The Mental Health Crisis in Chicago

In 2012 Chicago mayor Rahm Emanuel closed 6 of the 12 public mental healthcare facilities in the city. It was estimated at the time that around $3 million would be saved with this move, which came at a time of extreme fiscal insecurity. Today, the Chicago Tribune estimates that the city owes $33 billion dollars in pension pay and obligation bond debt. The Illinois Policy Organisation estimates the total city debt at $63 billion. 3 years after the closure of 50% of the city’s mental health facilities, serious questions are being raised over the efficiency of this move. The $3 million saving equates to far less than .1% of the city’s total debt, and has damaged the chances of thousands of individuals of getting adequate medical care for mental illness.

A recent Vice documentary estimates that around 30-40% of the inmates processed at Cook County Jail at 26^th/California are suffering from mental illness. Cook County sheriff Tom Dart notes that this makes the jail the largest mental healthcare provider in the state of Illinois. Why are we criminalizing the mentally ill in this way? A coherent mental health policy focused on treatment would surely reduce the number of crimes committed by the mentally ill, and eliminate the need for our jails and prisons to bear the burden of providing mental healthcare at a time when they too are strapped for cash. One of the most obvious reasons for this is that in passing the buck on mental health provision, the indebted city can shift the cost of treatment up to the county level, with Cook County taxpayers footing the bill rather than Chicago residents. With this highly political move, Emanuel can continue to push his low-tax policy in downtown, attracting business to the city.

But prison is far from the best place to treat a mentally ill population. For one, people do not get treatment until they have committed a crime. This leaves individuals suffering from deteriorating mental health without access to treatment. For someone suffering with a mental condition without access to health insurance or ObamaCare, the most likely end point is either in the prisons or on the streets. At this point in time, the city of Chicago is failing its mentally ill population.

And yet, despite these cuts to services and the handing off of much of the burden to the county level government, Chicago’s debt continues to increase. Emanuel’s policy has focused largely on austerity measures in the periphery of the city (leaving Downtown largely untouched by the cuts) and the increase of property taxes. However, there are other options. Roosevelt University professor Stephanie Farmer calls for the institution of a financial transaction tax on the city’s stock exchanges. This tax would be applied to financial exchanges on the stock market (currently Illinois’ most profitable economic sector) and encourage investor responsibility when trading by applying a cost to each transaction. This could cut the current unhindered ‘cowboy’ trading that was in large part responsible for the 2008 economic crisis by encouraging investors to be more sensible with their exchanges, and the Chicago Political Economy Group estimates it could raise $11-12 billion annually in Chicago alone, putting a much larger dent in the $63 billion debt than the £3 million saved by cutting mental health facilities.

As the city’s downtown continues to reach skyward and the periphery continues to descend into gang violence and disrepair we must begin to look for new ways of investing in the human capital that Chicago can offer. Chicago is not the Loop; it is 234 square miles and over 2.5 million people’s worth of largely underutilised resources. These people are worthy of investment, and in order to do so we must veer away from the current focus on finance capitalism that has facilitated the increasing inequality gap in the city. A 1% tax on each financial transaction that takes place in the city’s stock exchanges will be hardly felt by the million and billion dollar companies operating in downtown, but the loss of such a huge chunk of the city’s mental healthcare facilities has harmed, and will continue to harm, a significant section of the population that are being prevented from contributing to their communities by the incapacitating nature of mental illness and an inability to find treatment. Solving city level public health problems with mass incarceration at the county, state and national level is unsustainable. Cook County Jail is the largest prison complex in the US and the courtrooms at 26^th/California are overrun with minor cases. This strain on the criminal justice system breeds a mechanism that is neither morally just nor viable economically or socially. For Chicago to continue to grow it needs to invest in its citizens, and this in part can be achieved through providing help to those who need it most. The Emanuel administration has a duty to address these issues as it enters its second term.

The cutting of mental health services in the city is emblematic of Emanuel’s slash-and-burn approach to social services city-wide, with 54 Chicago public schools closing down on his watch and replaced by privately-owned charter schools. This wilful neglect of education and mental health provision may save money in the short-term, but it lays the groundwork for a full-scale crisis of humanity in the not-too-distant future. With a five-year high school graduation rate of only 69% in the 2013/14 school year (compared to the 80% national graduation rate) and an ever-expanding prison population, many Chicago residents are being set up for failure. Early intervention, better schooling and easier access to healthcare providers should be a starting point to mending the lives of an increasingly disenfranchised majority of Chicago citizens that reside outside of downtown. This is not a burden on the taxpayer, but an investment in the people that shaped, and continue to shape, one of the most vibrant cities on Earth.