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A Plea To Save Our Mental Health Centers From Rahm's Rampage

Dear Citizens of the City of Chicago:

Pending City Council approval, Mayor Emanuel is about to consolidate twelve Mental Health Centers into six, and it also appears that that's only Phase One of a plan to privatize a little later. This is a shortsighted decision which will deprive the citizens of the City of Chicago of the health, safety, and educational benefits that could be derived from a reorganized and well-managed City of Chicago mental health system.

It has already been pointed out by mental health advocates within and outside our system that mental health services can effectively reduce medical and legal costs, help public school students achieve their maximum potential, and improve the overall quality of life of the communities of the City of Chicago. There is plenty of research data that supports these assertions, and a major urban public health department ignoring it isn't intelligently understanding "Preventive Care" and aspiring to "healthiest city in America."

The previous administration tried to downsize our mental health system because it lacked the competence to effectively reorganize and preserve the system. In fact, the former administration could not even handle something as basic as billing for services rendered. The software was flawed, (and the procurement process itself was eventually called into question). Despite a clear and timely warning by the State of Illinois that the CDPH billing system was not working, the administration could not create an alternative method of billing for services while the bugs in the flawed Cerner computerized chart system were being removed. It is extremely demoralizing to have millions of dollars lost as a consequence of managerial incompetence.

The current administration (while emphasizing performance metrics and productivity-standards) was unable to spend money that was in the budget to partially alleviate a psychiatric shortage that was rippling through system productivity and "kicking the can down the road" onto other budgets - particularly Cook County's Emergency Room at Stroger (not just for emergencies but even for routine prescription refills), the Chicago Police Department (not only for occasional crimes but also for psychiatric crises, emergencies, and serious risk-factors) and Chicago Fire Department (for paramedics).

Generally speaking mental health centers have continued to be inadequately staffed and poorly organized, fostering the very difficulties now used to justify privatization. Upper Management treats mental health staff in a dismissive, almost disdainful, manner. Information is tightly controlled and only flows downstream. The concerns of clinicians and directors have been minimized or ignored. Some poorly maintained buildings have threatened the health of the CDPH employees and consumers. How ironic is it for the CDPH to neglect the health concerns of their own employees and the consumers they serve, while City Government implements a tax on employees who opt out of their new wellness program.

It is important to note that the viability and ultimate survival of the so-called "privatization partners" (the agencies who would replace some of the services currently provided by City clinics) depend upon an inflow of government funds that is unreliable given the horrible economic condition of the United States as a consequence of the outsourcing of American jobs and the unregulated financial environment that produced the housing bubble and subsequent bust. If these "privatization partners" lose their funding who will then take care of Chicago's mental health needs?

Moreover, mental health clinicians and directors, in their capacity as public health employees, have been assigned to work in triage centers in the event of a bioterrorism attack or some other dangerous contagious disease outbreak. Mental health clinicians are uniquely qualified to treat hysteria and other manifestations of emotional dysregulation that would predictably accompany such an event. All personnel assigned to these centers will be risking their health and their lives. Who will perform this important public safety service if our clinics are privatized?

Mayor Emanuel appears to be a staunch supporter of outsourcing and privatization, despite all of the negative consequences that are now glaringly apparent. He also appears to feel that the respectable middle-class wages and benefits provided to City employees are unjustified. The expression of these ideas by the Mayor and other privatization advocates leads to the promotion of divisive envy concerning these middle-class wages and benefits which have systematically been taken away from private sector employees.

No one can argue that the "privatization partners" can provide cheaper services than City clinics because their employees receive relatively low wages and almost no benefits. This is analogous to the argument that since corporations and their stockholders can make greater profits using $10/day labor in China or Mexico, the outsourcing of jobs is a necessity. The tragic results of this logic are becoming all to clear to the American taxpayers.

The mayor's recent assertion that the City is in the business of public health, not the provision of services, suggests that the mayor is unaware or does not appreciate the creative ways that mental health personnel could partner with our epidemiologists, our police department, our department of human services, our public schools and our religious institutions in order to substantively improve the quality of life for the citizens of our city.

Before privatizing a mental health system that has been in place for decades, CDPH administrators who have responsibility for mental health and lack the experience and knowledge to effectively reorganize and promote our system should be removed and replaced by individuals who understand mental health and the tremendous potential of our system. In the private sector it is customary to make managerial changes before you go out of business.

Hopefully the collective voices of our mental health staff, our consumers, our union, our communities and our elected officials will halt this unnecessary destruction of a system that has faithfully served our City and can continue to do so. In furtherance of this goal, we suggest the following steps be taken before a privatization option is given serious consideration.

1. A team of consultants, acceptable to mental health employees, consumers, the union, and the CDPH administration, be hired to assess the current deficiencies, current strengths, and potential value of a well-managed, well-integrated CDPH mental health system.

2. After the issuance of the consultants' report, there will be a public discussion of the merits of preserving our system. Citizens/taxpayers of the City of Chicago are entitled to an "informed consent" understanding of what is at stake if our system is dissolved and the privatization option exercised.


Friends of the MHCs


See also:
* Dear Rahm: Save Our Mental Health Clinics
* Rahm Not Tough Enough To Face Mental Health Advocates
* Community Declares City Hall A Budget Crime Scene


Comments welcome.


Posted on November 9, 2011

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