Chicago experiments with crisis response

Friday, December 23, 2022

By Josh McGhee

Today, we’re going in-depth with a MindSite News Original on Chicago’s CARE pilot program, which is evaluating alternative response models for mental health crises. We also hear about a Los Angeles mother who struggles to get help for her son, and the voices of people who have been involuntarily hospitalized in NYC.

Let’s get into it…

A look at Chicago’s CARE program – and the debate over the role of police in responding to mental health crises

Chicago’s CARE program debuted in September 2021 as the first attempt to integrate behavioral healthcare professionals into the city’s 911 response system. Currently, they’re testing two models through three teams: one that includes CIT officers and another that doesn’t. A third version, which also doesn’t include officers but adds a peer recovery specialist, is in the works. The inclusion of police officers on the teams has perturbed organizers around the city, who have been pushing to create a crisis response system that uses mental health workers instead of cops. Residents of three Chicago wards even voted in support of a non-police response in the recent election.

After reporting on the transition of the National Suicide Prevention Lifeline to 988 locally, I thought it was important to look at some of the crisis response options already available in the city. So at the beginning of November, I met with mental health crisis clinician Gabrielle Mitchell, a fellow South Sider and member of the multidisciplinary team, at the CARE team office just south of Downtown. We chatted about her typical day and I got a tour of the CARE van. (It’s basically just a bright blue van with a logo on it.)

So far, the team has responded to almost 500 calls for service with no arrests, according to their numbers. By all accounts, it appears the program is making inroads to meet a distinct need in communities that have been targeted for disinvestment from a mental health perspective. (In 2012, then-Mayor Rahm Emanuel closed six out of the city’s 12 clinics in low-income, high crime neighborhoods.) Yet, the existence of the pilot program raises some questions: Who asked for this program, and designed it this way? Hasn’t the involvement of police officers in mental health crises already been debated? Haven’t officers said they’d rather not be called into mental health crises? 

For community organizers in Chicago, the program is a manifestation of that frustrating feeling of being talked over. I first bumped into (I’m not sure of the virtual equivalent) Cosette Ayele at a Statewide Advisory Committee Meeting for CESSA, a new law requiring 911 to coordinate with mental health response service, in late November. While Illinois’ Open Meetings Act allows citizens to ask questions during the public comment section, no one has a responsibility to answer them. And like other public commenters that day, Ayele had a lot of questions, all of which went unanswered.

After the holidays, I called her up to learn more about her inquiries, frustrations, and Raheem, the advocacy group working to create alternative, community-run systems to help people experiencing crises, that she serves as organizing director. Her origin story reminds me of a lot of organizers: An injustice occurs close to them, it changes them, they journey towards a solution, and are met with silence by the powers that be. Emails and voicemails aren’t returned. Questions linger in the air as the Zoom app closes. Yet, they journey on.

“The city of Chicago has a history of prescribing solutions that residents didn’t ask for,” she told me.

That quote stuck with me. I don’t think it’s a misdiagnosis. Check out the full story here.

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In Los Angeles, a mother struggles with a byzantine system to try and get help for her son

Last week, The Los Angeles Time examined the failings of the mental health system through the lens of Deborah Smith and her son, who suffers from severe mental illness. 

Her son often goes missing and when he does, she starts her day on the sheriff’s inmate locator to see if he’s been jailed. It’s a sad ritual for mental health mothers, their only option for getting information since hospitals won’t tell you anything, she says. 

She’s watched her son grow from an attentive teenager to a delusional street dweller, who’s getting increasingly more violent. At best, the system would provide help and support to temporarily relieve the pressure of a mounting episode, but often they are met with resignation. While she’s grateful for the help she’s received from health care workers, she believes he needs long-term residential treatment – even if it has to be implemented involuntarily through the appointment of a conservator. But the system hasn’t helped her. 

“I want to conserve,” she says. “He’s not able to manage his own life. He’s erratic. We can’t control him. He doesn’t have a place to stay. He doesn’t eat.”

But, he’s not a danger to self and others, they reply. Smith believes the real reason health officials have refused to seek a conservatorship for him is their unwillingness to place him in one of a limited number of very expensive, acute-care facilities.

Read the full story here.

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And voices from New York City

In the wake of New York City Mayor Eric Adams’ new policy directing police and EMTs to force more people into hospitals for psych evaluations, Gothamist spoke to six people who had been hospitalized in recent years.

“They call it involuntary mental health treatment,” a 41-year-old man, who has been forcibly hospitalized twice this year, told the outlet.” But for me, it’s my head on the floor, my hands are cuffed. I’m chained to a bed in the middle of a room full of 50 people looking at me. That’s my reality. It’s not that I’m getting treatment.”

This story highlights not only the spectacle, but also the absurdity. A banker whose car was seized after a traffic violation went to the wrong precinct to retrieve her car and ended up at a Harlem hospital after police said she was emotionally disturbed. There, a doctor came up behind her and stuck a needle in her arm, she said.

She woke up a day later. No one in her family was contacted. The mayor’s directive, which empowers first responders to assess whether a person is not meeting their own “basic needs,” left her in tears.

“You can paint anybody to be anything when you’re a police officer,” she said. “A young Black girl can’t own a BMW, a young Black girl can’t be a banker.”

Stay warm until next time,

Josh McGhee

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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