Last year’s closing of six of the city’s twelve mental health clinics – for a reported savings of just $3 million – was “characterized by poor planning, mismanagement, inaccurate information, and profound insensitivity to clients,” according to a new report from the Mental Health Movement and AFSCME Council 31.
That meant a rocky transition for many clients, while the Chicago Department of Public Health seems to have lost track of as many as two thousand clients whose transition it had pledged to monitor.
According to the report, “Abandoning the Most Vulnerable,” the city listed 5,337 clients in October 2011 when the clinic closings were announced, but its report on the transition this July gave the total as 2,798.
Asked about this, the city told researchers that a March review found only 3,282 “active” cases. The difference includes clients who weren’t currently seeing a therapist but expected to be able to if necessary – and in any case, between March and July, nearly 500 clients “disappeared” entirely, according to the report.
One problem was that therapists who were being transferred from closing clinics weren’t informed of their new assignments until the very last minute, making it impossible to keep their clients in the loop, said Jo Patton of AFSCME.
The failure to monitor all the city’s clients “represents a signficant lapse at the top echelons” of CDPH, while “the attempt to cover up that failure by simply revising the total number of clients raises serious ethical concerns,” the report charges.
No comprehensive effort
“There was not a comprehensive effort to reach each client and provide them with the information they needed to continue to receive services,” according to the report.
Nor was the transition smooth – as shown by a spike in the rate of psychiatric hospitalizations of CDPH clients in April, the year of the closing. In that month, hospitalizations were nearly twice as high as the average over the previous year and a half.
There were other problems, according to the report. Two private agencies to which clients were referred closed their doors in the two months following the closings. Only 43 percent of clients transferred to private agencies were reported by CDPH as receiving services from them.
Meanwhile, with half of CDPH therapists laid off but 85 percent of clients continuing to attend the remaining clinics, caseloads and waiting times increased dramatically.
This all takes place at a time when national and state surveys have revealed increasing demand for mental health services and huge gaps in the capacity to provide services.
The report calls for reopening the six clinics closed in April and adequately staffing the remaining six clinics, rehiring African-American and bilingual therapists to ensure culturally competent care, and implementing an outreach program to let people in need know about CDPH services.
At a budget hearing held by the Progressive Caucus of the City Council in South Shore on Tuesday, mental health advocate Badonna Reingold said she’s “very, very concerned about a dramatic turnback of care for people with mental illness” on the part of the state and the city.
While the city has promised to provide care for people without insurance, it is only planning for 2,000 clients, she said, at a time when and increased unemployment and violence are certainly adding stress to the lives of many more people.
She called on the City Council’s health committee to hold a hearing and sponsor a full-scale needs assessment.
Margaret Sullivan of the Mental Health Movement criticized the aldermen for voting for last year’s budget after 28 council members signed a letter opposing the mental health cuts.