Chicago mental health professionals and advocates delivered an open letter to Mayor Lori Lightfoot Thursday at City Hall urging her to reconsider using police officers in her mental health crisis response pilot program.
The letter, signed by more than 300 mental health professionals, asks the city of Chicago to adopt a non-police crisis response system for mental health emergencies.
“We can emphatically say that having a non-police crisis response program in Chicago would make our jobs much easier by reducing ethical dilemmas and moral injury,” reads the letter, signed by psychiatrists, psychologists, counselors and social workers who live and work in 47 of the city’s 50 wards.
The letter is part of the “Treatment Not Trauma” campaign, which pushes for the passage of an ordinance of the same name. The Treatment Not Trauma ordinance, co-sponsored by Ald. Rossana Rodriguez-Sanchez, 33rd, calls for non-police response to mental health crises and increased funding for public mental health centers throughout the city.
The proposal is based on the Crisis Assistance Helping Out On The Streets (CAHOOTS) program in Eugene, Ore., in which a mental health crisis call is responded to by a nurse, an emergency medical technician and a mental health crisis worker. The open letter to Lightfoot touted the efficacy of CAHOOTS, stating the program successfully responded to more than 24,000 calls in 2019.
“If needed, [CAHOOTS responders] can contact the local police department for support, but they have only had to do that .006% of the time,” the letter read. “Moreover, from a financial standpoint, CAHOOTS estimates that the co-responder model ‘saves the city of Eugene an estimated $8.5 million in public safety spending annually.’”
The letter asks Lightfoot to reconsider her current pilot program, called Crisis Assistance Response and Engagement (CARE), which involves a Chicago Police Department officer trained in crisis intervention as part of a three-person response team that also includes a mental health clinician and a paramedic.
Brit Holmberg, a licensed clinical social worker, helped draft the letter to Lightfoot. He was joined on Thursday at City Hall by other mental health professionals and advocates who brought along a poster-sized card. The front of the card read “Treatment Not Trauma,” and displayed the photos of Chicagoans killed by police during a mental health crisis, including 19-year-old Quintonio LeGrier. Inside the card was the letter to Lightfoot.
“We’ve lost too many Chicagoans already. Having a mental health crisis in our city should not be a death sentence,” Holmberg told WBEZ.
Due to COVID protocols, police officers guarding the City Hall elevators would not let the group hand-deliver the card to the fifth floor, and instead called Cesar Rodriguez, Lightfoot’s press secretary, down to collect the letter.
In an interview on Friday, Allison Arwady, commissioner of the Chicago Department of Public Health, said the default response to many 911 calls and other emergencies had been to send in the police. But mental health professionals are often needed in those situations, Arwady added, and the city’s CARE pilot the past several months has finally provided opportunities to include them. She said each call must be evaluated to determine if the threat to public safety is too great. But the city continues to work with state regulators to expand the number of calls in which mental health workers can be involved, Arwady said.
However, she added that given the extreme nature of some calls, which sometimes include shootings, sexual assaults and other crimes, the presence of police officers is necessary. “But the police officer’s role is to ensure that the scene is safe, and to ensure the safety of the responders and the person who is called,” Arwady said. “We would like these to be primarily health calls, but where there has been a shooting … there also does need to be a police role.”
Arwady said the city is close to rolling out a long-awaited alternate model where police officers will not be involved in crisis response. That program will be launched in a police district on the Southwest Side that includes parts of Gage Park and neighboring communities. “The alternate response pilot is literally ready to go, sort of, any day here,” she said. “The team has been hired. The training is done. We’re waiting for the Illinois Department of Public Health to achieve final approval.”
Arwady insists that both approaches and both pilot programs are necessary to help the city understand when and how to provide the most appropriate services.
Other mental health professionals said the city’s current pilot is a start, but they are still concerned about the role police will continue to play.
“Even when you train police officers, it still doesn’t necessarily reduce the potential for escalation or a violent response on the part of police officers,” said Leticia Villarreal Sosa, a professor and researcher at Dominican University, citing a 2012 study that showed crisis-intervention-trained police officers do not use less force than untrained officers.
Villarreal Sosa added that police presence also stokes fear among undocumented immigrants, making them less willing to reach out for mental health help.
While some opponents of the “Treatment Not Trauma” campaign cite safety as a reason to include armed officers in mental health crisis response, Villarreal Sosa said the CAHOOTS model and similar programs show that, overall, there aren’t many situations that put responders in danger.
Chicago’s own data, released recently, shows the city’s CARE pilot program has resulted in no arrests and no use of force, according to a WTTW report.
Villarreal Sosa, one of the mental health professionals who signed the letter delivered to Lightfoot Thursday, said the city should also expand its network of public mental health clinics. Currently, Lightfoot’s plan to expand mental health services relies on building a network of private clinics. But Villarreal Sosa says private clinics have long wait lists, experience higher rates of turnover due to lower pay for clinicians and often lack the cultural competency needed to respond to various communities.
“If there’s ever a time to really focus on access to mental health services and also non-police responses, [it’s] right now,” said Villarreal Sosa, referring to the increase in mental health issues during the pandemic — especially among youth and communities of color.
Holmberg, the social worker, rejected the notion that the police officers in the city’s CARE teams have the training necessary to attend to people experiencing mental health crises.
“We know Derek Chauvin was a CIT-trained police officer,” he said, naming the Minneapolis police officer who killed George Floyd in 2020. “Cops are trained to command and control.”
Diane Adams, a longtime advocate of public mental health clinics, said the lack of trust in police adds to the tension. “People are scared and afraid; the police have made it so hard for us to trust them,” the 66-year-old Auburn Gresham native said.
Adams added that Chicago’s mental health care policy also falls short of Lightfoot’s 2019 campaign promise to reopen shuttered public clinics.
“She ran on that,” said Adams, who received care from one of the city-run clinics after her son’s 1996 shooting death drove her to depression and a suicide attempt two years later.
“I’m a living witness that mental health [care] helps,” Adams said. “I came from nowhere to where I am now.”
The five city-run mental health clinics are managed by the public health department. But Arwady argues that public health departments are ill-equipped to be the primary source for such services given reimbursement rates and other factors. Instead, she said, federally-qualified health centers and other direct care providers are better suited to provide behavioral health with public agencies filling in gaps and focusing on preventive care. “We are not healthcare providers, first and foremost,” she said. “It’s super, super unusual for a public health department to operate a mental health clinic, like when we look at this around the country.”
Arwady said the city is looking for better ways to provide access to mental health services and to reach all residents who might need such assistance. She touted the city’s efforts to divert individuals from the criminal court system to health and social services, to provide mental health services to individuals at homeless shelters and to provide outreach to individuals using public transit.
Esther Yoon-Ji Kang is a reporter for WBEZ’s Race, Class and Communities desk. Follow her on Twitter @estheryjkang.