Mental health activist N’Dana Carter says that in 2011, when Chicago Mayor Rahm Emanuel announced that half of the city’s mental health clinics would close, he pointed to the Community Counseling Centers of Chicago (C4) as an alternative resource. But now, C4 is shutting its doors—leaving clinic staff without paychecks and clients unsure about where to receive mental health services.
On April 23, C4 staff received an email from CEO Eileen Durkin with the subject line “Sad news about C4.” The email said the agency would close by May 31 due to financial difficulties caused by a transition to a new electronic health record (EHR) system. The Affordable Care Act (ACA) required all Medicare eligible professionals to adopt EHRs by 2015.
“We don’t really understand how that could account for shutting down an entire agency that’s 30-plus years old with 300-plus employees in six months,” therapist Anna Goldberger said.
Yesterday, around 100 people — including C4 staff and patients, activists with the Mental Health Movement, Arise Chicago and SEIU Local 73 members — rallied outside C4’s headquarters on Clark Street in the Uptown neighborhood. They called for a way to keep the clinics open — or at the very least, transparency in the crafting of a transition plan for over 300 staff who will lose their jobs and over 10,000 patients who will need to find new therapists and psychiatrists.
“We need to know what happened, why it happened and what’s going to happen now,” explained therapist Maya Joseph-Brooks.
At the rally, staff and clients testified to the closing’s effects on employees, patients and the entire city. Kelly Goodwin is a graduate student at the University of Chicago School of Social Service Administration who works at a C4 center. She says the impending closure has already meant a loss of two-thirds of her income in the lead-up to the closure and doesn’t know how she is going to pay her rent.
“I just think about [what’s going to happen to] our clients and I start crying and then I start thinking about myself and I start crying,” Goodwin said.
Therese Burton has been a C4 client for 24 years. Through tears, she said that because of C4, “I’ve been able to receive meds, therapy, support and become an active member of society. I am an artist who can create when I am taking my meds. I can mother my children. I’ve raised two daughters that have gone to college.”
Therapist Max Beshers said he is especially worried for his psychotic patients. According to Beshers, if they don’t find a Medicaid-accepting psychiatrist, “when they go off their medications next month, they’ll be experiencing hallucinations and delusions.”
As to the effect on Chicago, C4’s closure is “not happening in a vacuum,” said Adam Kader, director of Arise Chicago Worker Center. “If there’s not funding in one place, that means there’s not going to be enough funding from another place.” Goldberger said this will lead to patients ending up in the emergency room or in prison.
A report by Chicago public radio station WBEZ seems to support Goldberger’s claim. Journalist Shannon Heffernan found that from 2009 to 2013, psychiatric-related ER visits increased by 37 percent. The biggest increase came in 2012, the same year the city cut the number of its mental health clinics in half. The report also found “evidence that shrinking mental health services could actually cost money.” If Republican Governor Bruce Rauner’s budget is approved, the state will see an $82 million cut in mental health funding.
After the testimonies, staff, patients and their supporters walked upstairs to the office of Eileen Durkin, president and CEO of C4. Durkin emerged from her office to engage with the crowd in the office lobby. After hearing from patients and staff, she agreed with all of their critiques. When asked about a lack of communication, Durkin said that in trying to do everything to keep C4 open and not prematurely announce the closing, the administration ended up creating a lack of transparency and last-minute notifications.
As to why C4 is closing, Durkin said “things were fine” until they converted to the new EHR system. Durkin said C4 was not able to bounce back from this trouble because they don’t have any savings, since they spend all of their funding, nearly all of which comes from the state.
When In These Times asked why every similar health center is not shutting down if they were all required to convert to EHRs, Durkin said the product they chose is “a more complicated system than I think any of us with all of our planning realized. … It seems hard to believe that an electronic health record can cause this much chaos, but it did.” It is still unclear how the closure happened despite C4 receiving support from the state, city and technical experts.
Durkin did not offer any explanation of why C4 did not make any attempts to either switch the system or bring in outside support that could adequately assist with the transition without forcing C4’s closure.
Durkin agreed to send an email to staff and clients explaining transition of care plans by May 7 at 5:23pm — exactly two week after employees received the “Sad news at C4” email. She agreed to allow staff to participate in planning this transition and confirmed that all of their pay, which has been delayed, would be made up.
The clients who relied on C4, however, say they will still suffer from this additional loss of mental health services.
“They’re lying to the clients in saying there’s room to transition people [to other facilities]. There isn’t,” said Client Lawrence Sack.
Therapist Maya Joseph-Brooks offered a warning about the future for mental health patients. “You don’t want to see what’s going to happen. It’s going to be devastating — it’s already devastating. People are showing up in the emergency rooms already,” she said.