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Before the schools, Mayor Emanuel closed the clinics

Advocates fight for patients a year after Rahm shuttered mental health clinics across the city.



Amid the uproar over Mayor Rahm Emanuel's plan to close dozens of elementary schools, we shouldn't forget that it's been almost a year since the mayor closed six of the city's 12 mental health clinics.

In fact, activists from across the city are gearing up for another round of protests to mark the April 9 anniversary of the closings.

"They've been pimping us for years," says N'Dana Carter, a member of the Mental Health Movement, a citywide coalition. But "every once in a while even an old whore gets mad and fights back."

Will the fighters prevail? That is, will a relatively cloutless coalition of low-income patients and activists force the mayor to reopen the clinics?

If I were a betting man, I'd say the odds are against them. The harsh fact remains that the clinics serve a particularly vulnerable constituency that doesn't typically have access to the mayor: poor people with mental health issues.

That's what made them such a relatively easy target in the first place. There's nothing like kicking around some poor people to prove that you're making the tough decisions to fix the city.

At this point I should mention that the mayor—whose press office did not respond for comment—has a vastly different spin on the closings—any closings, though in this case I'm talking about the clinic closings.

He doesn't even call them closings, despite the fact that the clinics were closed. Instead, Mayor Emanuel calls them "consolidations."

Oh, read the city's press release yourself: "In 2012, the Chicago Department of Public health implemented a mental health reform plan to improve the quality of mental health services provided by the City. The reform plan focuses on serving the uninsured and strengthening the city-wide mental health system to better address the needs of all who depend on mental health services . . ."

In many ways the debate over the clinics mirrors the one raging over school closings. The mayor says patient visits to clinics have been falling steadily over the last few years, in part because the population in neighborhoods like Woodlawn has been dropping. He says we can actually do more with less if we're just more efficient.

The activists counter that mental health services were inadequate to begin with. They believe the city's cooking the books to make it seem like patient visits are dramatically falling, thus making it easier to justify closing the clinics.

It's as though the language came from the same spinmeister's playbook: They're not cuts—it's reform.

The mayor says he saved an estimated $2.2 million with the closings. But as the activists point out, he doled out $500,000 to private mental health providers to help pick up the slack. So he really only saved $1.7 million—in a budget of more than $6 billion—while firing 33 employees. They were among 125 medical employees, most of them black or Hispanic, who got the ax in Mayor Emanuel's first budget.

And you wonder why even some of the aldermen most loyal to the mayor are warning him they can't carry his water much longer.

The mayor says the private providers will absorb the caseloads of the clinics he closed in Rogers Park, Logan Square, Woodlawn, Auburn-Gresham, Morgan Park, and Back of the Yards.

Still, while the shuttered clinics served everyone, some of the private firms only take insured patients—though most patients from the closed clinics have no insurance, which is why they went to the city's neighborhood mental health clinics in the first place.

Any way you look at it, many of the uninsured have to travel farther for treatment. So there are people who live in Beverly taking several buses to the clinic on 43rd and Cottage Grove because the mayor closed the clinic on 111th Street. Or residents of Humboldt Park who have to take several buses to the clinic on Peterson because the facility at Fullerton and Milwaukee has been padlocked. And people in Woodlawn—well, you get the idea.

As hard as it is to overcome the stigma of seeking help for mental health issues, the mayor just made it harder.

"You're telling people to take two or three buses out of their neighborhood to an unfamiliar clinic with a new therapist who has a big caseload," says Carter, the activist. "A lot of people just aren't going to do it."

According to therapists I talked to, the city's pressuring them to carry caseloads of as many as 100 patients, far more than the 20 to 30 common in private practice.

"If you're seeing 100 patients, you're basically seeing someone once a month," says Allan Scholom, a psychologist with a private practice. "It's like the old joke: 'Doctor, my mother's indifferent to me.' And the doctor says, 'Oh, I feel bad for you. See you next month.' It's ridiculous."

Carter sees the clinic closings as a precursor to the school closings. And she has a point—it's as though the language came from the same spinmeister's playbook: They're not cuts—it's reform. They're not closings, but consolidations. The mayor didn't end service—he expanded it. So he's not really hurting poor people—he's helping them.

As if it's such a big favor to make a sick person schlep across town to meet with a new therapist who may have dozens of other patients to pay attention to.

Truth be told, Mayor Emanuel's not the first to consider closing the clinics. That honor belongs to his predecessor, Mayor Richard M. Daley. As opposed to Mayor Richard J. Daley, who built most of the clinics and whose name remains on the dedication plaque in their lobbies.

In 2009, the second Mayor Daley proposed shutting down four clinics. But the mental health activists forced him to retreat by holding a demonstration in his office at around the time a delegation from the International Olympic Committee was in town to review the mayor's proposal for the 2016 games.

You know, I have to admit that the whole Olympics thing came in handy, if only as a crowbar to wedge concessions from the mayor.

The activists don't have any similar way to leverage Mayor Emanuel. As a mayoral candidate, he said he was going to cut the clinics. And so he did, as part of that now-infamous first budget, in which he jacked up water and sewer fees, cut library service, and fired a whole bunch of west- and south-siders.

As with so many other initiatives, the City Council passed the clinic closings without a hearing, study, or any other independent review of the mayor's claims.

Before the cuts were approved, the mental health activists rounded up 28 aldermen who said they'd stand by them. But when the vote came along, all 28 deserted the cause—a story we've heard many times before.

Mayor Emanuel wouldn't even meet with the activists, though they conducted a sit-in in the lobby of his City Hall office.

By the way, the Woodlawn clinic is a few blocks from the spot where six-month-old Jonylah Watkins was recently shot and killed while sitting on her father's lap on the front seat of his car.

"We should be adding service to deal with the trauma of violence in our communities," says Carter. "But we're going in the other direction."

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