My 2023 wish for Chicago is that we all talk more about mental health, every day, not just after a crisis. Mental health is health, and I don’t want people’s struggles with it to go unspoken.
That’s why under the leadership of Mayor Lori Lightfoot, the Chicago Department of Public Health (CDPH) has expanded access to mental health services to reach 15 times as many residents as in 2019.
While we expand access, we also need to continue changing the conversation around mental health — decreasing stigma and sharing information broadly when new resources are available.
Back in 2019, we took a hard look at our data. That year, approximately 3,600 Chicagoans received mental health treatment funded by CDPH, including across five city-operated mental health clinics. Zero of these residents were under the age of 18.
This was clearly not meeting the city’s needs, but the right answer was not as simple as opening additional clinics.
In a city of 2.7 million people with huge unmet mental health needs — including youth in crisis and people with needs that will never be met by outpatient clinics — serving, say, 6,000 residents or opening clinics was not thinking big enough. We decided to aim for 10 times that number: 60,000 Chicagoans receiving high-quality, no-barrier mental health care, regardless of insurance status, immigration status or ability to pay. More than that, we wanted to treat children, to integrate treatment for physical health and substance use and to bring treatment beyond traditional clinic walls.
In three short years, even during a pandemic, we’ve hit that ambitious goal. Last year, 60,000 Chicagoans received high-quality mental health treatment funded by CDPH, up from 3,600 in 2019. Some 15,000 of those treated were children, up from 0 in 2019. We have a long way to go, but I want every Chicagoan to know there are increased mental health services available in your neighborhood, right now, regardless of your income, insurance status or immigration status.
Since 2019, the mayor and City Council have increased our department’s mental health budget by sevenfold, from $12 million to $89 million, allowing us to double the number of city staff working in mental health and build capacity at trusted community sites. We invested heavily in our city-operated clinics, adding evening hours, language access, tele-health and pediatric clinicians. We also doubled down on a trauma-informed care model, which shifts the conversation from a “What’s wrong with you?” stigma-inducing framework to a “What happened to you?” empathy-inducing framework.
CDPH now funds a new network of 50 mental health clinical organizations, known collectively as Trauma-Informed Centers of Care (TICCs). TICCs include community mental health centers, federally qualified health centers and community-based organizations, along with CDPH’s directly operated mental health clinics. A publicly funded clinic in every one of our 77 neighborhoods is no longer a pipe dream.
And for the first time, Chicago has integrated mental health professionals into the city’s 911 response system though the Crisis Assistance Response and Engagement (CARE) program, which has successfully responded to its first 500 calls with no arrests. We will be expanding CARE teams in 2023 and creating alternative transport destinations for patients, like a new sobering center for those experiencing alcohol intoxication.
Chicago has also newly funded integrated primary care and behavioral health care across the homeless shelter system, seeing over 5,000 patients last year for a medical visit. In late 2023, we will launch a stabilization housing program in which those experiencing homelessness and untreated mental health and substance use concerns can live in their own unit while receiving health care on site.
Stigma still exists and our “Unspoken” campaign seeks to remind Chicagoans that dealing with a mental health challenge does not need to be a silent, internal struggle. Everyone can help by spreading the word about these new programs and resources, talking about their own mental health challenges without shame and having the courage to start the conversation with someone who may be struggling. A new nationwide number, 988, has launched for mental health crisis support. And our phased plan for 211 is on schedule, with the call center launching in early 2023, following the 2022 rollout of a website and database for food, housing and utility assistance.
Support is available citywide. To find the care you need, visit mentalhealth.chicago.gov, call 311, or call the CDPH mental health clinic intake line at 312-747-1020.
Allison Arwady, MD, is commissioner of the Chicago Department of Public Health.
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