But unknown to many of his neighbors and clients, the Orem man suffers from a disease that, when left untreated, can send him into a self-destructive spiral.

Cottle is bipolar. Angered by a preliminary state budget that contains no money for Utah's uninsured mentally ill, he has chosen to "come out of the closet."

As a result of federal policy changes, states can no longer use savings from their Medicaid mental health care plans to cover the uninsured. Low-income advocates say this presents a crisis, leaving as many as 4,300 chronically mentally ill Utahns, including 800 children, no longer eligible for local mental health services.

Cottle, who would be hard-pressed to qualify for health insurance even if he could afford it, recently was notified he will be cut from Wasatch County Mental Health's counseling program.

"It's a shameful, embarrassing thing to go to one of those places to begin with. Now I'm sent a letter saying you have one visit left and the program has been cut," he said. "When we have a surplus like we have, how do we justify throwing away 4,300 people's lives? Is my life not worth anything to our state?"

Mental health advocates are asking for $3 million in state money to make up for the lost federal revenue, arguing that without the money, uninsured workers like Cottle could lose the ability to function and risk expensive hospitalization. They could overburden the jails and juvenile detention system, at great cost to the state, advocates warn.

Republican Gov. Jon Huntsman Jr. recommended replacing the federal money in his initial budget, but hasn't made it a priority in negotiations with legislators.

House budget chairman Rep. Ron Bigelow said the budget is still in flux, but stressed, "The federal government makes a cut. Does that then obligate the state to make up the difference?"

Advocates and Utahns battling illnesses, such as schizophrenia and severe depression, met in quiet protest at the Capitol lunchroom Wednesday.

"We're investing millions in economic development. But what we're saying to these people is, 'Your economic development doesn't matter,' " said Fraser Nelson, director of the Disability Law Center.

Nelson says many of these uninsured will wind up at the state mental hospital "at a tremendous cost to the state and these individuals, in terms of their civil liberties."

Utah Issues director Judi Hillman questions the logic behind investing $19 million to marketing Utah's tourism industry, when all that was asked for that purpose was $10 million.

"That's three times the amount we're requesting," Hillman said.

Cottle wasn't at the protest, but wants lawmakers to know there is a "human cost" to decisions they are weighing.

"There's no escape from mental illness. It has to be treated," Cottle said. "We don't go to people with cancer and say, 'Heal yourself.' "

kstewart@sltrib.com

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Tribune reporter Rebecca Walsh contributed to this report.