Chicago will spend next year what City Hall characterizes as an unprecedented amount of money to support mental health care — about $86 million.
But some activists say the battle won’t be over until all mental health clinics closed in 2012 under former mayor Rahm Emanuel are reopened.
Every budget season, the question is asked: Why is the city spending so much money on the police, when public health is under pressure?
The most recent cycle was no different, as participants in city-wide budget forums continued to push Mayor Lori Lighfoot’s budget team on the issue.
For many supporters of the cause, the issue of mental health goes hand in hand with violence prevention, addressing the trauma of gun violence and excessive policing. Two years of pandemic have put even more pressure on the city to invest in mental health.
So when Chicago benefited from nearly $2 billion in federal coronavirus aid under the American Rescue Plan (ARP), many activists and progressive councilors thought the city should spend it on mental health — specifically, reopening the clinics.
“We need treatment, not trauma, and investment in ARP funds to reopen closed mental health clinics to provide the follow-up care needed for crisis response,” Elena Gormley, a social worker, said at a news conference this summer with members of the City Council’s Progressive Caucus.
But from day one, Health Commissioner Dr. Allison Arwady made her position clear: the city can invest in mental health without reopening the community clinics. It was an issue that nearly wavered her confirmation hearing at the start of Lightfoot’s term, who hired her to head the health department in 2019.
More recently, during a Facebook Live Q&A with the public, Arwady and her behavioral health deputy Matt Richards explained why opening the clinics isn’t the savior that activists make out — while also agreeing that the city isn’t everything. has done what it could do to support mental health.
“I don’t think it’s a secret to anyone that we don’t have enough mental health services,” Arwady said. “And we haven’t really had a good system to coordinate all the places where people can get mental health care.”
But she didn’t say it’s wise to reopen the clinics. She even argued that it’s counterproductive to meet the mental health needs of the city’s most vulnerable, who may be better served with ongoing outreach.
“To me it’s kind of like clinics and — it’s that we’re interested in increasing and expanding access to outpatient mental health,” Arwady said. “But it’s about lowering the threshold for everyone, not just thinking about the people who can make an outpatient appointment.”
Richards said the city is capable of treating 26,000 people under its community-based strategy, one that consists largely of outreach versus a “if you build it, they will come” mentality. By comparison, 3,600 people were treated when Arwady took over, he said. Those numbers still represent a fraction of the city’s roughly 2.7 million residents.
When Emanuel closed nearly half of the city’s clinics in his first budget plan as mayor, bringing the total to seven, he proposed it as a way to save money without compromising the quality of care. According to its 2012 budget plan, CDPH clinics served 29,000 unique patients during 84,000 visits at a cost of $314 per visit.
Emanuel’s team predicted that community clinics, or federally qualified health centers, would help the same patients for less. In the years that followed, the city’s health department led by Emanuel continued to find ways to leverage those partnerships.
A CDPH spokesperson said reopening the closed clinics would cost the city about $15 million a year.
Lightfoot’s budget of nearly $17 billion for 2022 — approved by city council last week — makes substantial mental health commitments, including 29 new positions created for behavioral health services and outreach. And all positions will be funded with city tax dollars, meaning the positions could become permanent after federal COVID-19 aid dollars run out.
That alone was enough to get several Progressive Caucus members to support the budget.
“It’s the largest investment I’ve made in mental health clinics in more than a decade, and the leaders and people in the field I’ve worked with understood how meaningful it was,” Ald said. Rossana Rodriguez Sanchez, 33rd Ward, after the budget vote.
Rodriguez Sanchez, a self-proclaimed Democratic Socialist, is one of the freshmen aldermen campaigning for the clinics to reopen, and she has continued to push the government on this issue.
She disagrees with Arwady’s view that you can invest in mental health without reopening clinics, calling that an example of “neoliberal policies” promoted by Emanuel that relies on outsourcing social services to agencies and local non-governmental organizations. profit organizations.
“I think every community needs a public mental health clinic,” said Rodriguez Sanchez, adding that the battle will continue until those clinics reopen.
But for now she takes the win.
Claudia Morell is a WBEZ subway reporter. follow her @claudiamorell.