The Second Opinion

As budget cuts spark mental health concerns, Chicago’s WBEZ is on the story

May 21, 2015

After the closure in 2012 of half of Chicago’s mental health clinics and years of state and city budget cuts (with more on the table), Chicago is experiencing a “mental health emergency,” as the title of an audio segment by WBEZ reporter Shannon Heffernan recently put it. The public radio station–including Heffernan and her colleagues Cate Cahan and Jason Marck–has responded with a flurry of compelling on-air and online reports over the past month.

It’s solid and noteworthy work, because with so much happening on the healthcare beat, mental health coverage is too often postponed in triage. Cahan, WBEZ investigations and special projects editor, told me, “There’s a bias to think about mental health as niche, something that happens to other people. But it’s relevant to more people than I had realized. Not only were callers saying they had heard the pieces, they were saying, ‘That’s me or my sister.'”

Heffernan illustrated the city’s concerns in one piece through the eyes of veteran Chicago Fire Department paramedic Heather Linehan–who is “bracing herself” for a spike in ER visits by the mentally ill if Illinois Gov. Bruce Rauner’s proposed budget, with $82 million in mental health cuts, passes.

Heffernan reported:

Linehan said when policy decisions get made, she sees a difference in who shows up in her ambulance. Years ago, she noticed when state hospitals started to close and not enough community-based services filled the gap. More recently she noticed when the state cut funding and later when the city closed half of its mental health clinics.

The “trend” in mentally ill people visiting emergency rooms is “already underway” in the city, reported Heffernan. Examining data from the Illinois Department of Public Records and the Illinois Hospital Association, she found that between 2009 and 2013, Chicago emergency rooms experienced a 37 percent increase in patients who were discharged for psychiatric treatment. The biggest jump came in 2012, the same year the city closed half of its mental health clinics. Neither state nor city officials would agree to an interview. The state said in a statement that proposed budget “cuts are needed because of reckless spending from the past,” while the city claimed “the mental health infrastructure is stronger than it was four years ago.”

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In late April, Heffernan reported that one of the largest community counseling centers in Chicago, known as C4, was closing its doors at the end of May, apparently the victim of mismanagement and the botched implementation of a new billing system. The next day, WBEZ’s Jason Marck offered listeners an informative and engaging conversation with University of Chicago law professor Mark Heyrman discussing the government’s role in providing services (“We have mental health deserts in Chicago where there are no services to people who are seriously mentally ill,” said Heyrman), connecting patients to services (a “daunting task,” he said, because of cutbacks in infrastructure), and the stigma of mental health (“If you claim you don’t know someone with a mental illness,” he said, “it’s because you haven’t noticed or they haven’t told you.”)

The coverage continued this month. On May 1, Heffernan told listeners that, “in direct response to government mental health cuts,” the Cook County Sheriff’s office will open a new mental health clinic in the south suburbs. “If no one else is going to do it, we’re going to,” the director of Cook County Jail told Heffernan, noting that while the jail population is almost at a record low, the “population of medically and mentally ill people that need hospital level care is at an all-time high.” On May 15, Heffernan reported that the C4 counseling center had found a way to remain open, leaving some clients “giggling, others released a huge sigh of relief.”

Heffernan talked to me about two other projects in the works and her reporting methods—all of which could be useful for other reporters on this beat. For one piece, she’s planning to shadow Cook County Jail staff members who are tasked with the discharge process, arranging services for mentally ill inmates being released. Heffernan hopes to learn first-hand the challenges of connecting former inmates with services. She told me she heard from one former inmate and the sheriff that sometimes people got better services in jail than on the outside—something she will also explore.

She is also constructing an interactive map showing where all the city’s 36 mental health clinics are located and which areas are in fact deserts. But simply showing where they are located isn’t enough, she said. Gathering data the old fashioned way–by phone–she found many clinics had few therapists and psychiatrists on staff and very long waits for help which, of course, means patients in need turn to emergency rooms.

“We’re seeing waits as long as six months and some as short as four weeks,” she told me. “Six months, for the vast majority, is too long to wait.” Clinics with shorter waits tend to be pickier about who they will serve, preferring groups like veterans or kids. Medicaid patients might wait longer, for reasons that are well-known: reimbursements are too low; there’s a shortage of providers; the state is late paying the bills.

We also chatted about her broad approach to health stories. “One of the things about health reporting is that you can use it as a lens to look at anything you want–poverty, budgets, housing, food, environment, education,” she told me. “You can’t have good health without good housing.”

Cahan, Heffernan’s editor, calls the station’s recent mental health reporting “doing the public radio thing–to be of service and fill the gaps where others are not covering.”

Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for CJR's Covering the Health Care Fight. She also blogs for Health News Review and the Center for Health Journalism. Follow her on Twitter @Trudy_Lieberman.