Mental Health Clinics Chicago
Mayor Rahm Emanuel’s mental health care policies went on trial at City Hall Tuesday, with critics saying many patients ended up homeless, jailed or dead after the mayor closed half of the city’s clinics, while city officials maintained that care for the mentally ill actually has been expanded.
Those opposing views were aired during nearly five hours of testimony before the City Council Health Committee, where advocates for reopening the closed clinics got the hearing they’ve been seeking for years.
There was no clear verdict on what needs to be done, although all parties agreed on the need for expanded and improved mental health care for low-income city residents after years of local, state and federal cuts.
“The cold hard reality is that the mental health safety net in our city, across our state, is in crisis and has been for decades, ” said Heather O’Donnell, a vice president at Thresholds, which provides mental health care to more than 6, 000 patients in the Chicago area. “It is terribly underfunded, resulting in literally thousands of people with serious mental illnesses that are treatable to go without diagnosis and treatment for decades and even life.”
But Dr. Bechara Choucair, the city’s commissioner of public health, said the city is making strides.
“Our city is moving the right direction, ” Choucair said during a nearly 40-minute presentation. “Two years after starting our reforms, Chicago’s mental health system today is stronger than it was.
“Do we have a perfect mental health system in Chicago today? Absolutely not, ” he said. “But is our mental health system today better than it was two years ago? Absolutely yes.”
Choucair said that after half of the city’s 12 clinics were closed in April 2012, every patient was offered services at the remaining clinics or at other health care facilities funded by the state and federal government. Through those facilities, and the federal Affordable Care Act, thousands more Chicago residents are receiving mental health care, he said.
Emanuel, at an unrelated appearance before the hearing, said the city’s approach “expanded coverage to more people, and more importantly than just more people, expanded also new benefits like psychiatric care that never existed because the old system did not loosen up the resources.”
N’Dana Carter, a patient who for years has been the face of the Mental Health Movement coalition, said the city is ignoring people who fell through the cracks because of the closures and is undercounting the number of people treated at city clinics before half of them were closed.
“When you see the rising crime, when you see the people going to hospitals that didn’t go very often, you look at Cook County Jail, these are all a result of choices that were made, decisions that were made without consideration of the people most affected, ” Carter said.
It took months for many patients to get treatment after the transition, Carter said, while others just weren’t able to get to clinics that were farther from their homes, and many got reduced attention in the end. “People that were not in and out of the mental wards now are, ” she said.
Carter and other advocates note that city officials said more than 5, 000 people were being treated at the clinics as the closures were contemplated in late 2011.
The city now says that there were 2, 798 patients in the clinics at the time half were closed. Choucair told the Tribune that many of the patients on the original list were no longer “active, ” and that all of active patients either remained with the six surviving clinics or were referred to another provider.
Dr. Nneka Jones, who heads up mental health services at the Cook County Jail, has described the jail as the largest mental health facility in the state if not the country. She said the numbers of mentally ill detainees has grown about threefold to 2, 800 in the past four years.
“Many of the crimes run the gamut, but we can say that about a third of them fall under the terms of what we call crimes of survival: retail theft, possession of drugs, prostitution, ” she said. Those folks would be better served at less cost in the mental health system rather than the criminal justice system, she said.
Choucair said the city is considering serving Medicaid patients and plans to spend more money next year on mental health therapists who will respond to calls from street cops in three districts, an expansion of restorative justice programs in schools, and an increase in mental health care for children who are victims of sexual assault.