No one is certain how the rumor got started, but by mid-July word was that the Daley administration planned to close most, and perhaps all, of the city’s 18 community mental-health centers.
Critics charged that it was part of the mayor’s plan to privatize some city services in a desperate attempt to stave off a tax increase and maintain the support of conservative business leaders.
“They haven’t publicized their plans, but we know they’re there,” says Lena Raimondo, a volunteer at the city’s North River Mental Health Center in the North Park neighborhood. “We’ve heard it from enough people inside City Hall to know that we’re not being paranoid.”
Part of Raimondo’s concern stems from cuts earlier this summer in the mental-health budget, which have forced some centers to fire or transfer badly needed therapists. City officials blame the cuts on Governor Edgar, who has slashed health-care funding for the poor and lower middle class. And they adamantly deny all rumors about plans to close the mental- health centers.
“We are not–repeat, not closing the mental-health centers. We have no plans to do that, and we have never had any plans to do that,” says Tim Hadac, spokesman for the city’s Department of Health, which oversees the centers. “I don’t know where that rumor started, but frankly I’m tired of hearing it. It’s like an alligator-in-the-sewer story. Until you produce the alligator–until you produce some evidence that it exists–you ought to stop repeating the story.”
And yet the rumor persists. And centers across the city are preparing a campaign to force the city and state to increase the mental-health budget, to match its previous level.
“We understand that the state is cutting back, but we also feel that the city has not fought hard against those cuts,” says Frank Cavaini, another committed volunteer at North River. “They don’t seem to realize that proper mental-health care could help other health problems, like infant mortality or battered women. They just don’t seem on our side.”
Ironically the centers in question were built during the tenure of Mayor Richard J. Daley, the current mayor’s father. That was in the late 1960s, when the state was closing larger mental institutions and sending clients back to their homes.
“There was a large movement toward deinstitutionalization in the 1960s that had good and bad effects,” says Jim Fruehling, a professor of psychology at Northeastern Illinois University. “It led to the emergence of halfway houses, like we see in Uptown. But it also was linked to the philosophy of community-based health, which is what these centers are all about.”
All told, the city opened 18 mental-health centers, financed by a combination of state, federal, and local funds. The current budget is $14 million, down from $16 million. The centers are open to the public, providing outpatient service on a sliding scale (the wealthiest clients pay no more than $25 a visit). Altogether the centers see roughly 16,000 clients a year; the North River clinic (at 5801 N. Pulaski) has an open file of 900 cases.
“We deal with almost every aspect of the human condition,” says Raimondo. “We help clients who are alcoholics or who are depressed. A lot of times we are the last hope for a battered woman. We try to give her the help that will give her the confidence to finally leave her abusive husband.”
The North River center also counsels many of the senior citizens who live in a nearby complex.
“Seniors have special problems, like dealing with death or the despondency of aging,” says Eleanor Rapp, another volunteer at the center. “There’s also the problem of keeping your mind alert. We work on that as well.”
Like most centers, North River is staffed largely by therapists who have at least six years of undergraduate and postgraduate training combined. Most receive salaries in the neighborhood of $30,000.
“A therapist at our center will be asked to do what a private therapist with a downtown practice will do for twice the pay,” says Raimondo. “Maybe that’s part of the problem. Maybe after a while they’re taken for granted.”
In addition, the centers have to cope with a general bias against therapy. And there’s a tendency to think of mental-health services for the poor as a luxury taxpayers can’t afford.
“Let’s face it, there’s still a lot of prejudice against people who seek therapy,” says Raimondo. “A lot of people who need counseling won’t seek it, or they make fun of people who do. A lot of people have an attitude problem about therapy. They think you should be able to help yourself, that your problems aren’t real. We’re not a popular cause.”
Mayor Daley has never expressed such sentiments. But ever since the September 1989 publication of a controversial report, “Clinics in Crisis–A Report on the Conditions and Capacity of the Chicago Department of Health’s Clinic Facilities,” Raimondo and other mental-health activists have believed that the administration has been unfriendly to their cause.
That report, prepared by Board of Health president Whitney Addington and former health commissioner Richard Krieg, urged that the city consider consolidating some mental- and physical-health centers and privatizing others, including North River.
Addington and Krieg went on to caution against any program that would leave the poor with less health care. Hadac has dismissed the report as “only a discussion of possibilities.” But considering Daley’s plans to privatize other city services, like towing and preschool classes, the report seemed a warning to the health-care community.
“Privatizing mental-health centers won’t work, because no private agency can afford to do what we do,” says Raimondo. “We see hundreds of people each year who pay little or nothing. What will happen to them if a private clinic turns them down or cuts back their therapy?”
Some private insurers cap the amount they’ll pay for therapy or the number of visits; others won’t pay for therapy at all. And many of the clients at North River and other facilities are uninsured. “I think it would be medically unethical to force some of our clients out of treatment,” says Raimondo. “And that’s what would happen if we privatized. What bothers me is that the mayor did not publicly disassociate himself from this recommendation.”
Raimondo says that she attempted to arrange a meeting with Sister Sheila Lyne, commissioner of the Department of Health, throughout the spring and early summer. But Lyne didn’t return her calls. When the city announced in June that the state budget cuts would mean layoffs and transfers for the city’s community centers, Raimondo and others decided to protest openly.
They wrote up and printed a flier accusing Daley of hatching a plan to close the centers. In July, they went downtown to demand a meeting with the mayor.
“We wanted Daley to see our flier, but the policeman outside the mayor’s office told us Daley was on vacation,” says Raimondo. “We asked to see an aide. The cop said, ‘The mayor doesn’t have any aides.’ We said, ‘How about a secretary?’ He said, ‘The secretary types and doesn’t talk to anyone.’ Then he ushered us out of the office.”
The next day, however, Lyne called Raimondo. “She said she didn’t like us handing out propaganda,” says Raimondo. “And I asked why she hadn’t met with us. She said she had never seen our phone messages.”
A meeting was held on July 17 at North River between Lyne and about 40 mental-health activists.
“She was very insulting,” says Raimondo. “She kept blaming things on the state cuts. And we tried to impress upon her the importance of these centers.”
Lyne counters that the activists misunderstood what she was trying to say at the meeting, and that she does understand the importance of mental-health care. (In fact, she has a master’s degree in psychiatric nursing.)
“I was kind of frustrated by that meeting, too,” says Lyne. “They said they’d been trying to get me for two weeks, but I was unaware of that. I never got the phone messages. The point is, I was at the meeting. They could do with me what they will. Why take up time talking about phone calls? I was trying to convey a message. It was the state that cut back, and we fought those cuts as hard as we could. I don’t think they heard that.”
Raimondo and others concerned plan to take their case to the governor, but they will also press the issue with the mayor.
“We have to be honest and recognize that it would be more politically damaging for Mayor Daley to raise taxes than to shut down these mental-health centers,” says Fruehling. “Our constituency is not well organized and doesn’t have a lot of money. We’re easy pickings in tight times. That’s why we can’t let down our guard.”
Art accompanying story in printed newspaper (not available in this archive): photo/Bruce Powell.