Is It Time to Reopen Chicago’s Shuttered Mental Health Clinics?

As a candidate for mayor, Lori Lightfoot campaigned on a promise to reopen the six mental health clinics closed in 2012 by her predecessor, Mayor Rahm Emanuel. But her nominee for public health commissioner, Dr. Allison Arwady, may have other ideas to address mental illness – and it’s upsetting some members of City Council.

Last week, aldermen questioned Arwady’s stance on reopening those clinics, ultimately stalling her nomination. But that City Hall showdown begs the question: Is it time to reopen the six mental health clinics, or might there be a better approach to treating mental illnesses?    

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We asked two clinical social workers who are leaders in their field for their opinions about reopening those closed mental health clinics:

Alexa James is the executive director of the Chicago chapter of the National Alliance on Mental Illness who co-chaired Lightfoot’s Health and Human Services Transition Committee.

Arturo Carrillo is the program manager of St. Anthony Hospital Community Wellness Program, which provides free mental health care services to Chicago’s  Southwest and West side communities. 

Below, a Q&A with our guests.

Let’s start with what happened in City Council last week. When asked by aldermen whether she supported the reopening of the closed clinics, Dr. Allison Arwady said she didn’t think that was the best answer. Her nomination for public health commissioner has now been delayed. Where do you both stand on what happened there?

James: Allison is fantastic. She’s a great leader and would be a wonderful public health commissioner. She understands how mental health care needs to be holistic. What happened to her nomination in City Council is a travesty. Completely inappropriate of the aldermen to do this to her. 

Carrillo: The aldermen were absolutely right to stall her nomination. City Council is tasked with providing oversight of government, not just being a rubber stamp for the mayor. The aldermen wanted answers from Dr. Arwady about the future of the mental health clinics. She couldn’t provide those answers. She should come back when she has details about what approach her department and Mayor Lightfoot will take when it comes to mental health care.

Arturo Carrillo: Have you seen an increase in patients at your centers from areas with no clinics?

Carrillo: Yes. We run four centers in the city’s West and Southwest sides, and they’ve definitely been impacted by the closures. We’ve definitely had to take on more patients as a result.

Where do you both stand on whether the clinics should be reopened?

James: They shouldn’t be reopened. This is an outdated model for treating mental health issues. We need to put our resources towards more holistic approaches, like health centers that provide a multitude of services, from primary care to substance abuse. Mental health is primary care and should be treated that way. What makes people well is not always therapy. We also need to explore in-home programs, where a social worker might come by for a home visit.

Carrillo: Of course these clinics should be reopened. They’re an important part of the mental health landscape in Chicago.

City Hall argues that the five remaining mental health clinics aren’t operating at full capacity. Why should they open more?

Carrillo: People need access to clinics that are near them. Many people can’t travel across the city to get help. They’ll simply forgo treatment as a result. The city is currently not meeting its requirement to employ enough mental health professionals.

What about the strategy of providing mental health care that’s integrated into a medical office that offers many services, rather than a stand-alone mental health clinic?

James: I support that idea fully. This is how mental health care should be provided. People should be able to get various services at the same location.

Carrillo: We should be providing all of these options, including integrated clinics. It’s not an either/or situation. If we reopen the mental health clinics, that doesn’t mean we can’t offer mental health services in integrated primary care settings as well. But we have to reopen those clinics. If we don’t, I fear that mental health services will get watered down. If we go down the road of integrating mental health care into primary care clinics, I’m afraid mental health won’t get the necessary resources to employ enough therapists. Mental health needs to be a priority and I’m concerned that when you talk about including a mental health professional in a primary care office, then mental health is no longer the priority.

Follow Andrea Guthmann on Twitter @AndreaGuthmann

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