Chicago needs Treatment Not Trauma!

Imagine if a man walked into City Hall, demanding an audience with Mayor Lightfoot, said he was bringing a message from G-d, and was threatening a series of grisly plagues and natural disasters if the mayor did not immediately end city policies that caused unnecessary suffering of Chicago’s most vulnerable.

He would not receive an audience with Mayor Lightfoot, and the Chicago Police Department would be called to apprehend him and remove him from the halls of power. In the best case scenario, he would be hospitalized and assessed for involuntary civil commitment, and possibly released within days, and possibly face criminal charges. At worst? He would be shot and killed by the police.

If this sounds dramatic, consider the fact that people with a mental health diagnosis are 16 times more likely to be killed by the police than the general public. Police across the country have shot and killed multiple people who called 911 because they were in crisisor have shot their caretakers. In one disturbing case, a police officer in Grand Rapids, Michigan requested that ICE “check the status” of a disabled veteran after he was arrested after having a mental health crisis. Jilmar Ramos Gomez, a U.S. citizen, was then held in ICE detention for days until public outcry forced his release.

Chicago’s shameful approach to crisis response is rooted in a long history of austerity policies. The Daley and Emmanuel administrations aggressively cut public mental health services, and now there are only five remaining public mental health clinics operated by the Chicago Department of Public Health (CDPH). When Mayor Lightfoot ran for office, she promised to re-open the closed mental health clinics — a promise she immediately reneged when she took office.

In 2020, Ald. Rossana Rodriguez-Sanchez introduced a Council Order that would re-open closed CDPH clinics and create a public, non-police crisis response program that would serve the entire city —modeled after a similar program in Denver, Colorado. Under the Treatment Not Trauma model, any calls regarding mental health crises would be dispatched to unarmed teams of healthcare workers, including behavioral health workers employed by CDPH, who would arrive on the scene, make contact, assess needs, and work with the client to identify a plan to get to safety and stability. CDPH workers would then contact the person to arrange any needed follow-up care out of a CDPH clinic.

Ald. Rodriguez-Sanchez, a social work student at Northeastern Illinois University, developed the Treatment Not Trauma Council Order in coalition with other clinicians and members of Chicago’s Mental Health Movement and the broader Collaborative for Community Wellness (CCW). CCW is a coalition of organizations, community advocacy groups, and CDPH clinic patients who previously organized in opposition to health clinic closures — most notably by occupying the Woodlawn clinic in 2012 after it was closed by the Emanuel administration. JCUA joined the CCW coalition last year after members chose to take on Treatment Not Trauma as its second Community Safety campaigns, alongside Empowering Communities for Public Safety (ECPS).

Organizers in Chicago and across the country are challenging our current approaches to public safety, where police are allocated billions of dollars to respond toto every challenge and issue — when police are inherently ill-equipped to do so. Treatment Not Trauma provides a framework for a better approach. Instead of escalation and criminalization, we can provide care and support.

A major component of CCW’s work is challenging a false narrative about mental health: CCW research indicates that access, not stigma, is the biggest barrier people have to receiving care in Chicago. The emphasis on “stigma” also misses the fact that it’s not stigma, but state oppression, that forces people to not seek help or share experiences with mental health treatment. If seeking assistance — or even talking about mental health concerns with peers — can mean losing custody of your children, losing your job, and suspension or expulsion from school, people will be rightfully reluctant from seeking help.

While Chicago agreed to fund a very limited non-police pilot, it has placed most of its focus — and money — on the “CARE” program, which is a police co-responder model. Results from FOIA requests show that the “CARE” program was developed primarily by the Police Department, despite marketing that frames the program as being led by social workers. Social workers partnering with police during crisis calls is a serious violation of our profession’s Code of Ethics, which many social workers, including myself and coalitions I have been a part of, have brought attention to in recent years. However, the profession is deeply resistant to actually applying any of the ethics that social workers are taught to follow and take seriously, due to decades of ideological capture by a right-wing bloc and a culture of learned helplessness among well-meaning leaders. This can be seen beyond endorsing police collaboration with the long-standing injustices of the family policing system, the use of the DSM as the main diagnostic text, the exploitation of unpaid student social work interns, and the most recent outcry after the Association of Social Work Boards finally released data that demonstrates serious racial disparities in social work licensure exam passage rates after, after ASWB lied and said they didn’t have access to this data.

Paradoxically, if social workers want to actually protect the integrity of the social work profession, we will have to damage the so-called integrity of our current framework for mental health treatment. What we are doing right now — letting insurance companies dictate care and treatment, forcing our most vulnerable patients into the nonprofit community mental health system, requiring social workers to be complicit agents of state repression, paying clinicians as little as $40,000 a year, and emphasizing divisions between “social work professionals” and “the working class” and between “social workers” and clients — is not working. When we view our work as a universal public good, open to all, where workers are public employees covered under union contracts, we will upend the structures of the current social work profession while improving our care infrastructure in a significant way.

Treatment Not Trauma is both an ambitious proposal, and also the bare minimum for people seeking care and workers in crisis care and response. Like every policy proposal, there are pitfalls and unintended consequences, and other high profile organizing wins supported by JCUA members can make Treatment not Trauma as effective as possible.

Effective implementation of the ECPS Ordinance can protect community members from police mistreatment during crisis calls, and the ECPS framework can be transferred to long-overdue state legislation that would create public community control and oversight over the Illinois Department of Children and Family Services, and the Illinois Department of Financial and Professional Regulators. This would ensure that people in crisis receive support from qualified and publicly accountable behavioral health workers, without getting ensnared in other harmful systems like the notoriously corrupt and poorly run state family policing system — which has been under a consent decree for decades.

Currently, the Treatment Not Trauma campaign is pushing for a full hearing on the Council Order in the Health and Human Services Committee, and will be advocating that TNT be funded, and that funding for 200 of the 800 unfilled CPD positions be reallocated to behavioral health positions in CDPH in the upcoming 2023 budget. Last year, the campaign won the first permanent increase in CDPH behavioral health funding in decades, and secured 20 behavioral health positions in CDPH clinics. Mayor Lightfoot was entirely resistant to any increased CDPH funding, but agreed to this increase, even her allies signed on to a demand to increase public mental health funding.

You could easily diagnose Moses with any number of mental health conditions, and claim that he experienced delusions and visual and auditory hallucinations. You could also consider that Moses’ community identified him as a leader, and provided a great deal of communal support, and saw his ability to see and hear things others couldn’t as a strength and talent. Moses is one of the first social workers documented in recorded history who advocated on behalf of his community, and connected the Israelites to resources and worked to resolve numerous conflicts and disputes during 40 years of wandering in the desert. We need to change the way we approach mental health care because together, we have a world to win.