Chicago Department of Public Health – Chicago Newstips by Community Media Workshop Chicago Community Stories Mon, 08 Jan 2018 18:45:05 +0000 en-US hourly 1 Patients ‘disappeared’ in mental health closings Wed, 31 Oct 2012 23:17:59 +0000 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.

Needs assessment

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.

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Charge city ‘dumping’ mental health Tue, 06 Mar 2012 01:49:25 +0000 [UPDATED]  With six mental health clinics set to close next month, activists say the private community clinics that are supposed to take many city patients are already turning them away – one of many signs that the city’s claims of improving services and efficiency are a screen for an agenda of dumping mental health services entirely.

Mental Health Movement activists and workers from city mental health centers and public health clinics slated for closing will protest outside 13 threatened facilities at 4:30 p.m. on Tuesday, March 6. They’ll also be marching on three aldermanic offices (see below).

Big crowds are expected at the Northwest Mental Health Center, 2354 N. Milwaukee – one of two centers serving Latino populations, both of which are being shut down – and at the Woodlawn center, 6337 S. Woodlawn, where the Mental Health Movement has a strong base, and where the local alderman has promised to introduce a resolution calling for hearings on the closings.

Press conferences will be held at 5:15 p.m. at three clinics: Northwest (2354 N Milwaukee Ave.), Northtown/Rogers Park (1607 W Howard St.) and Auburn-Gresham (1140 W 79th St.).

“Private providers are turning people away,” said N’Dana Carter, who represents the MHM on a city health department committee overseeing clinic transitions.

She said the sole private community mental health service on the South Side, Community Mental Health Council, was not responding to calls for appointments from people referred by city clinics. She told of one woman who managed to get an appointment but was turned away when she came to the center at the scheduled time.

A staff person at CMHC said the center was accepting Medicaid patients and welcomes patients who’ve been pre-approved for Medicaid by the city.

Carter said that at a recent transition committee meeting, there was no discussion when a city clinic director reported on private providers turning away city clients. (A major topic of discussion at the meetings is who will get the furniture from facilities slated for closure, she said.)

Carter said she later put the issue directly to Deputy Commissioner Tony Beltran, who is overseeing the closings. According to Carter, he told her, “We can’t make the providers take anybody.”

“They talk about consolidation and improving services, but they’re just placating people to justify the fact that they don’t want to provide services any more,” said Darryl Gumm, chair of the Community Mental Health Board, which advises the department under a federal mandate.

“Mental health is something that can be dealt with – treatment works,” he emphasized, stressing its public safety value. “It should be as important as police and fire.”

South Side, Latinos losing services

Four of the six clinics slated for closing are on the South Side in areas designated as having a shortage of mental health services by the U.S. Department of Health and Human Services, according to a recent report from MHM. These communities need more – not fewer – services, the group says.

Also slated for closing are the two clinics serving predominantly Latino populations, the Northwest and Back of the Yards centers. Those centers serve areas with significant undocumented populations, who are far more likely to be without insurance – the segment the city claims it is focusing its resources on covering.

Most of the department’s Spanish-speaking therapists have been laid off, according to MHM. (All the department’s black male therapists have been laid off, the group says.)

Downward spiral

Other indications that the “consolidation” is less about improving services than shutting them down, according to the MHM:

While this year’s caseload reductions are projected at 20 percent, staff is being cut by 34 percent.

This perpetuates a long downward spiral of cutting staffing and services and then using resulting decreases in patients served to justify further cuts, the group says.

And past experience shows that more patients will fall through the cracks when they’re shifted to new clinics in unfamiliar neighborhoods.

The city is forgoing revenue that supports mental health services by sending Medicaid patients to private providers.

Meanwhile those providers, struggling with Medicaid cuts and late payments from the state, are steadily reducing the number of clients they serve – down nearly 20 percent from 2007 to 2011 statewide.

The city is setting aside $500,000 to fund psychiatric services by private providers at $150 an hour – after claiming for years that it was unable pay more than $80 an hour in order to fill its own psychiatric vacancies.

While the health department saves a net $1.5 million on the clinic closings, it’s increasing spending on three additional deputy commissioners, outside contracts, and advertising and surveys by close to $1.7 million.

Cost savings due to clinic closures are illusory, MHM argues. Taxpayer costs will be shifted to ER visits, hospitalizations, police calls, jails and homeless shelters as clinics are unavailable.

Just 150 additional psychiatric hospitalizations in the next year (with an average cost of $13,000, there were nearly 40,000 such hospitalizations in Chicago in 2010) will eat up all savings from the closings.

The city is focusing on existing patients while studies indicate a large and growing population that isn’t getting treatment, particularly among low-income residents.

Closed door

“What’s remarkable is the extent to which people who are directly affected by this, and who have first-hand experience with these issues, have tried and tried to get the ear of officials who are making decisions about things they don’t know anything about,” said MHM organizer Matt Ginsberg-Jaeckle.

“They’ve consistently shut the door to discussion,” he said. “It’s clear they’re just washing their hands of it.”

Mental health advocates first sought to meet with Mayor Emanuel while he was still a candidate for office, and got no response, Ginsberg-Jaeckle said.

In August, Health Commissioner Bechara Choucair backed out of a mental health town hall meeting hours before it was scheduled to take place.

In October MHM delivered 4,000 letters to Emanuel warning of the risks of closing the clinics and asking for a meeting. Mayoral staff promised to get back to them but never did, Ginsberg-Jaeckle said.

In November, MHM members sat in at Emanuel’s office calling for a meeting, and got no response. In January they crashed Emanuel’s announcement that he was restoring library hours, and he said he’d talk with them, according to Ginsberg-Jaeckle. Nothing came of that, either.

Lights out

In the City Council, health committee chair George Cardenas has promised hearings but backtracked several times, reportedly under pressure from the mayor’s office.

Ald. Willie Cochrane (20th), whose ward includes the Woodawn Mental Health Center, which is scheduled to close, and the Englewood clinic, which will receive patients from Woodlawn and Auburn Gresham, has promised to introduce a resolution calling for hearings on the closings, activists say.

On Tuesday evening, protestors will march on the offices of Ald. Joe Moreno (1st), Latasha Thomas (17th) and Joe Moore (49th), demanding they support the resolution. Thomas was among several aldermen who refused to talk with constituents about the clinics on their ward nights, Carter said. (Cardenas turned out the lights in his office when 28 constituents showed up, she said.)

Meanwhile, planning for the scheduled closings is slipshod and inadequate, Carter said. Therapists who are being reassigned haven’t been told where they’re going, and so their clients don’t know what to do. “People are afraid and confused,” she said.

Closing dates have changed several times since January. “They don’t have a plan, and we’ve put a spotlight on them so they can’t just push it through without a plan,” said Ginsberg-Jaeckle.

Although transportation assistance has been promised, details have changed regularly, Carter said. Now the city is talking about a couple months’ worth of bus passes, she said.

“If people need transportation now, they’re still going to need it in three months,” she said. “They’re just pushing people out of the system.”


UPDATE: MHM ally Southside Together Organizing for Power issued a statement on the cancellation of the G8 summit:

“The cancellation of the G8 summit comes as this city sits at a crossroads. Will we be a global city based on strong neighborhoods, robust public services, human rights and active public participation or a global city based on catering to corporations and hiding the poverty left in their wake?

“A good first step towards choosing the former path and putting people before profit would be to use a chunk of the $60-plus million raised by the city to cover the costs of the G8 summits to stop the closure of the 6 mental health clinics and the privatization of all seven of its neighborhood health centers and use the rest towards creating jobs, saving and improving schools and taking care of the people and communities that make up this city.

“STOP calls on Mayor Emanuel to immediately halt the closure of the mental health clinics and privatization of its neighborhood health centers as a first step in showcasing to the world the Chicago that the people demand and deserve. “

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