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Brave Words

Mental health patients and providers fight their fears to speak up against budget cuts.

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It's commencement day at the Moody Bible Institute, and the front steps outside Culbertson Hall look like a flea market. Furniture, bags of clothing, luggage, and boxes are strewn about in a maze of piles through which students mad-dash between Wells Street and the hall, where an information desk is surrounded by other students asking God knows what. Taped to the wall next to a plaque marking a spot near the spot where Dwight Moody decided to establish the school is the cardboard sign "Convention 2002," with an arrow. The convention is in Alumni Auditorium, a plain white room in which every seat comes with a foldout desk and a Bible. About 80 of the seats are occupied by the conventioneers, a group of conservatively dressed people ranging in age from mid-20s to mid-70s, many wearing name labels and pins made from wooden ice cream spoons painted white, with decorative flowers glued under the inscription "Help Save our MHC." If a student looking for a hand to move a couch doesn't know the initials stand for "mental health centers," he might think this a convention of missionaries.

Volunteers climb the aisles to pass the collection basket for Moody, which has donated use of its auditorium to the Chicago Coalition to Save Our Mental Health Centers. Today's convention is only the second in the coalition's 11 years of existence--and the first to be attended by a health commissioner. That's Dr. John Wilhelm. Hands clasped on the table in front of him, he sits flanked by the convention's cochairs, Diane Plotkin and Kevin Birnbaum, as coalition board member Robert Koptik--who's a "consumer" studying to be a social worker--says a few words.

The history of the coalition, which Koptik calls "Chicago's original consumer empowerment movement," begins in 1990, the year after Richard M. Daley was elected mayor. At the time the city operated 19 mental health clinics and substance abuse centers that served over 16,000 patients, or "consumers." Daley closed the Chicago Addiction Treatment Center and farmed its services out to private companies. In 1991 fears that the city would close or privatize all its clinics and centers led a group of therapists and consumers to form the coalition, which fought Daley and then health commissioner Sheila Lyne throughout the 1990s.

The number of mental health clinics and centers has now dropped from 19 to 14 and the number of consumers to 6,000 (with no apparent decrease in the number of mentally ill people in Chicago). Again a rumor is going around that sometime soon all the clinics and centers will be closed.

Prior to the convention, Wilhelm assured coalition members that clinics would stay open. But Birnbaum says, "A verbal promise not to close the centers is not good enough. Once they're closed, they're gone." He invites the audience to approach the stage, where an elderly man in a yellow T-shirt holds a microphone. A line immediately begins to form. Because it's after two o'clock and the convention must end by four, each conventioneer will have just one minute to speak his or her piece.

Frank says he uses the Southwest Mental Health Center, urges the commissioner to keep the centers open, and is done in about 30 seconds. Natalya, who speaks with a heavy Russian accent, says that when the centers close, services will be provided "only to arrestees and welfare recipients." Kelly, an organizer of the convention, says cutbacks have reduced her therapy sessions to ten minutes. Her voice trembling, she says, "If we don't get the help we need there will be many more ill people on the streets, or dead."

Being a doctor, the commissioner is accustomed to listening to patients with a sympathetic demeanor. Some of the speakers tell short horror stories--of being cut off from necessary medications by private hospitals, of suffering from years of domestic abuse, of children being taken from them. Some speakers are frightened, all are emotional. The wife of a former patient says, "The River North Center has literally meant life or death to us," and begins to cry. Helen, a heavyset woman in a floral-print dress, says her clinic keeps her out of the hospital, which in turn keeps her dependent parents out of the hospital. Her mother follows with a prepared statement, seconding her daughter in a voice that pauses after every word. Another woman says sarcastically, "They're building Millennium Park, and if they close the centers we can go sleep in the park, I guess."

The speakers all talk to Wilhelm as they might to their own doctor, or at least to an ally. No one is confrontational until a social worker asks if censorship is departmental policy.

Wilhelm says he's confused. "No, censorship is not our policy, but I'm not sure of what you mean."

The social worker says he and his coworkers were told to stay away from the convention. "My superior told me that I can get fired for consumer advocacy." The volunteer holding the microphone asks Wilhelm, "Is that true?"

"I don't know," he answers mildly. "You'd have to ask the supervisor." Looking around the auditorium, he says, "It's unfortunate if staff believe they'll lose their jobs if they speak up. Much of the staff is unionized. But I only see three staff members here." He wonders why.

Someone shouts, "Because they're intimidated." Not by me, Wilhelm insists. "I'm surprised to find myself perceived as intimidating." Given his demeanor, this isn't a surprise. "I haven't fired anyone for speaking out. It's Saturday, and what you do on Saturday is your business."

The social worker asserts that threats kept staff attendance down here, but his minute is up.

A woman says she's no longer ashamed of her mental illness; a big man informs Wilhelm that he's taking his meds now; a therapist says, "We're making history today--consumers talking directly to the commissioner of public health without a layer of managers is unprecedented"; the volunteer holding the microphone booms, "We're tired of being the stepchildren of the health department!" Then Plotkin gives the floor to the commissioner.

Wilhelm says he's been keeping track of the number of people he's listened to (he thinks it was 26) and taking notes. He agrees that the centers are necessary. From the back of the hall, the former patient whose wife said he owed his life to the centers calls out, "Yer not a politician, yer a nice guy." Wilhelm replies that being commissioner requires him to be both a salesman and a politician. But he'll take the compliment.

The two major concerns he says he's heard from the audience are privatization and closing the centers. While the city will search for ways to "get both public and private sectors to work together," he wants to assure everyone that the city has no plans to close the 14 clinics and centers.

"Please don't put your energy into this rumor," he tells them. "As consumers, you know what this does to your anxiety levels. And for people who work in the system it's very stressful. People would lose their jobs, and that's stressful."

"People are losing their jobs," Kelly calls out.

Wilhelm doesn't argue, but points to a shortage of state funds. However, referring to the coalition's campaigns, he says he believes "your voices were heard in Springfield," and insists "we're going to be here and work to improve mental health across the city."

Two women have brought proposals. Elaine suggests creating an advisory board made up of consumers and current and retired staff to meet with Wilhelm on Bureau of Mental Health policies. Kelly proposes a liquor tax specifically targeted to raising money for mental health centers. Over the past few years the city has spent twice as much on street planters as it has on mental health, she says. The conventioneers know their place in the pecking order. They may be mentally ill, but they're not crazy.

Both proposals pass by voice vote, and the convention comes to a close. As her mother waits in her seat, Helen stands at the door passing out petitions. The consumers file out into the continuing madness of commencement day at the Moody Bible Institute, where each could be mistaken for a missionary or anybody else out for a walk on Wells Street.

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