Chicago Needs Treatment not Trauma

Lindsey Bailey

A Chicago social worker explains how the mental health crisis response system put forward by the “Treatment not Trauma” plan is a crucial step toward permanently improving the fabric of Chicago’s public health and public safety independent of the police.

A robust, publicly funded mental health crisis response system, independent from the police, is a critical first step towards establishing a robust, public mental health care system for Chicagoans. 

With this year’s budget, we have the option to create such a program through the Treatment Not Trauma plan. The proposal calls for the development of a 24-hour crisis line that provides residents an option to request support from a non-police mental health response team, staffed by clinicians and paramedics. This system will be based out of the Chicago Department of Public Health and will connect residents to one of the city’s five mental health clinics. This will provide immediate access to care and allow Chicagoans to avoid harmful, traumatizing, and sometimes deadly police interactions. 

For the past six years, I have been a clinical social worker providing free, long term, trauma-informed services primarily to uninsured and undocumented community members of the Southwest Side of Chicago. I have seen up close and personal the erosion of the public mental health care system here in Chicago and its disparate impact on Black and brown communities. At my last place of employment, the wait list time increased from 6 to 12 months in the months after the 2016 presidential election. As we find ourselves in a time of great anxiety and uncertainty—due to COVID-19, uprisings against police violence and political instability—the mental health crisis and lack of access to care for Black and brown Chicagoans is more urgent than ever. According to a 2018 report by the Collaborative for Community Wellness, there are just 0.17 clinicians per 1,000 residents in the Southwest Side.

Mental health care is a human right. Every Chicagoan deserves access to high quality, free services when experiencing a mental health crisis and needs access to reliable and consistent mental health care options on a long term basis. 

Recently, a social work colleague called me at 9pm. He was trying to support a community member whose daughter was having a mental health crisis. This family did not feel safe calling the police for fear that that police would escalate the situation and put their daughter and family in more danger. This family needed the compassion, expertise, and deescalation skills of a mental health professional as well as a free, high quality outpatient mental health service provider to support their daughter’s ongoing mental health needs after the crisis subsided. 

Nearly one in four people killed by police involve an individual with a mental illness. According to a WBEZ analysis of 911 calls, dispatchers received around 150 mental health calls per day—that’s nearly 55,000 calls from people seeking mental health support per year. Meanwhile, research shows that one-third to two-thirds of 911 calls could be handled without police officers. Here in Chicago, we can look to the case of Quintonio Legrier and Bettie Jones, as well as that of Charles Soji Thomas, to see the tragic consequences of a police response to mental health issues. Whatever you think about the police, it should be obvious to everyday residents—and especially us mental health professionals—that responders should be those whose entire profession focuses on how to handle these situations.  We need an alternate number for people to call, and we need trained mental health professionals ready to care with compassion and use crisis intervention and deescalation skills to support community residents in need.

Other cities across the country are charting the path for us—from New York City, to Albuquerque to San Francisco. And for those concerned that a non-police response would somehow be “dangerous” for mental health professionals, we can look at data from the CAHOOTS mental health response program in Eugene, Oregon, which has been operating for over thirty years. In 2019, only 150 of the approx. 24,000 calls that CAHOOTS responded to—or less than 1 percent—actually needed police back-up. Additionally, legally police presence is required at incidents that require involuntary hospitalizations, so even that 1 percent is not necessarily an indication of perceived danger. As a mental health professional, I am not fearful of community members experiencing mental health emergencies and know that what they need is care, support and resources. 

The privatization of these critical services creates great instability for employees, organizations, and community residents desperately in need of support. Non-profit agencies sustain themselves on unstable grant funding, lack robust public oversight and accountability systems, and provide poor salaries and benefits that lead to high employee turnover. According to a Bureau of Labor Statistics analysis, hourly wages are $10 lower in the nonprofit sector than similar work in the local government. This is why we are calling for a publicly funded response system and infrastructure in the city of Chicago. 

I know so many talented and passionate clinicians, especially clinicians of color, who pursued a degree to serve their communities. Yet after graduation, they are left choosing between doing what they love or making a sustainable wage. Many clinicians can only afford to stay working within community-based organizations until they get their clinical license, at which point they are often forced to join private practices to earn a living wage by depending on insurance billing rather than offering services for free to the uninsured and underinsured. 

The Treatment not Trauma plan and the jobs it will create for social workers both through the crisis response system and the publicly funded mental health clinics are exactly what we signed up to do when we chose to become mental health professionals.

As social workers, we abide by a strong and specific code of ethics which is based on the values our profession holds near and dear, the values of service, social justice, dignity and worth of a person, importance of human relationships, integrity, and competence. The Treatment not Trauma plan and the jobs it will create for social workers both through the crisis response system and the publicly funded mental health clinics are exactly what we signed up to do when we chose to become mental health professionals. 

The city needs to re-invest into a mental health delivery model that is responsive to the needs, values, cultures and strengths of communities across the whole city. We need to ensure that Chicago residents actually get the help and resources they need instead of the all too often drop off at a local emergency room or a phone number to a local organization that is overburdened and under-resourced in the best of cases. In the worst of cases we know people in a mental health crisis often end up getting locked up, hurt, or killed in their moment of most need. This is why I believe having a publicly funded mental health crisis response system that feeds into a robust and well-funded network of public mental health clinics run by the Chicago Department of Public Health is needed. Chicago must embed free, high quality mental health care into its fabric of public health and public safety. This will provide more opportunities for clinicians who wish to work in community mental health to be able to do so while earning a living wage. 

I am calling on mental health providers to sign this petition and join me in fiercely advocating for Treatment not Trauma in this year’s budget. 

Together, let’s declare that:

  1. Mental health care is a human right. 
  2. Chicago needs a publicly funded mental health crisis response system without police involvement.
  3. Chicago needs a robust, publicly funded network of mental health clinics to ensure equitable access to counseling services.  
  4. Mental health professionals should have access to well-paid, quality public sector employment while providing high quality services to communities across Chicago. 

It’s time to do what is right and build our city’s mental health care infrastructure. Chicagoans deserve to have reliable and accessible services that support them, their families and communities.

Lindsey Bailey is a clinical social worker who lives in the 16th ward. She provides social work consulting services through ReStorying Consulting Cooperative and is a co-founder of Centro Sanar, a local mental health program offering free services located in the Back of the Yards neighborhood.