, school, or home, or when substance use is physically hazardous; 5) important social, occupational, or recreational activities are given up or reduced because of substance use; 6) continued substance use despite knowledge of having a persistent or recurrent social, psychological, or physical problem that is caused or exacerbated by the use of the substance; 7) marked tolerance--need for increased amounts of the substance (at least a 50 percent increase) to achieve intoxication or desired effect, or markedly diminished effect with continued use of the same amount; 8) characteristic withdrawal symptoms; and 9) substance often taken to avoid or relieve withdrawal symptoms. Based on the number and duration of these symptoms reported, a diagnosis of abuse or treatment need may be determined.

In adolescents, warning signs often include: changes in sleeping, eating, or grooming habits; hypersensitivity or temper tantrums; unexplained weight loss or gain; red or watery eyes; shaking of the hands, feet, or legs; frequent nausea or vomiting; excessive sweating; a drop in grades at school; skipping school; loss of interest in family activities previously enjoyed; an "I don't care" attitude; excessive need for privacy or secrecy; and/or an unexplained need for money or stealing money.

The amount a client pays for services in Oklahoma Department of Mental Health and Substance Abuse Services -supported programs depends upon his or her income, family size, and insurance status. A representative of the service provider discusses these factors with the client and determines the extent to which fees may be applicable. Clients may use the behavioral health coverage in their private insurance policies to help pay for treatment. The Medicaid program also covers the cost of some services for those who are eligible. Clients who are not eligible for Medicaid benefits, those who have no insurance, or those who have used all the benefits allowed by their insurance policies may qualify for fully state-supported services.

There are dozens of substance abuse treatment programs in Oklahoma supported, at least in part, by funding from Oklahoma Department of Mental Health and Substance Abuse Services. They offer a range of services, including detoxification, outpatient counseling, residential treatment, halfway house, and other services. One easy way to find a program near you is to call ReachOut (800-522-9054), a statewide toll free number that's answered 24 hours a day. The ReachOut staff member can help you find the right services for you or your family member. If you are deaf or hard-of-hearing, you can use a TDD to call ReachOut. If you prefer, you can look at a listing of Oklahoma's state-supported substance abuse treatment facilities on this website. The list is arranged alphabetically by city to make it easy to find a program near you. There is also a listing available on the Internet, prepared by the federal Substance Abuse and Mental Health Services Administration, that includes treatment providers all across the nation. This list can be found at www.findtreatment.samhsa.gov.

The Oklahoma Department of Mental Health and Substance Abuse Services ReachOut hotline, 800-522-9054, has information on support groups across the state. ReachOut is toll free and available 24 hours a day. In addition to voice calls, it can receive calls from deaf or hard-of-hearing persons who use a telecommunications device for the deaf (TDD).

There are numerous DUI schools across the state. For help in finding one near you, call the ReachOut 24-hour toll free line, 800-522-9054. If you are deaf or hard of hearing, you can use your TDD to make the call.

You must first get an ADSAC assessment. The ADSAC Assessment fee is set at $175 by law and assessment must be completed by an assessor certified by the Department of Mental Health and Substances Abuse Services specifically for the purpose of reinstatement of driver's license. Client must follow and complete all recommendations made by the certified assessor and any additional requirements made by the Department of Public Safety before driver's license will be reinstated. Upon completion you will be provided a completion certificate to present to DPS. You must meet all statutory requirements to be reinstated. To find an assessor call 800-522-9054.

The Oklahoma Department of Mental Health and Substance Abuse Services operates a toll free line called ReachOut (800-522-9054) that is staffed 24 hours a day with a person trained in mental health, substance abuse, and domestic violence/sexual assault issues. You can describe your particular situation and the ReachOut staff member can offer information and referral. If you are deaf or hard-of-hearing, you can use a TDD to call ReachOut.

There is also a toll free line specific to domestic violence and sexual assault issues. The Safeline (800-522-7233) is operated 24 hours a day, and is available for those seeking information or service referrals. Through Safeline, callers can be referred to crisis intervention and shelter services, obtain information on filing a victim protective order, or learn about their rights under law. All calls are free and confidential.

Teenline (800-522-TEEN) is a toll free line operated by Oklahoma Department of Mental Health and Substance Abuse Services that is specifically for adolescents and young adults. It provides a caring listener to respond to questions or concerns that young people have. It's completely confidential. Many teens call to talk about boyfriend/girlfriend problems, family relationships, drugs and alcohol, sexuality, and other topics. Teenline staff members don't judge; they listen and provide information. Teenline is open from noon to midnight daily, seven days a week.

The confidentiality of client information is protected by state and federal law. This means that a treatment professional cannot discuss your treatment with your family members, friends, or anyone else without your written consent. In fact, the ODMHSAS will not even confirm that an individual is or is not receiving treatment services unless that individual gives consent to do so.