Around 10 p.m. on March 20, 2021, Marian Owens flipped on the rear light of her West Side Chicago home and was startled to find her 22-year-old grandson standing motionless on the second-floor porch, backed against a wall with his hoodie up. She spoke to him, but he didn’t respond, she said.
She ran through the house in a panic, then knocked on the bedroom door of her grandson’s father. When she didn’t get a response, she began dialing.
“I’m frantic when I see him out there like that and my first thought is he might jump off this porch,” she said, adding she can’t remember if she dialed 311, a non-emergency number, or 911. “I’m all alone. I don’t know what to do. All I could think of is getting some help.”
Paramedics and eight police officers rushed to the scene, some arriving within minutes. Initially, the officers failed to get a response out of him either, but eventually lured him down the stairs by inviting him to shoot some hoops on the backyard basketball court, Owens said.
“When his foot hit that concrete off of that last stair, they all pounced on him. They were trying to drag him towards the ambulance, but he was fighting them off,” she said. “Then all of a sudden I see him fall, but I hear his head hit the concrete.” Officers tased him multiple times before handcuffing him to a gurney and putting him in an ambulance, according to arrest reports.
This is the kind of clash between mental health needs and police response that a new national mental health emergency hotline — 988 — was set up to avoid.
In mid-July, the national 988 Suicide & Crisis Lifeline made its debut. It created an easy-to-remember phone number that people anywhere in the country can call to get help for themselves or for others who are feeling suicidal or experiencing a mental health crisis.
The goal was also to start reversing a uniquely American tragedy that has become a flashpoint in recent years. Since 2015, 1,647 people with a history of mental illness have been killed by police officers — more than a fifth of the people who died in confrontation with police, according to a database maintained by The Washington Post.
In Chicago, an enormous number of 911 calls are for mental health emergencies: From January 2020 to June 2022, the Office of Emergency Management and Communication (OEMC), which runs the 911 call and dispatch center, received more than 171,000 calls classified as mental health-related — an average of 193 a day. OEMC classifies these calls using a range of categories, with the majority tagged as mental health disturbances, well-being checks or suicide threats.
Between January 2020 and June 2022, officers responding to such calls filed 147 tactical response reports, indicating some kind of force was used by officers, according to data from OEMC and the Chicago Police Department.
While fatal shootings almost always make the news, other violent encounters with police — like the one experienced by Marian Owens and her grandson — are far more common and generally fly under the radar.
An analysis of the calls by MindSite News and WBEZ shows that 93 — or nearly two out of three — involved a Black person, including Owens’s grandson. Thirty-five of these incidents led to an arrest. In all but one of these incidents the person arrested was a person of color. In 28 incidents, officers used a weapon — tasers, batons and, in two incidents, a gun.
Owens’s call left their West Side family in shambles. After her grandson was dragged, tased and arrested, Owens spent the next three hours with him at the hospital before he was taken to district lockup and eventually Cook County Jail, she said. He was charged with six counts of resisting arrest and aggravated battery to a police officer, according to the arrest report.
Toxicology reports showed PCP was in her grandson’s system. He would later be diagnosed with schizophrenia and bipolar disorder. MindSite News is withholding his name because we have not had the opportunity to speak with him.
Representatives of the Chicago Police Department did not reply to calls and emails seeking comment about this incident or about racial disparities in officers’ responses to mental health-related incidents.
That was her grandson’s first arrest, Owens said, but he’s since been arrested at least two more times and has been cycling between hospitals, therapists and court appearances. Despite his diagnosis, he seems reluctant to cooperate with clinicians, according to his father, Brian Hardimon.
“I feel like he refuses help and stuff like that because he looks at it like, ‘Look how help did me when it came,’ ” Hardimon said.
Will 988 lead to change?
So will the transition from 911 to 988 change this dynamic? In one way, perhaps, it may.
In the months leading up to the July 16 rollout of 988 — and for years before — Illinois ranked last among all states in a metric critical to the success of any crisis call center: the likelihood of reaching a counselor in the same state, who may be familiar with local services. That dubious distinction now appears to be improving.
From April through June, 81% of Illinois calls to the old 10-digit suicide prevention number were sent to out-of-state call centers. But in August, the first full month since the three-digit 988 number officially went live, that number flipped, and 85% of the 12,300 calls placed from Illinois were handled by crisis counselors within the state.
That’s the largest improvement of any state in the country, according to Vibrant Emotional Health, the national administrator of the National Suicide Prevention Lifeline. The advance was enabled by $9.4 million in funding for a primary call center built into Gov. JB Pritzker’s state budget for 2023.
The grant was awarded to the PATH Crisis Center in Bloomington, home to 77,000 people and the campus of Illinois State University. As the state’s principal emergency call center, it will handle calls from 67 counties around the state.
PATH and five other call centers have also received $2.2 million in federal funds funneled through the Department of Human Services, according to the governor’s office.
Chicago, with the state’s largest population — and largest concentration of people of color — has only one call center, Community Counseling Centers of Chicago (C4). (Community Counseling Centers of Chicago is an underwriter for WBEZ 91.5) In budget year 2022, it was awarded a $60,000 grant, $140,000 less than the organization asked for.
For Fiscal Year 2023, C4 did better — receiving $375,000 of the $500,000 it requested, said Kelsey Di Pirro, the program’s director of community and rapid response programs. But it’s still not enough for the program to operate around the clock.
It’s also located on the opposite side of the city from the South Side, which has a predominantly Black population of 750,000 with pockets of poverty. Between January 2020 and June 2022, more than four in ten of the city’s mental health-related 911 calls originated from the South Side. These include calls classified as mental health disturbances, threats of suicide, domestic disturbances and attempting suicide, among others.
The problem with 911
The Chicago Police Department’s response to mental health-related calls has been under scrutiny for years. In 2015, the high profile shootings of Quintonio LeGrier and Bettie Jones and the release of a video showing a white officer shooting Laquan McDonald, a Black teenager, 16 times led to months of sustained protest and to the Department of Justice initiating an investigation of the department.
That investigation culminated in a 2017 report which found, among other things, that officers used force against people in mental health crises that could have been avoided. It also found the department doesn’t effectively use de-escalation techniques to reduce the need for force and failed to adequately document the reasons for using force.
In one example, officers tased an unarmed, naked, 65-year-old woman suffering from bipolar disorder and schizophrenia. In another, officers tased an unarmed suicidal man who pulled away from the responding officers, according to the report.
An alternative to 911
A principal aim of the 988 hotline is to get help for a person feeling suicidal or experiencing a mental health crisis without calling a 911 operator who might summon the police.
Hotline callers can be successfully helped over the phone more than 80% of the time, according to a spokesperson from the Illinois Department of Human Services — if the call is answered by an experienced phone counselor who knows how to work with a person in distress and knows about locally available resources to which they can direct the caller.
But creating an alternative to 911 and limiting the use of police to respond to mental health crises requires a reliable alternative that people know to call and trust to help them, said Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness (NAMI), a leading mental health policy organization. Without that, she said, people are likely to default to what they’ve known all their lives: dialing 911.
A system that relies on counselors based in call centers far from the area will have a harder time creating that trust and confidence, Wesolowski said.
Obari Cartman, president of the Chicago Association of Black Psychologists, said that in his experience, Black people usually dial 911 out of desperation and are unaware of other resources — especially if the resources are not based in their community. His organization held a Black suicide prevention town hall last year.
“People aren’t aware of the suicide hotline in the communities that I’m working with,” he said. “They’re calling in hopes they get an ambulance to take them to the emergency room. They get to a place where they don’t know what to do. They just know something is wrong.”
Cartman is also concerned about the large number of calls to hotlines that went unanswered in Illinois and were diverted to out-of-state call centers — as well as the large number of callers that simply gave up and hung up before their call could be answered.
“We’re having, in the field, a serious access problem all around,” he said. “The hotline is supposed to be the first line of defense, and if it’s falling short, it’s hard to imagine what the potential consequences are for a person seeking help and not being able to get it.”
All of which raises the question: Are Black and brown people who experience a mental health crisis in disinvested neighborhoods in Chicago well served by a crisis lifeline in Bloomington, roughly 130 miles southwest of their reality? And, if not, where can they turn for help?
“It’s a problem we’ve been grappling with across the country,” Wesolowski said. “We want people connected to local call centers. We know a lot of those calls can be resolved over the phone with these crisis counselors, but we want to connect people to additional resources that are going to help them get well and stay well.”
The lack of call centers in the Chicago metro area has been a problem for some time, said Matt Taylor, Vibrant’s director of network development, and leads to calls being diverted to a national backup network. They still get answered, he said, “assuming that the person was willing to stay on the line long enough.”
But often, they were not. An analysis of Vibrant data by MindSite News and WBEZ shows that over the past two years, more than one out of five callers hung up before they ever reached a counselor — a failure at step No. 1. This so-called abandoned call rate has been consistent for years, our analysis shows: Over the last six years, the rate of abandoned calls has ranged from 18% to 26%.
The number of abandoned calls is strongly related to the number that are handled in state, since both are a reflection of call center staffing within the state. Call centers set their hours and coverage areas based on funding and staffing levels. When local call centers aren’t available, those calls are sent out of state, where callers are more likely to abandon their call or wait two to three times longer, according to Vibrant.
Vibrant tracks the percentage of calls answered within each state because it is considered an important indicator of whether callers are likely to get connected to local resources after the call ends. “It starts with call centers, because 988 is the front door in some ways to crisis service,” Taylor said.
The $9.8 million state grant to PATH in Bloomington was intended to increase Illinois’ call center capacity and reduce the large number of calls being diverted out of state. PATH CEO Christopher Workman told WGLT Radio in February the funding would allow the center to hire 115 people. He declined to comment for this article.
Before the grant, only 35 counties were covered by call centers and half of them didn’t operate 24/7. Over the last year, PATH expanded to cover 67 counties, according to a spokesperson for the Illinois Department of Human Services, which funds mental health services in the state.
Madhuri Jha, executive director of the Kennedy-Satcher Center for Mental Health Equity at the Morehouse School of Medicine, reviewed literature and surveyed practitioners to develop a policy brief aimed at ensuring the 988 lifeline and new call centers are visible and inviting to groups that are historically excluded in both urban and rural communities.
Her biggest takeaway from the work was the glaring lack of trust among behavioral health professionals that the funds would actually be used to spread equity and not just fund the usual agencies, she said.
“People want to see equity in 988. People want to see historically invisible groups be reached by 988,” she said. “People are skeptical, however, [because] it has been left to each state to determine their use of funds.”
Few dollars to areas most in need
Other states are indeed dealing with similar issues, but none of them had a steeper hill to climb than Illinois.
Only California, Florida, New York and Texas received more calls, and none of those states had an in-state answer rate below 50% in the final quarter before the transition to the three-digit 988 line. Illinois was previously handling close to one-third of calls in state. As call volume increased in recent years, the rate dropped to one in five in-state responses by early 2021 — at a time when the pandemic limited options for mental health services.
By the end of 2021, the number of calls to the hotline had doubled, but fewer than 20% were answered in state, according to an analysis of the data by MindSite News and WBEZ. In contrast, in the final quarter before the transition, California handled 86% of its calls in state, New York handled 70% in state, and Texas improved its in-state answer rate to 50%.
In preparation for the transition to 988, Illinois invested millions of dollars to grow its mental health infrastructure, but few of these dollars have gone to call centers that are well-positioned to serve the communities of color where most Chicago mental health calls come from.
“How is this not supposed to be interpreted as disinvestment in Black and brown communities,” said C4’s Di Pirro.
The state has put more resources into funding mobile crisis response units and seems to be spreading the money more equitably, spending about 25% of the $68.5 million in Chicago. C4 now provides crisis response to 19 ZIP codes, including the entire West Side, but doesn’t cover the South Side.
If funded properly, NAMI’s Wesolowski believes these units could make a real difference by providing more humane and appropriate responses to mental health crises than police.
Kate Hoffman, a licensed professional counselor and peer specialist, hopes so. At 7:30 a.m. on the last Tuesday in July, she gathered in a circle with other staff members of a mobile crisis team at the offices of Trilogy, a nonprofit agency focused on mental well-being on the North Side.
They’re all dressed in business casual — no camo or paramilitary uniforms — giving them an approachable appearance. She’s in a flowery sundress, and lines of ink flow from tattoo to tattoo on her exposed arms.
On her forearm lives her visual interpretation of a Haiku written by the Japanese poet Mizuta Masahide:
Barn’s burnt down
I can see the moon
“It’s just a way for me to think about how that is the case,” she said. “Stuff can go really badly. Afterwards, things are different.”
Her job is to help people experiencing deep distress to see how things might be different — and help them regain a clear view.
Josh McGhee is the criminal justice and mental health reporter at MindSite News, a nonprofit, nonpartisan digital journalism organization dedicated to reporting on mental health in America. Follow him @TheVoiceofJosh. Ola Giwa is a data journalist with WBEZ. Follow her @amazingspeciali.