CHICAGO — The access to mental health care is increasingly becoming a critical need for Chicago’s Latino communities. In addition to the disorders that stem from medical, psychiatric or psychological conditions, many Hispanics face additional pressure as they may be victims or witnesses of violence or harassment, face poverty or unemployment, or live in uncertainty due to their immigration status, among a myriad of other challenges.
The COVID-19 pandemic and the economic crisis it has unleashed have exacerbated the problems many people face. More resources and mental health care options are more imperative than ever for Chicagoans as they face the dangers of the disease itself, unemployment, confinement and other issues.
All in all, neighborhoods inhabited mostly by minorities have faced deficiencies in the availability and scope of mental health care. This problem worsened in 2012 with the closure of six municipally-operated mental health clinics in the South and West sides of Chicago.
Given this, a movement to fight health care disparities has shifted into two different directions. One move has been to demand City Hall to reopen all six specialized mental health clinics, a proposal that Mayor Lori Lightfoot supported during her electoral campaign in 2019.
The other push has been to expand the specialized clinics’ capacity and support other clinics that are being operated by organizations and entities to provide a range of options to Chicago residents.
Although Lightfoot supported the first option in her campaign, her actions have focused on the second.
However, the coronavirus crisis has catalyzed the expansion of these services by the city and other entities, due to the enormous pressure on the population’s mental health caused the pandemic. Still and yet, the reopening of the six clinics is a promise that hasn’t been fulfilled.
‘There is a lot of work to do in the community’
Living with depression has not stopped Estela Díaz from getting ahead in life. She acknowledges it is a constant struggle with ups and downs, but says sharing her experience as well as helping people has been therapeutic.
Díaz, 41, suffered sexual abuse when she was 6 years old. This traumatizing experience caused her to have panic attacks, anxiety and depression. “I didn’t know I suffered from depression until I reached adulthood, more or less at age 22, when I suffered a panic attack and anxiety in public. I went to the doctor, and he prescribed antidepressants and sleeping pills, but he did not refer me to any counselor or therapist.”
As her depression and anxiety worsened, Díaz continued taking medication for years. At the age of 35, she tried to commit suicide.
Díaz began to volunteer at her children’s school, and it was there where two therapists came to talk about mental health. She shared her experience, and they offered help. “They offered to give me the support in group therapy, not individual therapy because the waiting list was already full. I had to wait a long time to get one-on-one therapy, which I was needing.”
Díaz has been receiving individual therapy every week for two months and has been working for the Brighton Park Neighborhood Council (BPNC) mental health campaign for a year. “Hearing all those experiences and knowing that I have been able to help more people in the community who are in a situation like mine, or are starting to, or are in a worse situation than mine, fills me with satisfaction, although we still have much work to do in the community.”
After struggling for years to receive individual therapy, Díaz says that reopening the city’s six mental health clinics closed during Mayor Rahm Emanuel’s tenure would be an excellent option for low-income patients seeking these services in minority communities.
Some top concerns in the mental health area are depression, anxiety, stress from acculturation, the need for parental support and trauma.
A 2018 study found that at least 178,000 people in Chicago reported that they needed mental healthcare during the previous year but did not get it, according to a survey by the Chicago Department of Public Health.
Lightfoot has allocated a budget of $9.3 million to provide a coordinated and comprehensive mental health care system.
When Lightfoot was running for mayor, she campaigned to reopen the six mental health clinics. But to date, those public clinics have not reopened. Lightfoot’s strategy to tackle this crisis has instead focused on expanding existing services and supporting other organizations dedicated to mental health care.
In a statement to La Raza, her office indicated that the $9.3 million would be used to “funding 20 public and nonprofit health centers to expand care in high-need neighborhoods, regardless of patients’ ability to pay or insurance status.”
Besides, these resources will be used to “creating violence prevention programming to address mental health needs in communities most impacted by violence and poverty; investing in crisis prevention and response teams for people who have additional mental health challenges and have trouble accessing brick-and-mortar clinics; and coordinating the city’s mental health system to ensure every resident can access the care they need, where they need it, including an enhanced 311 helpline.”
The disparity in mental health services
Arturo Carrillo, coordinator of the St. Anthony Hospital Wellness Center and the Collaborative for Community Wellness, has advocated for the reopening of the city’s six mental health clinics closed during Emanuel’s administration. “These are the clinics that we, with our efforts, ensure that they can serve the uninsured by providing access to mental health services.”
According to research by the Collaborative for Community Wellness, therapists who are trained to provide these services to people who have experienced trauma in their lives are mostly in the wealthiest communities that can afford these services.
“If you look at the map across Chicago, Latino communities have the least access to mental health, while white communities have a very high ratio of therapists,” Carrillo said.
In 2018, the Collaborative for Community Wellness reported that while in the Chicago’s Gold Coast area, one of the wealthiest in the city, there were 381 licensed mental health professionals, or 4.45 per 1,000 residents, whereas, in low-income communities on the Southwest Side there were only 63 professionals or 0.17 per 1,000 residents.
This report focused on 2,859 adults from the southwest side from 10 communities: Archer Heights, Back of the Yards, Brighton Park, Chicago Lawn, Gage Park, Little Village, McKinley Park, Pilsen, West Elsdon and West Lawn.
Part of mental health services in Chicago are offered by five specialized public clinics operated by the City of Chicago and one by Cook County, and by general community medical clinics, whose services include mental health care.
Some patients say that there are waiting lists in medical nonpublic community clinics and that the therapy sessions they offer only last between 20 to 30 minutes.
“I have had this trauma since I was 6 years old, and now I am 41 years old, I won’t get better in a 20-minute session. The therapist is watching the clock to see when the session will end. It doesn’t make any sense,” Díaz said.
“Public clinics now have no waiting list. Medical [nonpublic community] clinics that propose to offer mental health services give half an hour appointments. It is very little time to consult when a person is talking about an experience of rape [or another traumatic] experience that they have lived in their life,” said Carrillo. Also, he added that public clinics have the time and space to give one-hour consultations, but since there are only five clinics, there are just not enough clinics to serve the entire community.
The analysis conducted by the Collaborative for Community Wellness in mostly Mexican neighborhoods in southwest Chicago found that 80 percent of Latinos surveyed said that they would surely or very likely seek professional help to address their problems. But cost and lack of services turned out to be the main barriers to accessing mental health services.
“More than anything, we are asking Mayor Lightfoot to hire therapists. If they cannot work in those five clinics because they are not within the community’s reach, let’s see other possibilities where they can work, for example, with schools, libraries and community centers, so that these therapists [work] in the communities in partnerships with organizations that can provide them with the space [and] don’t have the way to hire personnel,” Carrillo said.
‘We need more focus and more funds for other resources’
According to Jessica Boland, director of mental health services at Esperanza Health Centers, Chicago city clinics are good because they offer free counseling and therapy services, but they can serve a very small percentage of residents. “The services in these clinics are important, but they are not the only resources. We need more focus and more funding for other resources across the city as well, because there are other types of providers, other clinics, organizations that are also doing this mental health treatment work.”
According to data provided by Lightfoot’s Office, there are more than 100 clinics in Chicago that receive public funds and offer mental health services. About 25 percent of the current clinical staff is bilingual in English and Spanish.
For Boland, Chicago has professionals who provide mental health services, but the problem is that there aren’t enough of them working in neighborhoods where there is the greatest need.
In the city’s wealthiest areas, such as Downtown or the Wicker Park and Gold Coast neighborhoods, the number of mental health professionals, therapists and psychologists is much higher. In contrast, in Latino areas, such as Little Village, the number of mental healthcare professionals is substantially lower.
Regarding barriers to accessing mental healthcare, Boland mentioned transportation because these mental health services are often not close to where people live. The appointment cost is another barrier, especially for the uninsured, in addition to language and stigma.
‘The problem is more complex than opening or closing clinics’
District 12 Councilman George Cárdenas, who chaired the city’s Health Committee at the time the six clinics closed, said the focus on mental health should be comprehensive. “A person with mental health problems is likely to have other types of problems, such as homelessness, illness, unemployment, addictions, [is more likely to] divorce, lost custody of their children, or is pressured by a thousand things.”
In this sense, Cárdenas said that we must see how we can improve and how we can better serve people. “Not only mental health services but of all kinds, such as social, access to work because everything is a set.”
For Esther Sciammarella, executive director of the Chicago Hispanic Health Coalition, the problem is more complex than the opening or closing clinics. “The idea is to integrate health with mental health. You cannot consider mental health something independent of what health is,” she said.
Sciammarella, who is also a member of the city’s working group on mental health, believes that systems need to be more integrated and less fragmented. “We have to look at what other underlying issues or conditions of illness the mental health patient has. It’s not about a one-issue topic but rather treating the case comprehensively and holistically.”
Lightfoot agrees. According to a statement to La Raza, the Chicago mental health plan “will build equity and transform mental healthcare by investing in and supporting a holistic system of care that prioritizes the people and communities most in need.”
Efforts against COVID-19
The COVID-19 crisis has exacerbated the mental health problems that many people suffer in Chicago. In light of this problem, Lightfoot announced a few weeks ago new initiatives to address them.
Lightfoot said in a statement that “the [mental health] issues we’re addressing now didn’t start when COVID-19 hit our City, and they aren’t going to end with it either. We will continue to work with our city advocates, experts, patients, and communities to enhance mental healthcare in Chicago and give our residents and families the support many so desperately need.”
For example, the Chicago Department of Public Health has teamed up with four community mental health organizations to expand access for people with schizophrenia, bipolar disorder, and other related disorders. About $1.2 million in support has been allocated in support of organizations, including Friend Family Health Center, Healthcare Alternative Systems, Thresholds, and Trilogy Behavioral Healthcare.
Several of those organizations’ clinics are located in neighborhoods with a high concentration of Hispanics.
And, in a statement, Chicago Department of Public Health Commissioner Allison Arwady announced a few weeks ago the acquisition of doxy.me, a telemedicine system that will offer digital mental health services at the five municipally operated mental health clinics. Those services will be provided regardless of the patients’ income, health insurance status, or immigration status.
The Chicago Department of Public Health will also offer assistance to other health organizations to increase their capacities to provide telemedicine services during the COVID-19 pandemic crisis.
Mental health resources during the pandemic
- The National Alliance on Mental Illness (NAMI) offers a helpline with mental health advice. Call 311 or directly at 833-626-4244. A resource guide in Spanish is available at https://www.nami.org/Support-Education/NAMI-HelpLine/COVID-19-Information-and-Resources/COVID-19-Guide.pdf
- Call 312-747-1020 for free telehealth therapy services from the Chicago Department of Health mental health centers
- Text HOME to the 741741. This service is available 24-hours a day.
- For more information on Covid-19 in Chicago, visit chicago.gov/coronavirus.
The ‘Lens On Lightfoot’ project is a collaboration of seven Chicago newsrooms examining the Mayor Lori Lightfoot’s administration. Partners are the BGA, Block Club Chicago, Chalkbeat Chicago, The Chicago Reporter, The Daily Line, La Raza and The TRiiBE. It is managed by the Institute for Nonprofit News.