Andrea Cooke and Jeanette Hanson were best friends. They both lived on Chicago’s South Side, both loved music and thrift stores. And they both had schizophrenia.
Cooke says the two of them took good care of each other. They brought each other little gifts. Cooke went to Hanson’s family picnics and Hanson sent Cook’s mother a get well card when she got sick.
Hanson went to a mental health clinic run by the City of Chicago, and she went there all the time — not just for therapy, but for help finding jobs, filling out paperwork and making appointments.
In 2012 the city shut down that clinic along with six others. Cooke says it was clear that Hanson had lost something important. She still had a therapist, but it was harder to schedule regular appointments. Cooke says Hanson especially missed the group therapy sessions at the clinic and having a place she could drop into if she felt out of control.
“Jeanette really depended on that clinic,” said Cooke. “And she stopped taking very good care of herself when it closed.”
Hanson’s family says that after 30 years without a hospital visit, Hanson began cycling in and out of hospitals. One night Hanson ended up on Cooke’s doorstep after airport security was called when Hanson went to the airport, dragging along luggage and her cat, with plans to travel, but no plane ticket. Cooke took Hanson in and for a while she made her food and gave her a place to sleep.
But it was not easy. Hanson had stopped taking her psychiatric medication and started to think that Cooke should not take medication either.
“She told me she didn’t believe I had schizophrenia. So she went into my room and took all my medication and hid it,” said Cooke.
Cooke says eventually Hanson ended up back at her own apartment. She was later found dead from hypertensive cardiovascular disease at age 66.
Family and friends believe it could be because Hansen had stopped managinger her heart condition. They think she because she was in the the throes of mental illness, she may have been isolating herself from doctors, not consistently taking her blood pressure medication, or following medical instructions.
“I think Jeanette would be alive today if she had someone monitoring all of her conditions — mental and physical,” said Cooke.
It is impossible to know what would have happened if the clinic had not closed. Hanson may still have died. When it comes to individual stories, it is hard to say with any certainty if things could have been different.
But what we do know is this: According to one study, people with severe mental illness die on average 25 years earlier than the rest of the population, and the majority of those deaths are from physical ailments.
Aaron Stuewe was surprised at just how much he ended up dealing with preventable illness when he started working at Thresholds. It is a mental health agency and for over two years he has worked with people who need the highest level of support.
“I was looking at a list of people that have passed away while I’ve been here, and it really struck me. God, it’s like seven out of eight of them passed away from preventable illness. And we haven’t had any people die of suicide,” said Stuewe.
Other mental health case managers tell eerily similar stories, about how they find people dead in their 40s and 50s from physical problems like diabetes.
There are different theories on why this happens. Some psychiatric medications are rough on the body. But people with mental illness are more likely to be homeless, tend to have poor access to healthy food and smoke more. Some people with mental illness may also have more trouble complying with medical instructions or getting medical attention at all.
The thing that makes Stuewe so upset is that most of those problems are preventable with early and consistent services.
“When you lose a member it is hard. But when you lose somebody to something that you can look back and say if this was changed for this person earlier in their life it would have been really different,” he said.
But Stuewe says when it comes to those with mental illness, it seems like people do not actually believe there is a chance for a good long life: “I think a lot of people think of it as a forgone conclusion. Like … all these things were wrong with this person so of course they died early.” Stuewe says that’s flawed thinking because if services are there early and consistently in someone's life, conditions could be manageable.
Patrick Corrigan, Professor of Psychology at Illinois Institute of Technology, has worked on psychiatric recovery. He points to a number of services that directly tackle the problem of physical health for people with mental illness.
LISTEN: Patrick Corrigan discusses addressing physical health and mental illness on WBEZ's Morning Shift
He says traditionally, physical and mental health have been provided separately, so a psychiatrist might not be in conversation with a person’s primary care physician. But there has been a new movement towards integrated care, where someone may receive both services from the same provider.
He also says programs that match people with peers who are in recovery from mental illness can be helpful. Those peers can help a person develop strategies and plans.
“The issue is one of practicality. Help them get to… see a primary care physician. Help them regularly take their meds,“ Corrigan said.
But Corrigan adds that an “equally, if not greater, part of this is health disparities.” People with mental illness are more likely to live in poverty. That can mean challenges in accessing food, housing and health care-- basic needs for maintaining physical health. Improving those conditions costs cash. And if there is one thing everyone knows about Illinois, it is that it has big money problems.
Democratic State Rep. Greg Harris says that is not an argument against investing in these services, it is why we should.
“Just from a financial view from the state, if we were to provide assertive mental health treatment to people with severe mental illness, we could do it for about $20,340 a year. The most regular users of the hospital cost an average of 45,000 dollars a year. So we are paying double,” said Harris.
Illinois still lags below the national average for investing in mental health, a funding issue that precedes this budget impasse. In written statements Gov. Bruce Rauner said Illinois doesn’t have the money to spend on important services because Democrats mismanaged the budget. And Democrats say it’s because Republicans are shortsighted.
So as yet another budget is caught up in politics, people wait. And life and death move on.
Shannon Heffernan is a WBEZ reporter. Follow her @shannon_h