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Thousands More Chicagoans Are Getting Mental Health Care, City’s Top Doc Says — But Critics Say More Must Be Done

The city expects to provide funding to at least one mental health clinic in each of Chicago’s 77 community areas by the end of the year, but relying on often-underfunded nonprofits to bear the brunt of the city's mental health needs is problematic, one alderperson said.

Dr. Allison Arwady, Commissioner, Chicago Department of Public Health, speaks at a press conference promoting COVID-19 vaccination in Chicago communities of color at City Hall on Nov. 16, 2021.
Colin Boyle/Block Club Chicago
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CHICAGO — Chicago is on track to provide nearly 60,000 residents with mental health services this year, up nearly 57,000 people from 2019, officials say.

The city has tried to provide more mental health resources for Chicagoans since the pandemic changed life for many — and it has made significant progress on that work, health Commissioner Dr. Allison Arwady said at a Wednesday event.

Arwady, who was being interviewed by reporter Monica Eng for the Axios event, said the city is working to provide funding to at least one mental health clinic in each of the 77 community areas by the end of the year.

“I am so proud of the progress that we’ve made in the behavioral health space,” Arwady said. “A lot of attention during COVID, of course, was on COVID for the public health department, but we’ve made just as much progress when we’re thinking about city approaches to mental health.”

City-run mental health services were drastically scaled back under Mayor Rahm Emanuel, who closed half the city’s 12 clinics in 2012. Four of the closed facilities were on the South Side.

Mayor Lori Lightfoot pledged during her 2019 campaign to spend $25 million to restore the clinics; but, after she was elected, she reversed course, opting to partner with neighborhood mental health organizations.

That plan has faced heavy criticism at times: Residents have repeatedly called for some of the clinics to be reopened, and Arwady’s confirmation to the Chicago Department of Public Health stalled because she sided with Lightfoot’s stance not to reopen the clinics.

But Arwady said Wednesday the city has seen a boost in people receiving its mental health services since 2019.

When the public health department announced Lightfoot’s Framework for Mental Health Equity in late 2019, the city was only providing outpatient mental health services to about 3,500 residents, Arwady said.

That framework, released just months before the start of the COVID-19 pandemic, included several goals helped by a $9.3 million increase that doubled its budget, including:

  • Funding 20 public and nonprofit health centers to expand care in high-need neighborhoods, regardless of patients’ ability to pay or insurance status.
  • Creating violence prevention programs to address mental health needs in communities most impacted by violence and poverty.
  • Investing in crisis prevention and response teams for people who have mental health challenges and have trouble accessing brick-and-mortar clinics.
  • 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 help.

Officials also wanted to serve tens of thousands more residents and fund community groups in neighborhoods, Arwady said.

The city is now working to provide mental health services to those who’ve been the victim of direct and indirect gun violence by making services more affordable to those most in need of it and moving care outside of clinics, Arwady said.

“We knew the biggest barriers here in Chicago, where people said, ‘I had mental health needs but they weren’t met,’ [are when] people didn’t know where to go or they were worried that they’d have to pay for them and wouldn’t be able to afford it,” Arwady said. 

Arwady also said the health department is embedding mental health professionals in 911 call centers for the first time so police aren’t the default to address mental health crises. It’s also collaborating with the police and fire departments, providing funding to bring mental health services to homeless shelters and building its trauma-informed care network, she said.

Workforce challenges and a limited number of mental health professionals make it difficult to provide more mental health care across the city, Arwady said. But she said she is proud of the investments the city has made.

“Those investments, even during the time of COVID, have already paid off significantly for Chicagoans,” Arwady said.

But as many struggle with mental health crises exacerbated by the pandemic, some have said the city needs to do more.

Ald. Rossana Rodriguez-Sanchez (33rd), who has pushed to reopen city-backed clinics, told WTTW in June that kind of care is necessary because city employees are paid better, have better benefits and job protections, and are less likely to burn out, better ensuring long-term care for patients.

Rodriguez-Sanchez said Thursday the city’s 2012 decision to close half its mental health clinics has led to an over-reliance on nonprofit clinics and delegate agencies, who’ve absorbed the workload from previously closed clinics.

“You are asking people with master’s degrees and who have gone through a rigorous process to license themselves to bear the brunt of the trauma, of this very highly segregated city with a huge violence problem, to just bear the brunt of that by delegating that work right to nonprofits,” Rodriguez-Sanchez said. “So what’s the alternative? The alternative is reopening and expanding the public mental health system of the city of Chicago.

“We have to make sure that the people who are delivering the services are being taken care of and are in are in the best state that they can possibly be in order to be able to deliver that service, because we know that that has a lot to do with rationing of services.”

Rodriguez-Sanchez also said questions remain about the quality of care Lightfoot’s program has provided to those 60,000 people.

“The Department of Health tells us we have been able to reach — the word is ‘reach,’ usually — we have been able to reach this amount of people,” Rodriguez-Sanchez said. “What does that mean? Does that mean that you had [60,000] therapy sessions? Or does that mean that you had ‘X’ amount of interactions of any kind, that you saw somebody at a fair and gave them a stress ball?

“What does that mean that you have contact with all of these people? Does that translate to continuity of care? Are people getting better? Were you able to solve like specific issues for people? I think that’s a really important question.”

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