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Finding purpose in mental health coverage Date: 03/30/17

Jaclyn Cosgrove

By Jaclyn Cosgrove

I was about a year into my job as a health reporter at The Oklahoman when my editor said, “We’d like you to do a project on mental health.”

“That’s specific,” I joked.

I ended up doing a project titled, “Gray Matters,” where I looked at what happens when an adult in Oklahoma experiences a mental health crisis.

That was June 2013. About a week after the project ran, I got an email from Kathleen, an angry and concerned Oklahoma City resident whose friend Jean had struggled for years to get mental health care for her adult son Fred.

Fred not only had a serious mental illness, but had a hard time understanding why he needed medicine. He had been in jail and prison multiple times. Jean did not have much money, which meant she depended on the state system for his care, which meant he typically only received care when suffering from a crisis.

That June, Fred stabbed Jean in their kitchen. The following morning, he called his sister and said, “I did a bad thing. I stabbed momma.”

In writing about Fred and Jean, I looked at a pile of Fred’s medical records. I saw several notes that Jean wrote herself to remember a medicine or a doctor.

At that moment, I got really angry. I did not understand how a mother could love her child so much and try so hard to get him the care he needed, but still the one outcome everyone feared – what she was working so hard to prevent – happened. Jean sometimes slept in her locked car while Fred slept inside so they would both have a safe place to sleep.

After writing Fred and Jean’s story, I decided I wanted to integrate mental health and addiction coverage into my daily beat reporting. I also wanted to be more purposeful about the stories I focused on.

Three years later, in 2015, I received one of the Rosalynn Carter Fellowships for Mental Health Journalism. The focus of my Carter Center project would be to examine barriers that low-income, uninsured adults in Oklahoma with mental illnesses and substance use disorders face in finding quality, consistent treatment. Oklahoma spends among the least in the country on mental health care, even though our state has a high rate of adults with severe mental illness.

The first story in my project, “Epidemic Ignored,” ran in January 2016 and told the history of Oklahoma’s mental health system. I wanted to know whether there ever was a time when Oklahoma had a good, well-funded mental health system. I wanted to understand where everything went wrong.

In March, I wrote about why the number of Oklahomans with mental illnesses going to prison continues to increase. I focused on the story of Justus Skyler Cobbs, a 22-year-old Oklahoman man diagnosed with a mental illness who also has developmental delays. I wanted people to understand how someone who had not hurt anyone but themself could end up in prison.

While reporting on the prison story, I heard several sources bring up county jails. They talked about how our county jails could be used to divert thousands of people away from prison and into treatment. Instead, they have become warehouses holding hundreds of Oklahomans with mental illnesses and substance use disorders.

It seemed like a good next step for the project. I had no idea what I was walking into.

I started by looking through jail inspection records from Oklahoma’s 90 city and county jails and 41 temporary holding facilities. When I printed the records from 2015 and 2016, the stack of paper was about two feet high.

I used Google Drive to build a spreadsheet of information from each county’s inspection report. It included the complaints about each county jail and whether anyone died, attempted suicide, escaped or was injured while in custody. My main spreadsheet became 35 columns wide.

The names of inmates were redacted from the inspection reports, so I requested records from the medical examiner’s office to help identify inmates who had died in jail. I cross-referenced the dates in the records, and in some cases was able to find obituaries. While it was one of the harder parts of the project, this activity made tracking down family members somewhat easier. LexisNexis and Facebook were invaluable.

My four-part jail series, “A Broken System,” began running in November. In the first chapter, I told the story of four people with mental illnesses who had died in county jails. I focused in the second chapter on a county jail that has hired a psychologist and now offers group therapy. The third chapter explored what accountability – if any – there is for jail employees when people get hurt. The last part of the series concentrated on solutions to the situation.

The jail series ended up much longer, more in-depth and more graphic than I anticipated when I began. I initially thought I would write only one story explaining how people with mental illnesses cycle in and out of county jails. After reading jail inspection records, I knew there was a much larger story to tell.

Since the jail series ran, I have received extensive feedback from readers and public officials. Readers said they appreciated the coverage and wanted to see change. Two legislators asked questions about the project’s findings.

My Carter Center project now is complete, but like any project worth pursuing, I still have more questions to answer on the issue and more story ideas to pursue.

Jaclyn Cosgrove (@JaclynCosgrove ), an AHCJ member since 2012, is an Oklahoma native who covers health, medicine and policy for The Oklahoman. She received a Rosalynn Carter Fellowship for Mental Health Journalism in 2015, which she used to report on the problems of low-income, uninsured residents in her state.