Police or no police: Will Chicago’s new mental health crisis pilot address structural failure?

People with mental health issues are usually met by police as public safety disorders. (Creative Commons)

By Emmanuel Kizito

Medill Reports

“Suicide by Cop” refers to situations where a person calls an officer or takes an action with the expectation that the officer will kill them. Sometimes carrying a toy gun or weapon, they depend upon the assumption that the police will shoot, even if mental illness or distress seems to be apparent. 

With police officers as the primary responders, people with mental illness and disabilities are often met as disorders to public safety and treated with force during acute crises.  But Treatment Not Trauma, a Chicago ordinance proposed by Ald. Rossana Rodriguez-Sanchez (33rd), seeks to upend this model by replacing officers as first responders to mental health calls with a 24-hour crisis response team composed of social workers, emergency medical technicians, and nurses. 

Meanwhile, In the city’s proposed 2021 budget, Mayor Lori Lightfoot proposed a less transformative alternative: a $1.3 million investment into a “co-responder dispatch pilot” where mental health professionals, community paramedics and police officers together respond to mental health crisis calls. The budget also includes $500,000 for a dispatch pilot without officers. These programs represent differing responses to ongoing debates shaking the legitimacy of policing as a response to public safety.

Treating mental illness as a threat

According to the Treatment Advocacy Center, a national non-profit organization dedicated to accessible treatment for severe mental illness, one in four fatal police encounters involve people with mental health issues. This makes them 16 times more likely than other people to die from encounters with police. Strikingly, people with mental disabilities, neurodivergence, or deafness represent over 50% of fatal police encounters according to a 2016 report published by the Ruderman Family Foundation, a disability rights organization. 

This occurs despite police-driven reforms in certain cities including Chicago, like a prominent model known as Crisis Intervention Teams. But many advocates say retraining police is unlikely to work. That’s because, they say, training has already conditioned officers to enter into encounters with the assumption that a threat is imminent. Their commands often agitate those experiencing crisis, may not be heard by those in psychotic episodes, and can escalate conflict leading to death.

In 2015, Quintonio LeGrier, a 19-year-old engineering student from West Garfield Park, met this fate. After the teenager called 911 for help while experiencing a mental illness episode, Officer Randy Rialmo arrived and found LeGrier carrying a bat. Rialmo pulled his weapon and fired, killing both LeGrier and Bettie Jones, a 55-year-old neighbor attempting to calm the teenager down.

In the aftermath of LeGrier’s death, the Chicago Police Department created a Crisis Intervention Team that would train officers in  de-escalation techniques, the ability to recognize and handle a mental health crisis, and knowledge of community-based services. Yet, with police as primary responders, these services only become accessible when police are called to address instances of public disruption from those in crisis.  

An array of public disorder and quality-of-life violations often punish homeless or marginally housed people who are experiencing acute mental health crises in public space. Needed treatment or diversion programs only arrive after a crisis and an officer arrives, because of a lack of community outreach and outpatient care that provides consistent treatment to those who cannot afford private healthcare. With charges hanging over their heads, some find healthcare dependent on guilty pleas and the threat of incarceration.

With the deterioration of publicly funded mental health services, criminalization becomes the primary model for addressing mental health in cities across the country. Decades of deinstitutionalization shut down publicly funded inpatient and outpatient psychiatric care while police budgets expanded to absorb mental health patients pushed out of care.

A 2019 report issued by the Chicago City Council on public mental health clinics reports a pattern of reduced spending and closure of the city’s public mental health clinics since 2004. In 2012, Chicago Mayor Rahm Emanuel closed half of the city’s 12 public mental health clinics; only five remain. Reliance on private mental healthcare providers is laden with economic and racial barriers including cost, a lack of insurance coverage, and proximity due to an ongoing history of de facto segregation and municipal disinvestment that deprives the South and West Side of needed services. Lightfoot’s budget proposal puts $9.3 million into improving mental health access and addressing racial inequities, with $8 million worth of grants heading to 32 organizations. Though double last year’s budget for mental health, it represents less than 1% of her $12.8 billion spending proposal.

In contrast, the Chicago Police Department commands a budget of $1.69 billion in Mayor Lightfoot’s current 2021 proposal, which is over 13% of total spending, including grants. Chicago has nearly tripled per capita spending on the CPD since 1964 according to analysis by Injustice Watch

With a dearth of treatment resources for the most vulnerable, Chicago’s Cook County Jail has become the city’s largest de facto mental health service provider, as Sheriff Tom Dart — who oversees the jail — and others describe it. Cook County Jail joins  LA County Jail and New York’s Riker Island as among the country’s largest inpatient psychiatric institutions, according to Mental Health America, a national non-profit organization advocating for those with mental illnesses.

Of the 2 million people that pass through prisons and jails every year, 15% of men and 30% of women enter with serious mental illnesses, according to the National Alliance of Mental Illness. Their research shows that when those with mental illnesses enter for short terms, they do not receive needed medication or treatment, stay longer than those without serious mental illness, and are prone to be victims of violence. This comes at great public cost: a 2013 report from the Vera institute found that incarcerating those with mental illness is twice to triple the cost of investments in community-based services.

Response without police

The Treatment Not Trauma proposal follows the lead of Eugene and Springfield Oregon’s CAHOOTS teams. Their police-free response teams involve social workers armed with de-escalation and crisis training as well as knowledge of local resources. By responding to non-life threatening mental health emergencies,  CAHOOTS handled around 20% of 911 calls made to Oregon police departments in 2019. Officers are called if the situation requires it but, out of a total of 24,000 calls made last year, only 150 required police backup — speaking to the efficacy of de-escalation and crisis response without the underlying expectation of force from either party.

Arturo Carrillo is the director of Violence Prevention and Neighborhood Health Initiatives for the Brighton Park Neighborhood Council, a Chicago non-profit that organizes the working-class community of Brighton Park. He is also a member of the Collaborative for Community Wellness, which has been advocating for Treatment Not Trauma as part of a larger goal of addressing the dearth of mental health services without the use of police.

“The recent announcement of $8 million to expand capacity in the non-profit sector is a bit of a farce,” said Carrillo. “In playing the role of philanthropist, the city is trying to prop up a system with enormous holes in service delivery and coverage and funding them at a fraction of what is needed.”

He discussed the high turnover rates of the non-profit sector and how funding such organizations alongside private medical centers fails to expand access or the variety of services available.

Treatment Not Trauma is seen as a first step in reworking public infrastructure and resources to fund city-wide community mental health responses that provide both humane crisis intervention and free or affordable preventative mental health care to a city in dire need.

“When we engage proactively and when social workers are given the tools to mediate a crisis, we can provide follow up care and case management so that we don’t rely on punitive systems,” said Carrillo.

Progress or lip service?

Treatment Not Trauma was to be funded by the 2021 budget and led by the Chicago Public Health Department. Instead, the mayor’s 2021 budget proposal offered $1.3 million to a co-responder model that includes CIT trained police officers in their new crisis response team. The Chicago Department of Public Health director, Dr. Allison Arwady, presented a pilot response team set to begin in 2021 that will handle mental health service calls in two police districts.

The pilot is based on a similar model implemented by the Dallas Police Department, which is also where Chicago Superintendent David Brown was the former chief of police.

Dallas began their pilot program in 2018 to create a new crisis response team that involves a social worker, paramedic, and police officer. It began as a response to a spike in mental-health related calls and mirrors Chicago’s crisis of public infrastructure which is filled in with police response. After two incidences of officer-involved deaths from mental health crises, Dallas’ RIGHT care model is slated to expand in light of protests against police brutality this year

Yet, Dallas is also facing criticism from its own community organizations over any first responder model that involves officers. Asantewaa Boykins, co-founder of MH First, a community-based response team, argued that officers are not needed or trusted in the community to handle their safety. She cited Oregon’s CAHOOTs team as an example of a community-based response team that required police back up less than 1% of the time.

After negotiations between the progressive caucus and the mayor, Chicago’s approved budget also allocates $500,000 to test out a complete non-law enforcement response team. While this pleased other aldermen, Rodriguez-Sanchez voted no to the budget, citing inadequate concessions with little transparency or planning. In a November 24 statement made from her office, she detailed her no vote to the budget, which had narrowly passed earlier that day, 29-21. “We are voting on a budget that includes promises without plans, plans without personnel or metrics, or ways to hold our agencies accountable in their execution,” she stated. According to the statement, money allocated to the two pilots was “not enough by any stretch of the imagination to even complete a planning phase of either pilot.”

Emmanuel Kizito is an investigative journalist at Medill. You can follow him on Twitter @AnansiKZ.