This Is What Happens When a City Shuts Down Mental Health Clinics

The wait for mental health services at Saint Anthony Hospital, a nonprofit community institution on Chicago’s West Side, is about a year. The hospital sits on the border between North Lawndale, an African-American community, and Little Village, which is mostly Latino. It tries to offer culturally sensitive care to both constituencies, and it gives free mental health services to the uninsured. But it’s swamped.

Arturo Carrillo, the mental health program manager at Saint Anthony, says there’s been a near-constant waiting list since he started as an intern in 2005. The list is longer in 2018 than it’s ever been. This is despite a widespread belief that Hispanics and African-Americans are less likely than other groups to seek out mental health treatment because of a widely felt stigma against it.

Despite its name and size, the 151-bed facility feels more like a community health clinic than a sprawling city hospital. Spanish is often spoken when people check in at the front desk. On one recent morning, a child played with an adult in the waiting area, while a couple in the reception room waited for medication-assisted treatment, an FDA-described “whole person” approach to weaning people off substance abuse.

Two waves appear to have contributed to the exceptionally long waiting list for mental health services at Saint Anthony. The most recent came in the aftermath of the 2016 presidential election, when Spanish-speaking communities reported growing anxiety as a result of the new zero-tolerance immigration policies. But the much bigger wave came a few years earlier, in 2012, after Mayor Rahm Emanuel’s administration shuttered half a dozen city-run mental health clinics. Two of those clinics were in the low-income areas that Saint Anthony serves. “The Woodlawn clinic was a crucial clinic for the African-American community in need,” Carrillo says. “The Back of the Yards clinic had Spanish-speaking psychiatry services. It’s the degradation of many layers of the social safety net. That’s not just a Chicago problem, but in Chicago there’s been an intentional disregard for investment in these areas.”

In 2011, Chicago had 12 community mental health clinics. Now it has five. Local officials cite both cuts in state funding and a consolidation plan from the city that aimed at shifting patients to private mental health centers. Protesters sat vigil day and night outside the clinics in the months leading up to their closure, arguing that the patients wouldn’t have anywhere to go. It didn’t make a difference: By the spring of 2012, Chicago was down to six city-run clinics. That number was reduced to five after one was privatized in 2016.

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