Chicago Mayor Brandon Johnson this spring announced a sweeping change to the city’s mental health policy, promising to reopen public clinics that have been closed for more than a decade.
““Today, my administration is taking extraordinary steps to reverse course and expand our city’s mental health systems,” Johnson said in a speech in May. 30outside the Roseland Mental Health Center. “We stand here in the deep south to make it clear that we prioritize those who have been abandoned and neglected by previous administrations.
In addition to Roseland, the city plans to reopen two other public clinics, in the Pilsen and West Garfield Park neighborhoods. The move represents a triumph for a sustained movement of grassroots organizing and electoralism that prioritizes public goods over neoliberal privatization.
Chicago hasn't opened a public mental health center in three decades. 2012Former Mayor Rahm Emanuel closed half of the city’s 12 public clinics. Community groups strongly opposed the closures and called for their reopening under the banner of the mental health movement.
in 2019Emanuel's successor, Mayor Lori Lightfoot, campaigned on reopening the centers, but ultimately backed down in favor of the private sector, saying: ““There are a lot of different providers who have frankly done a better job.” In reality, many patients have fallen through the cracks, receiving worse care or not being able to get care at all.
Just as libraries cannot replace libraries, private clinics cannot replace public mental health care.
Research conducted by the Coalition for Community Health (CCW), a coalition of more than 70 Organizations that advocate for accessible mental health care found that when residents tried to contact private nonprofits to make appointments (the same nonprofits funded directly by the Chicago Department of Public Health), “Trauma-Informed Care Centers Model 17% did not serve unregistered residents and 25100% of these hospitals did not provide services to the uninsured. Fewer than half offered free services. Other callers reported barriers to receiving care, including long wait times, confusing phone systems, and high costs.
A 2023 Report from the AFSCME Council 31 I found that ““Cost is the biggest barrier to people who need treatment.” Less than half of the city-funded private agencies provide free services, while all of Chicago’s public mental health centers are free to city residents.
Previously, the Human Rights Commission has found that such burdens fall starkly along racial lines, with black and Latino communities facing gaps in access to care at a much higher rate than their white counterparts.
Just as libraries cannot replace libraries, private clinics cannot replace public mental health care.
after that 2020 Amid the uprisings for racial justice, a coalition of organizing groups across Chicago launched the “Heal Not Trauma” campaign to advocate for public mental health care and alternatives to police-based emergency response systems.
Now, Chicago is showing what is possible when neoliberal service delivery models are rejected for the public good.
As a mental health professional, I know from personal experience that access to healthcare is often a barrier to treatment. The need for more accessible healthcare is a universal need across Chicago.
Beyond the Center for the Prevention of Violence Against Women reports, research examining differences in working and treatment conditions between public centers and private nonprofits is scarce. It is important to remember that the working conditions of clinicians are the treatment conditions of clients, and what research does exist looks at the challenges faced by violence prevention workers and street-level workers—with recommendations for more sustainable funding, higher wages, and improved work-life balance.
in 2021Catherine Bocanegra, an assistant professor at the Jane Addams School of Social Work at the University of Illinois at Chicago, was inspired to conduct a comprehensive study of the working conditions of nonprofit violence prevention workers, driven by her own experiences working for a nonprofit agency. Relying on private agencies is bad not only for patients, but also for the dedicated clinicians who work for them.
Chicago’s nonprofits offer inconsistent or downright nightmarish working conditions, largely due to the lack of unions and a fragile funding structure—not to mention decades of the mental health profession’s embrace of an anti-union mentality that seeks to separate care workers from the rest of the working class. Private agencies in Chicago pay therapists up to $1,000 a month.20,000 less than they might earn in similar positions at Chicago Department of Public Health (CDPH) clinics (which are covered by a union contract with AFSCME), leading to high staff turnover and disruptions in the continuity of care.
Many of these private, nonprofit agencies receive public money to provide free or low-cost counseling services—including, for example, Chicago’s community counseling centers, which failed to pay workers on time throughout the crisis. 2019It was targeted by the Illinois Attorney General with an investigation into its finances, leading to the firing of the company's CEO.
Another nonprofit community mental health counseling center, Thresholds, engaged in such egregious union-busting behavior that it inspired 2023 City ordinance that prevents city-funded nonprofits from breaking up unions at taxpayer expense.
There's also Howard Brown Health, where workers won their first union contract in May — after two years of organizing and negotiating, facing mass layoffs and filing multiple charges of unfair labor practices.
Treatment Not Trauma has led community conversations across the city, encouraging current and former patients, caregivers, and workers to speak out. Through this organizing, we are working to build a mental health care system that focuses on care—not policing or coercion.
It is critical that we stand in solidarity with these workers and advocate for their rights, while also demanding that the hundreds of millions of public dollars CDPH spends in the nonprofit system be used to expand care in CDPH’s public centers, which are already unionized.
Public centers have also become more transparent. Contracts, budgets, and even emails between the administration and city leaders are available through Freedom of Information Act requests. But the same cannot be said of the vast network of nonprofit social service providers, and Chicago’s most vulnerable deserve basic transparency and accountability.
Dedicated community leaders and persistent organizing have helped make the new expansion of public mental health services in Chicago a reality. For more than a decade, community leaders have fought against divestment in public mental health, such as the occupation of the Woodlawn Mental Health Clinic, which closed in 2008. 2012.
Treatment Not Trauma has led community conversations across the city, encouraging current and former patients, caregivers, and workers to speak out. Through this organizing, we are working to build a mental health care system that focuses on care—not policing or coercion.
in 2022The campaign ran a successful non-binding referendum in Chicago. 6dh, 20Th and 33rd wards, where 93100% of voters supported the Treat Not Trauma vision for mental health care. That vision is beginning to become a reality.
Organizers through the organization Treat Not Trauma played a significant role in building support for Johnson's campaign during 2023 municipal elections, after promising to implement key policies. Since then, we have made great strides as the city has expanded. 911 Alternative response teams to dispatch social workers (instead of armed police officers) to assist with mental health crises. 2024 Budget includes $15.9 $1 million has been allocated to double non-police emergency response.
Conflicts over inadequate access to mental health services and dangerous police interference in mental health calls are not unique to Chicago.
The recent expansion also includes a significant increase, not seen in decades, in physician employment in the CDPH system. Under the previous health commissioner, the positions remained vacant; under Dr. Olusembo, who was appointed by Johnson, ““Simbo” Eiji, hiring continues, with over 20 New doctors have been brought in to work in the reopened centres.
We desperately need more street outreach workers, frontline workers who directly respond to shootings and intervene to prevent violence. The city’s current hiring portal is cumbersome and needs to be updated to allow workers with the most direct knowledge and understanding of community violence to do the work that can save lives—regardless of education level or conviction history, and at reasonable salaries and benefits.
Conflicts over inadequate access to mental health services and dangerous police interference in mental health calls are not unique to Chicago. In developing what Chicago’s policy should look like, leaders of the Treat Not Trauma organization, including 33City Councilwoman Rossana Rodriguez-Sanchez has toured programs in other cities, including Denver and Portland, Oregon. And because crises happen everywhere, focusing on alternatives to policing and investing in public mental health infrastructure could help provide a model for cities across the country. Philadelphia has its own “Treat Not Trauma” campaign that works to provide mobile crisis services, and even New York City—which is much larger and doesn’t have a progressive mayor—is working to expand non-police responses to some crises. 911 Calls.
There is no better way to combat grief, anxiety, and despair than to get the care we all deserve.
