Reopening Chicago’s mental health clinics will be an important early test for Mayor Brandon Johnson

CHICAGO — Mayor Brandon Johnson’s inauguration pledge to reopen Chicago’s city-run mental health clinics puts him on the clock to deliver a win for advocates who have been waging that fight for more than a decade.

It also sets him up to make good on a longtime goal of one of his strong union supporters, by creating jobs at the clinics for members of the American Federation of State, County and Municipal Employees.

Whether he follows through could be one of the most important Rorschach tests on how Johnson’s first term gets viewed.

To appreciate the existential parameters of this fight, head back to 2012. That’s when then-Mayor Rahm Emanuel shuttered six of the 12 city-run clinics.

Almost from the moment Emanuel announced his intention to close the centers, patients and their supporters commenced a series of protests that drew attention to what they said was the mayor’s disregard for their well-being.

Twenty-three people were arrested after barricading themselves inside a Woodlawn clinic in 2012, and protesters turned up at Emanuel’s public events around that time to heckle him over the decision.

AFSCME lost dozens of positions for its members when the clinics closed, and the union joined in the push to reverse the decision. It’s a fight that’s never ended.

Toussaint Losier was a volunteer with the Mental Health Movement, which worked with patients to spearhead protests against the closures. Now a professor in the Department of Afro-American Studies at the University of Massachusetts at Amherst, Losier said he’s struck by how the fight to reopen the clinics has remained potent for over a decade.

“What’s really amazed me has been the degree to which the question of the closure of the clinics and the struggle around trying to prevent that has remained fixed in people’s political imagination in the 10 years since,” he said.

It remains to be seen whether Johnson will follow through on his campaign promise to reopen the clinics and his inauguration applause line about finding a bunch of ways to make sure Chicagoans get the mental health care they need, “including reopening our mental health care centers across the city of Chicago.”

A Johnson spokesman declined to comment on the administration’s plans for the mental health clinics.

Mayor Lori Lightfoot likewise campaigned in 2019 to reopen the city-run facilities, only to back away from the pledge when she won, saying it made more sense to boost funding to a broad array of mental health nonprofits. She increased mental health spending to $89 million as part of her 2023 city budget.

But Johnson faces a much different political base than Lightfoot did, with progressive grassroots organizers and union activists who expect him to deliver on their priorities, noted Matt Ginsberg-Jaeckle, a co-founder of Southside Together Organizing for Power, a group that played an important role in fighting the clinic closures.

“What I’m excited about with this political moment — don’t get me wrong, I love Brandon, Mayor Johnson, I think he’s a great guy — but what gets me excited is not him and his personality as much as the structural pressures upon him,” Ginsberg-Jaeckle said. “The same things, to be frank, that are causing such alarm among those who like to, who are generally in Naperville and like to throw bombs at city politics, are the same things that have me excited.”

AFSCME has been a strong Johnson supporter.

The AFSCME International Union PAC contributed $100,000 to his mayoral campaign this year ahead of the April runoff election, according to state campaign finance records. And AFSCME Illinois Council 31′s PAC contributed $56,750 to Johnson in 2018 during his successful run for Cook County commissioner.

AFSCME Council 31 spokesman Anders Lindall said the union doesn’t back candidates because they expect a quid pro quo. “We support candidates who have the right position on our issues, not the other way around,” he said.

“And the other thing is, Mayor Lightfoot campaigned on (reopening the clinics) four years ago, and we did not endorse Lori Lightfoot,” Lindall continued. “That wasn’t a political consideration. And Brandon Johnson campaigned on it this time around and we remained neutral in the (mayoral) primary. So this is really about the policy for us.”

The need to reopen the clinics has become more commonly accepted over the past decade, Lindall said, making it easier for Johnson to do so.

“This is not happening overnight, and I certainly think the new mayor alone is not out on an island,” Lindall said. “But there has been a growing consensus to the point that I think it’s probably difficult to find a lot of people today that would not say that the 2012 closures were a mistake.”

Lindall argued the clinics provide much more consistent care in part because they can, in most cases, pay better salaries and offer better benefits than private providers that experience a lot of staff turnover.

And he said there’s better transparency when the city is running the facilities, allowing the public to see what kind of care patients are receiving and how funds are being spent.

“When the city is providing the services, we know who is being served, when, how and by whom,” Lindall said. “And the accountability is direct. CDPH (Chicago Department of Public Health) has a management structure, the agency head reports to the mayor and the City Council has the legislative oversight of all of that.”

Lindall said nonprofits have a role to play too.

“It’s definitely not an ‘either-or’ situation,” he said. “The level of unmet need in our city is such that it’s ‘both-and.’”

There are “around 70″ AFSCME-represented mental health worker positions currently on the city payroll, including 62 employees working at the remaining five city-run clinics who also conduct mental health outreach in Chicago libraries. Five other city workers represented by AFSCME serve as mental health co-responders with police.

That’s down from 92 positions when 12 clinics were operating, Lindall said. The Cook County Health Department took over the sixth remaining city clinic, in Roseland, beginning in 2017. That one is now run by a private company, with the county putting in $800,000 annually, according to a county health department spokeswoman.

The city clinics see just a small fraction of the number of people in Chicago who receive mental health services.

According to the Chicago Department of Public Health, city clinics served 1,782 patients in 2022 while there were 73,899 patients served citywide at city clinics and the various nonprofit agencies and other mental health programs in the city that receive public funding.

Federal COVID-19 relief grants are drying up, however, and mental health needs are soaring citywide since the start of the pandemic.

Alexa James, chief executive officer of the National Alliance on Mental Illness Chicago and a member of the Johnson postelection transition team’s Health & Human Services Subcommittee, said the city needs to be nimble to deal with the crisis.

“If you look nationally at city health departments, they have learned that being their own provider is complicated, because they haven’t found that they have the flexibility to innovate, and that just being a clinic-based care center, we’ve all learned through a lot of work, that integrated health systems, meeting people where they are … is really the way to create more trust in the mental health system,” said James, whose nonprofit receives city funding to help pay for a mental health helpline.

Reopening the city-run clinics would buck that trend, she said.

“City health departments nationally have really stopped becoming providers,” James said. “They’re really gap-fillers, they’re funders, they’re conveners. What I’m understanding from this administration is they may want to change that agenda, they may want to get back into the provider business … There’s definitely strong opinions on either side, but what we believe is that sharing costs with the state, the county and the city is going to give us more bang for our buck.”

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