Social worker Jonathan Foiles has written about Chicago’s fractured mental health system before. In a January 2018 report for Belt Magazine on the current state of the city’s mental health, he included an intimate story about a client named Anthony who’d lost his son to gun violence on the city’s west side. Using Anthony as an example, Foiles addressed the inadequacy of the city’s mental health system in treating similar clients. That story, however, was just grazing the surface.

Now Foiles, who works at Mount Sinai Hospital in Douglas Park, is digging deeper. In his book, This City Is Killing Me: Community Trauma and Toxic Stress in Urban America, published by Belt Publishing, he seeks to highlight how larger traumas within a community—things like unemployment, poverty, lack of affordable housing, violence—as well as historical factors (Jim Crow laws, redlining, displacement) can have a toxic impact that makes it harder for people within those neighborhoods to thrive.

These issues are covered regularly in the media. Gun violence on the south side, for example, is frequently reported on, with outlets like the Chicago Sun-Times publishing weekly articles on how many shootings or killings occurred over the weekend. But Foiles says the mental impact of these traumatic events remains incomprehensible beyond numbers.

In his book, Foiles puts faces to these issues. “As humans, we thrive on stories,” he says. “So to really illustrate how policy in Chicago affects all people, it’s important to look beyond statistics.”

This City Is Killing Me highlights five of Foiles’s clients’ stories (their names and any identifying details have been changed for confidentiality), all with different experiences that address flaws within Chicago’s public systems, including Illinois’s Department of Child and Family Services (DCFS), the Chicago Housing Authority, and Chicago Public Schools.

Jaqueline, for example, is a transgender woman of color diagnosed with borderline personality disorder. Her life was put at risk when in 2012 Rahm Emanuel shut down the mental health clinic she was attending, along with another five throughout the city. Other patients include Frida, a traumatized child turned traumatized mother whose children were taken away by DCFS, and Robert, a boy who endured severe trauma in the Cabrini-Green projects and then created a narrative for himself in which he believes he’s an African prince in exile to cope with reality. Foiles also tells the story of David, who failed out of selective enrollment high schools and lived impoverished among his textbooks, and Anthony, the subject of the Belt Magazine story that inspired the book.

Despite undergoing individual treatment with Foiles, these patients remained in a cycle of depression and toxic stress because they lived in neighborhoods that are plagued by violence; had few supportive community resources such as after-school tutoring programs, affordable housing, and workplace development programs; and regularly experienced chronic disinvestment from the city. “I can do my best work as a therapist to help someone improve,” writes Foiles in the book’s introduction. “But there is only so much that can be accomplished in individual therapy before we run up against the structures that continue to perpetuate suffering.”

Even if resources like workplace development programs are created, Foiles says, they are not the solution. These programs certainly help, but the issue remains rooted in systematic disinvestment, meaning there just aren’t enough jobs located within these neighborhoods that pay a living wage. Then there’s the issue of employers not hiring people who were once incarcerated which, again, continues to uphold this cycle of poverty and mass incarceration.

“We need to think bigger to create a framework that addresses these issues and how they continue to affect people and communities of color,” he says.

Foiles is aware that fixing the system won’t be easy. His book is not an attempt to solve any of these issues, nor is it an effort to make you feel sorry for his clients. “Rather, I want you to see them,” he writes, “to be forced to confront the impact that policy decisions have upon the lives of our city’s poorest residents.”   v