brian bean: While there has been a lot of discussion and debate about this year’s budget, one of the clear wins was the securing of $2.1 million per year from the city’s corporate fund to go to new permanent positions for the city’s public mental health clinics. What is the significance of this win for the mental health movement?
Arturo Carrillo: This year’s budget introduced by the mayor did not include any money for public mental health services. Lightfoot’s office proposed 20 million dollars over three years to fund the public sector by way of subcontracting mental health services to existing private providers. It was really clear that their intention was to essentially take credit for infrastructure that already exists by funding federally qualified health centers, community mental health organizations, and community-based organizations that do mental health services. This was their way of saying that they were going to increase service provision.
But it was not clear that they would be adding much more capacity or serving new people needing access based on how they report on numbers served from these agencies. So we saw an opportunity, for the first time since the clinic closures under Rahm, to push for sustained funding for the public mental health clinics that we know are underfunded and honestly kept out of the public’s view.
Building on victories from previous years, we hoped to take half of the money that was going to be allocated to the private providers and dedicate that to rebuilding the public mental health system that has been decimated over so many years. Our call was to reopen public mental health centers in this budget cycle. Unfortunately, that was not something that we were able to win in this year’s campaign, but we were able to have twenty-seven aldermen sign on to a budget amendment that was introduced by Alderwoman Rossana Rodriguez-Sanchez and Alderwoman Sophia King to funnel funding to re-establish the public mental health centers.
What that led to was a concession on behalf of the mayor’s office to establish additional funding that would increase the capacity of the five public mental health centers that currently exist. This is a tangible victory that really makes a significant impact in making sure that the five clinics in operation can be a true resource to community residents. Those clinics are limited by staff capacity to only operate between the hours of 8:30 a.m. and 4:30 p.m. We know that most working-class individuals will only be able to access services after work hours, and that’s when these public mental health centers currently are closed. So through this victory we are able to increase hours of operation for the public mental health centers, and my understanding is that the expanded evening hours will run to 8:30 p.m. at the five centers.
Another limitation that has been allowed throughout all the years is that they don’t provide mental health services to children and adolescents. With the additional capacity we will be able to find ways of partnering with public schools and be able to offer more services for children and adolescents.
The organizing, as you have alluded to, is connected to the now almost ten-year-long struggle since Rahm Emanuel closed the majority of the public mental health clinics. Can you provide more of a backdrop as to how the organizing around this budget relates to the neoliberal attack on health care generally and to the historical organizing to repair the damage that Rahm inflicted and that Lightfoot has done nothing about?
The Collaborative for Community Wellness has worked with many of the trailblazers and the organizers who were part of the Mental Health Movement and STOP Chicago who challenged the closure of the public mental health clinics, both during the Daley administration and the Emanuel administration. As a coalition, we have sought to strengthen and support the efforts to reestablish public mental health that has been decimated by neoliberal policies. We know that the neoliberal doctrine is to privatize public-sector goods and to put them in the hands of operators that are not accountable to the general public.
As you know, the public mental health clinics that were closed remain so, and our position stands that they are a vital part of the public safety net for mental health access that is no longer available to many communities of high need. There is an enormous disparity when it comes to access to care in low-income communities of color throughout the city. Our research has shown that affluent, high-income areas of Chicago have an average of 4.3 therapists per 1,000 community residents, while in other parts of the city, where 79 percent of the population lives, there are only 0.2 therapists per 1,000 community residents.
That data clearly identifies the disparities in access to care. The communities that I’m talking about are the very same communities where those public mental health clinics have been closed. So through this campaign we’ve really sought to bring attention to why the public sector matters as far as providing mental services in areas of high need in order to give people true options.
Secondly, the fight against privatization, throughout many campaigns in the city, is against the decimation of the public-sector workforce. The city of Chicago has prioritized policing as the main public-sector “service” that it provides to all of its residents. The city employs nearly 14,000 police officers and only 20 therapists. That gets to the core of our campaign.
By building up a public workforce that can provide free services to community residents in all parts of the city, we can also build up a workforce of well-paid clinicians that can be part of the community fabric of every neighborhood in Chicago. As you pointed out, Mayor Lightfoot ran on a campaign promise to invest at least $25 million to reestablish the public mental health centers and has not done so at all.
This concession that we were able to pry out of her hands was the first time that she invested in expanding any funding for public mental health clinics. A key part of this victory was that the $2 million investment is coming from the corporate fund. While the current public mental health centers are mostly funded by federal block grants, we now can finally point to a real investment from our corporate general tax revenue to make the public mental health centers sustainable. We will continue to work to ensure that we can reverse this trend and to reopen public mental health centers here in Chicago.
The Treatment Not Trauma campaign was a centerpiece of the Collaborative’s work and a major fight in City Hall last budget cycle. Last year, City Council allotted a small pilot program. Can talk a little bit about Treatment Not Trauma one year in, connected to this budget, and what do you see as the way ahead?
Last year, we were told that public investment in the public mental health centers was a non-starter, so for us we really intentionally wanted to see where and how our influence could be best felt, and were looking to find ways of responding to crises in Chicago’s communities without the involvement of police. A non-police crisis response was, again, something that the mayor was not considering whatsoever. That small victory of the pilot program allowed us the opportunity to push forward this current year and see how the city was misusing federal relief dollars. Instead of rebuilding investment in structural reforms, they were using it as giveaways to police and banks.
We saw this as an opportunity for us to finally call out the fact that the money is on the table to invest in public mental health services, and if the city chooses not to act, it’s a political choice. Our effort this year was really tied to these federal relief dollars. It was really tied to the mismanagement by the mayor, who had exclusive authority to use CARES funds last year and chose not to invest in public mental health services. This time we aimed to hold the aldermen accountable for that decision to invest in public mental health services.
So for us, we see this as an incremental gain. It’s not the victory we were calling for. It’s not the victory we need in this city. But, for the first time, there’s been substantial expansion of capacity at the five public mental health clinics that exist, and we can’t discredit that.
And again, we will continue to fight for more.
What about Treatment Not Trauma? Is that ongoing or is there room for expansion beyond the limited pilot program, and work to get a non-law enforcement crisis response in Chicago?
Unfortunately, the way policy is defined and determined here in the city is by appointed representatives of the nonprofit sector that maintain close alliances with the mayor’s office, and they define the parameters and the programming that is established. They have been really committed to establishing the co-responder model [where mental health professionals respond to crises along with police] as the main crisis response system in the city of Chicago. I’m talking about the Chicago Council for Mental Health Equity. So without community input, without residents of Chicago being fully engaged in the process of planning, our coalition has had to act as a counterweight to what the Chicago Council for Mental Health Equity has continued to push forward in their agenda of linking crisis response to the nonprofit sector and the carceral state.
Establishing the crisis response as a non-police element of the City of Chicago is something that we are committed to doing as a coalition, and we have received support at the state level with the passage of Community Emergency Services Support Act (CESSA), which explicitly calls for non-police crisis response. But in order for that to be implemented in the way that it’s intended, it will take political pressure and for us community-based organizers to bring providers, social service allies, and community advocates to the table. That’s the only way we’re going to counteract the force of the Chicago Council for Mental Health Equity and some of the aldermen who believe that police involvement needs to be part of crisis response.
Unfortunately, nationwide, there is a tension between crisis response advocates who call for non-police crisis response and those who are fully committed to involving police in every aspect of social services. We want to really mark a line in the sand and say, “This is acceptable for communities, and this is not.” Our advocacy efforts want to prevent the incidents of violence that will happen when co-responder teams respond to crises. We’ve seen examples of that happen in other cities, and we want to prevent that from happening here in Chicago.
It sounds like the Treatment Not Trauma initiative is a little stalled because of how politics in the city plays out, and that it is going to take building more of that pressure and that movement to break out of the logjam. Connectedly, the Treatment Not Trauma initiative came so much to the fore because it came in the wake of a massive rebellion against anti-Black racism and police violence. That certainly changed some of the political dynamics.
Absolutely. Unfortunately, police involvement and police as part of social response to crises is very ingrained In the mentality of many of the alders in our city council, so proposing a clear alternative is something that absolutely needs to happen, and our community allies and people who are part of that movement have to be vocal on this issue. It will take community pressure in order to change the alders’ investment in police as crisis response.
So we’ve talked about the wins that came out of the last budget cycle that are real that we can build upon. At the same time, there’s the fact that in the same budget the Chicago Police Department got probably the largest single-year funding they’ve ever received. While we’ve talked about fighting around Defund and Treatment Not Trauma as a movement, how do we square that contradiction? What does that mean for our actions moving forward?
Our community voice has to be as strong as the voice of the Fraternal Order of Police. A lot of the increase, in my understanding, of this year’s police budget was tied to police contracts being renegotiated that allowed for retroactive pay increases for police officers.
Defund is a message that has to continue to be made loud by communities in order to provide support for our alders and ensure that there can be meaningful disinvestment in policing. We still have many, many vacant police positions.
For us, having investment from the corporate budget for the first time since the clinic closures and better staffing the public mental health centers was a meaningful change, but it’s only a start. We need so much more. So when we think about this contradiction of increasing investment for policing and also increasing investment for non-police solutions, it really is an open conflict of priorities.
If we don’t build the alternative, if we don’t develop the public infrastructure as a vehicle for crisis response and support that does not involve the police, then how do we call for disinvestment? We have to be able to point to concrete and tangible ways that Chicago’s residents will benefit from public investment in areas outside of policing.
So as a coalition, not only are we committed to ensuring that there will be investment, but we want to see that the public mental health centers that exist are successful. We want to increase the investment in community outreach that would be tied to the public mental health sector. To this date, the community mental health clinics do not have the community outreach workers committed to by this mayor in 2019. In this budget we are guaranteeing that those centers will now have fully funded community outreach. We want Chicagoans to be aware that the public mental health centers are a resource for them.
As a coalition we did a citywide survey asking residents what their mental health needs were. We found 94 percent of Chicago residents need mental health services. Ninety percent of those residents said that they would be interested in receiving public mental health services through the city-run public mental health system. However, 73 percent of the residents did not know that the city still operated public mental health centers that could provide free services. There has been a very intentional lack not only of investment but also of publicity of public mental health centers up until this budget year.
We have to build the alternatives to continue to invest in them and call for their scaling up as tangible solutions that can really benefit people and address community needs in opposition to policing.
So, there’s this contradiction you have alluded to of the city funding both alternatives and the police. This was largely made possible this year by the massive amount of federal money that came in. Even though the mental health money came from the corporate fund, the mayor could afford to throw cash at things because of the special circumstances of the COVID pandemic and its impact on national politics. At the same time, you are describing just how much of a fight it has been to block disinvestment, neglect, and abandonment and make the clinics work well for people as a way of forging alternatives. That’s a very tenuous circumstance. Going forward, what kind of movement do we need to change the game? What will it take?
I think we have to increase our expectations of what our government can address and what problems they’re able to solve. We are currently living through a very clear mental health crisis. As I mentioned, 94 percent of Chicagoans are interested in mental health services. I don’t think we could get 94 percent of Chicagoans to agree on much else.
But part of what we’re seeing is that the reliance on the private sector to address these issues is a neoliberal paradigm. It’s this idea that the private sector, the market, and the nonprofit sector can address the issues of society. That’s just not the case. We never in the past have sought out the private sector to explicitly solve all of our societal problems. We could look back to the Chicago fire as one prime example. The city took a look at itself and said, Wow, we need to invest in a public, citywide, formalized, centralized fire department to make sure this does not happen again. Our public dollars were spent to build the infrastructure, ensuring that every corner of the city can have coverage by a fire department so that we would not have a Chicago fire like we did one hundred years ago. That was also the moment that the city realized it also needed to invest in other public infrastructure as well. The public library system came in the wake of the Chicago fire.
What we’re seeing now is an opportunity to really explain to the public that mental-health services as a human right is achievable if we build the public infrastructure. The real fatal flaw of the mayor’s plan is that, as you’re pointing to, the federal dollars that are going to the private sector right now will expire in two years. After those two years of funding go away, the private sector is expected to maintain its own operations based on its own operating budget. It’s not going to receive any additional money, because those federal dollars will have been spent.
Now is the opportunity for us to really sell the public on why we should build permanent relief, permanent structures that are necessary to address these issues that we’re dealing with. This is something we can do if we get back to understanding that the role of government is to solve and address social needs. We had that system here in Chicago over two decades ago with nineteen public mental health centers throughout the city of Chicago.
We are inviting the public to help us envision what those public mental health centers can provide for our communities. This is our responsibility if we are looking to create a new reality.