CW: this article mentions an attempt to die by suicide
For years, Arturo Carrillo, who is Latinx, has crossed the city of Chicago to get to a therapist who is also Latinx and speaks Spanish. He hasn’t been able to find one with his shared cultural identity in his part of the city.
The trek would take about two hours there and back by public transit, so instead, Carrillo drives to his appointments, which is about an hour round trip. He says relying on public transportation is a limiting factor for people from his part of the city (Chicago’s L train system has fewer stations on the South Side, and buses can be slow, inconsistent, or never show up). Born and raised in the city’s Southeast Side, where he still lives, Carrillo never had access to mental health professionals growing up.
“My parents never took me to mental health services; they never saw it as an option. They never even thought it was a possibility because it wasn’t something that was offered,” Carrillo said.
Carrillo said that, years later, he learned that a mental health clinic that would have been accessible to him and his family was shut down during the first wave of mental health center closures in the late 1990s and early 2000s.
Recently, the city has swooped in to try to address its ailing mental health resources.
In September 2021, Chicago debuted a pilot program that sends mental health professionals to respond to non-emergency 911 calls, in some cases alongside police officers. The teams, known collectively as Crisis Assistance Response and Engagement, or CARE, operate in five pilot areas in the city.
The teams’ primary focus is mental health calls, including the West Side one, which specifically helps people experiencing overdoses. Only two of the five CARE units—the North and South Side teams—are staffed with police officers.
Many organizers and advocates aren’t fans of CARE
But many community organizers and mental health advocates in Chicago say police shouldn’t be sent on mental health crisis 911 calls at all.
Carrillo, also a licensed social worker and the director of health and violence prevention on the Brighton Park Neighborhood Council, a predominantly Latinx neighborhood in southwestern Chicago, is one of the advocates who sharply criticizes the CARE model.
“You’re creating a pilot that is tiny and that is also oriented to reinforce your original position that police should be involved. [Chicago policymakers] haven’t tried to hide their agenda to have [CARE] be a police-centric model,” Carrillo said.
However, Matt Richards, Chicago Department of Public Health’s (CDPH) deputy commissioner of behavioral health, said a CARE officer’s primary responsibility is to ensure the scene is safe for the mental health professionals and the patient.
While organizers aren’t happy with the police component, some can understand, at least for now, why it exists.
“Police officers have always gone on mental health calls. What’s different now is they’re trying to also send social workers on mental health calls. That’s the change,” Cheryl Miller, a public health organizer with Southside Together Organizing for Power (STOP), said. “Part of it is a change in mindset.”
“It’s really sad to say this, but cops get made fun of for being on these teams, and they get crap from other officers because they don’t consider it to be legitimate police work,” said clinical social worker and organizer Brit Holmberg, who learned about police attitudes toward CARE during their ongoing work with the Treatment Not Trauma campaign.
Richards, for his part, said the police are “very supportive of the program.”
Miller said that while some people have told her that they’ve interacted with a police officer during a mental health crisis and found them helpful, she pointed out that police officers typically escalate these situations. Indeed, at least 1 in 4 fatal police encounters happens when officers kill someone with a severe mental illness.
Models like CARE
Other organizers and advocates interviewed by Prism have multiple complaints about the program. For one, they say CARE’s limited hours (teams operate Monday through Friday 10:30 a.m.-4 p.m.) can’t accommodate people with mental health crises on weekends or during early morning and late hours.
Advocates and organizers say Chicago officials aren’t listening to their own data, which reports none of these calls has resulted in use of force or arrests and thus, they argue, shows that police officers aren’t necessary on mental health crisis calls.
A co-responder program operating in Denver since 2016 has found similar results, according to Andrew Dameron, Denver’s director of emergency communications.
“Clinicians that were a part of that [co-responder] program quickly identified that there were a lot of calls that they were being sent to where they didn’t need a police officer with them. These are folks that are community mental health workers; they are used to operating out in the public and going to people’s homes and meeting them where they are,” said Dameron.
This realization gave rise to Denver’s Support Team Assisted Response (STAR) program, which began June 1, 2020. The STAR van consists of a clinician and a paramedic, Dameron said, who are sent on low-risk 911 calls.
For higher-risk calls, like when a weapon is involved, co-responders are dispatched with a police officer.
“One of the things that they [mental health clinicians] told me [is] the co-responder gave them the opportunity to work side by side with law enforcement, and it gave law enforcement the opportunity to see what kind of value mental health clinicians can bring in the field,” Dameron said. “[Officers] came to respect and rely on those skills.”
Stephanie Van Jacobs, a program manager with WellPower, which provides mental health clinicians to STAR, agrees with Dameron’s assertion about clinicians and police officers complementing each other’s learning. Van Jacobs oversees all of the clinicians who ride on the STAR vans and supervises the day-to-day operations of STAR.
While she’s held her current role for almost two years, Van Jacobs, a licensed clinical social worker and licensed addiction counselor, was a co-responder and also rode in a STAR van during the program’s pilot phase.
“Police officers and mental health clinicians are historically very different, and so being on a team together, there’s always opportunities to learn how to approach situations, how to support people differently,” said Van Jacobs. For example, police officers have learned to adapt some of their language so it mimics more what a mental health clinician would say, and, in turn, clinicians have learned about the internal mechanisms of police work.
With CARE in Chicago, Richards said there’s no agenda other than learning from the data CDPH collects.
“We’re not looking to include anyone unnecessarily on a [mental health 911] response if the data suggests they don’t need to be there,” Richards said.
Richards does admit there are downsides to the program.
“You are responding to someone who has a mental health crisis, and bright lights and loud sounds are typically dysregulating for people, particularly if somebody has a brain health condition like a schizophrenia spectrum disorder that affects how you process stimuli,” he said. “So we made the decision to not use lights and sirens for that reason, but one of the trade-offs is it probably increases the number of times we are unable to locate the person.”
Do Chicago residents know about CARE?
Another common gripe organizers have is that CARE isn’t well advertised, so many community members don’t know it exists.
Any Huamani experienced this one summer afternoon in September last year. As part of her work as the Treatment Not Trauma community organizer with the Brighton Park Neighborhood Council, Huamani heard from several people at a community event in West Lawn (one of the neighborhoods where CARE operates without police) that they’ve never heard of CARE. Treatment Not Trauma pushes for non-police crisis response to mental health emergency calls.
“[T]hey know nothing about this program even though it has been there since early summer, … and [Chicagoans are] like, ‘Well, we never see any ads about it,’” Huamani said. “It’s a very simple old propaganda technique because we see how many ads there are for police officers.”
She also points out the lack of logos on the CARE vans, at least at the start of the pilot.
“Obviously, when you see a cop car, you know it’s a cop car. But when you saw a CARE van in the beginning, you couldn’t tell what it was; it just looked like a very suspicious van with nothing on there,” Huamani said.
In August 2022, Chicago outfitted its CARE vans with bright blue and red lettering and images, reminiscent of Chicago’s flag. Richards said the city has been getting the word out about CARE via press releases, social media, and elected officials.
In West Lawn, Huamani says the community is mostly pro-cop, meaning that many there think a heavier police presence results in less crime. While she no longer lives in West Lawn, she lived in the neighborhood for several years. However, Huamani said, when it comes to mental health crises, residents in the neighborhood understand why cops shouldn’t respond to these calls because the officers have other things on their plate and “cops are not the solution to everything.”
CARE is no replacement for public mental health centers
Instead, advocates say, opening the shuttered public mental health clinics would go a long way toward tackling the city’s many mental health needs.
Public mental health centers in Chicago have long been fighting for their existence. Back in the 1960s and ’70s, several clinics were built. But former Mayor Richard M. Daley shuttered seven by the end of his term in 2011. The next mayor, Rahm Emanuel, followed Daley’s lead and closed half of the city’s 12 remaining centers, including four on the South Side. Now, just five clinics remain (one was privatized in 2016). The current mayor, Lori Lightfoot, campaigned on opening the clinics closed under Emanuel but then reneged on her promise.
While the city has directed funding toward nonprofit mental health centers, from Holmberg’s perspective, nonprofit mental health organizations can’t adequately fill the holes that the closed public mental health clinics have left in their wake.
“What we’ve noticed with the Treatment Not Trauma campaign when we go through nonprofits, there’s something that’s really lost in that process in terms of accessibility,” Holmberg said. “Anyone can go [to the public mental health centers] regardless of immigration status, regardless of any sort of criteria that these private institutions, nonprofits may have.”
Ms. Diane Adams, who is also a volunteer with STOP and advocates for the reopening of public mental health centers, can speak to the power public mental health centers hold. In 1996, after her son was killed by gang violence in Chicago, Ms. Adams sought help from the Auburn-Gresham Mental Health Facility (closed under Emanuel). Two years after her son’s killing, Ms. Adams attempted suicide. But today, she says she feels much better, and that it is thanks to the mental health facility she visited where she received psychosocial rehab.
“I’m not depressed anymore. I don’t have anxiety. I have my self-esteem. I got my confidence. I’m a strong person now. It’s all because of me getting help with the therapist and a psychiatrist I had,” Ms. Adams said.
Lisa Salazar, a community nurse and Treatment Not Trauma volunteer, is also a proponent of the public mental health centers. But she says most people she interacts with through her work don’t know about the facilities.
“The individuals who do try [the public mental health centers] out, they love it. And that’s the heartbreaking part, right?” Salazar said. “There is a wonderful service available to children and to adults, and they just don’t know that it’s there.”
Salazar places the blame on the city.
“They fail to advertise it, and there is no other way to look at it,” she said. She points to the recent extension of mental health services from the public centers in select libraries around the city.
“We were promised that in February that [city officials] were going to start doing the four library locations,” Salazar said, with a fifth that would have a later start date. In one of the locations meant to open in February, however, the community told Treatment Not Trauma mental health clinicians didn’t show up in the library until March.
“There was no signage, the staff in the library was not really aware the clinicians were coming,” Salazar added.
Salazar travels around the city to try to fill these gaps with the Treatment Not Trauma campaign’s healing villages. Volunteer mental health providers provide free anxiety and depression screenings, reiki, and meditation with acupressure and acupuncture. However, Salazar said, a crucial aspect is informing communities around the city of mental health resources, most notably the five public mental health centers.
While Salazar finds her work rewarding, watching what these communities go through is tough.
“They’re very devastating because it does seem like COVID just put gasoline over fire. There are a lot of individuals who have losses: they’ve lost a family member, they’ve lost opportunities, they’ve lost employment, and then they’re struggling with their own family members,” Salazar said.
While Salazar knows there’s no magic wand to erase the mental health needs of Chicago, if she had her way, she’d opt for a public mental health center in every ward with holistic practices and a collaboration between the centers.
“I know staffing is very hard … especially being a Spanish-speaking practitioner, these are very difficult positions to staff, but they can be staffed, and they should be staffed with experts,” Salazar said. “But it needs to be handled in the public sector.”
Despite the plans the city has for expanding CARE to reach more residents, the advocates and organizers say CARE can never replace the closed public mental health centers they fought so hard to keep on life support—and the facilities that still endure.
Carrillo, when nudged, couldn’t say anything positive about the CARE pilot and the political leanings he believes are behind the program.
“There’s a political agenda here that was very clearly defined by [outgoing Mayor Lightfoot] from the start that police have to be part of crisis response, everybody has to bend over backward to make that narrative fit, even though the data is showing the opposite,” Carrillo said.
