Report: The Case Against Closing Mental-Health Clinics
And watch this accompanying video: “OUR LIVES ON THE LINE: Voices from Chicago’s Mental-Health Clinics.”
Report summary
Mayor Rahm Emanuel’s 2012 city budget will close six of 12 mental health clinics operated by the Chicago Department of Public Health that serve 5,300 city residents—most of them African-American (61%) or Latino (17%)—without regard to their ability to pay. These steep service cuts come even as public need for mental health services is growing.
While the city presents these reductions as a “consolidation” of services, an analysis of the CDPH budget, an assessment of need in Chicago and first-hand accounts from patients make clear the Emanuel closures are risky, ill-conceived, and riddled with hidden costs. Any closure of city MH clinics will disrupt services to thousands of patients, but the current headlong rush to closure is particularly ill-timed, poorly planned and dangerous.
The city’s claimed cost savings are tiny and illusory. CDPH claims closing clinics will save $2 million—barely 1% of its $169 million annual budget. And this claim ignores the budgetary, societal and human costs of inevitable disruptions in patient care—including increased emergency room visits, hospitalization, police intervention and incarceration.
CDPH should cut waste—including $1.67 million in new spending on upper management salaries, outside contracts, advertising and surveys. This amount should be used to sustain and improve city MH clinics.
CDPH would transfer at least 1,100 Medicaid patients to private providers—effectively giving away federal reimbursement for their services. If this plan is budget-driven, it is illogical to turn away patients with the ability to pay.
Closing six clinics will force 2,549 patients to travel to other city clinics or seek private care. There is no guarantee that private providers and hospitals will offer treatment regardless of ability to pay. The system’s more than 3,000 uninsured individuals are least likely to find private care since such providers already face shrinking budgets and reduced state funding.
CDPH is rushing to close clinics in just eight weeks—despite having six months of funding in the budget and nothing but an outline of a plan for patient care. CDPH has circulated a list of private providers, but admits it has no formal agreements with or information regarding capacity, services and wait times from these agencies.
