Closing City of Chicago Mental Health Centers Will Cost Taxpayers More than Keeping them Open

Why close the Mental Health Centers now?  Cook County Hospital ER is already overrun with mental health patients, as is Cook County jail.  The police stations have mentally ill homeless people living in their lobbys.  Close half of the city's mental health centers and where do you think the uninsured mentally ill will end up?  In ERs, police stations and cook county jail - no doubt about it...doubling the numbers already there.

The state is currently about six months behind paying mental health providers who bill medicaid.  The mental health safety net is bursting at the seams and has massive holes in it now.  Add the stress of closing the City's Mental Health Centers and we will PAY DOUBLE the cost to keep them open with increased ER visits, jail costs, cost to CPD, etc..

This whole plan is one BIG MISTAKE. 

Ripple Effects of Center Closings Will Continue for Many Years

James Warren writes a column for The Chicago News Cooperative.

The cavalry may be on the way. But until it arrives, some of Chicago’s most at-risk citizens — many of whom were once productive members of the community — will be in greater jeopardy from what experts describe as a frequent nonsystem of care.

Expect more of those who are uninsured to be turned away from community centers, more desperate souls seeking shelter with their families, more children whose conditions go undiagnosed, more patients than John H. Stroger Jr. Hospital can deal with, more disturbed offenders shuttled off to Cook County Jail and more homeless people.

As budget cuts continue, the ripple effects will hit many: people with chronic mental illnesses whom we may avoid on the streets; and hidden cases, like the suburban mother whose depression is so strong she can’t work or care for her children.

The cavalry is President Obama’s health care reform law, which takes effect in 2014. It’s seen by advocates as a way to ensure equal access to quality mental health services. But its worthy aims can only be achieved if it survives court challenges and if state legislatures don’t undermine it when devising related regulations, according to nonpartisan experts like Harold Pollack at the University of Chicago’s School of Social Services Administration.

The help would come in the form of insurance for those often uninsured and incentives for providers who now often spurn the uninsured. But while the law’s full impact can’t be predicted, the Chicago area’s mental health landscape will deteriorate in the interim.

Should we expect continuing declines in government support and a worsening mess?
“Yes. Historically that’s been the pattern,” said Sara Feigenholtz, a state representative from Chicago who chairs the human services appropriations committee in the Illinois House.
The budget cuts affecting a traditionally weak mental health system show no sign of abating. Mental health will remain low on the priority lists of most legislators, and among the first items to be slashed.
Mental health gets about 6 percent of health care spending, according to The American Journal of Psychiatry. But the journal estimates staggering indirect costs of perhaps $200 billion a year nationally when one includes the impact of incarceration, homelessness, a high rate of medical complications, dependence on emergency room care, lower educational attainment, a reduced ability to hold jobs and the burden on families.
But the mentally ill don’t have an army of lobbyists and clout-heavy executives making hefty campaign contributions.
“In Illinois, mental health services have never been a serious political priority, as evidenced by the recent city and county cuts,” said Dr. Ronald Davidson, director of the mental health program at the University of Illinois at Chicago’s department of psychiatry. “And reform is at risk of being whittled away by 50 state legislatures, and that means a powerful insurance lobby in Springfield gets one more shot at limiting access to mental health services.”
When Illinois cut mental heath financing for the uninsured several years ago, hundreds of mentally ill people were told they could no longer get help at the five Community Counseling Centers of Chicago, said Dr. Anthony Kopera, president and chief executive officer.
Dr. Kopera runs those centers, employing 260 people with a $17 million budget. But he said the state is six months late with $3 million in payments to him for treating mentally ill patients.
“Now the unfunded don’t ask us for help,” he said. “They suffer until they go to the hospital emergency department, or their symptoms flare up and they get picked up by the police and taken to state hospitals.”
Mr. Pollack concedes there is immediate stress on a system whose configuration is based on old assumptions as to where the needy live. The suburbanization of poverty, as many exit Chicago, means the migration to Harvey, Calumet City, Hazel Crest and elsewhere aggravates the problem because our network of facilities is based on where they lived long ago.
And even if the street peddler confronting you is getting help from a city center that’s closing, said Mr. Pollack, he probably won’t have the wherewithal to switch to one that remains open.
His last-ditch options? Bridget Gainer, a Cook County commissioner, foresees unrealistic demands placed on the jail and Stroger Hospital, and quotes the poet Robert Frost.
“Home is the place where, when you have to go there, they have to take you in.”

jwarren@chicagonewscoop.org