While lawmakers in Illinois and Chicago were busy slashing the budgets for mental health resources last year, Cook County Sheriff Tom Dart asked his staff to create a map of zip codes to illustrate where the people cycling in and out of the county jail were coming from.
The result was staggering, revealing that a concentration of inmates hailed from the suburbs south of Chicago, mainly in and around Markham, Illinois. The sheriff then compared his chart to a map of functioning mental health care facilities. It made perfect sense.
"It doesn't take a moron to figure these things out." Dart told VICE News. "South suburban Chicago, from the boundary of the city to the boundary of the county, going south, there are no mental health care treatment centers. And that's where a significant number of inmates in on low-level charges are coming from."
With steep cuts state and citywide to the health sector budgets, the sheriff knew the problem would not solve itself. In conjunction with Adler Community Health Services, a part of Adler University, last month the sheriff's office opened its own mental health clinic connected to Cook County's Markham courthouse.
The Markham facility is a satellite branch of the Mental Health Transition Center (MHTC), which the sheriff's office opened at the Cook County jail in August of 2014 to provide inmates with therapeutic mental health treatment, job skills training, and overall support as they prepare to re-enter their communities.
Once inmates re-enter the community, they're encouraged — and sometimes required — to continue receiving treatment at the Markham facility. The goal is to keep them on their meds and help them avoid further contact with the criminal justice system.
"Generally when somebody is processed in a bureaucratic system like a jail or prison, they're not looked at as a unique person, but often as a proverbial number," Dan Barnes, director of Adler Community Health Services, explained to VICE News, "So when an individual gets diverted to a clinical professional who is trained to pay attention to their individual experience [and their mental health needs], it makes a big difference."
Tinley Park Mental Health Center, a large facility located near Markham that was once funded by the state of Illinois, closed in 2012 amid uproar from the Illinois mental health community. According to Dart, the state's constant cuts to mental health spending have significantly impacted this part of southern Cook County.
In an attempt to fix the state's financial crisis, Illinois reduced mental health funding by 32 percent — a total of $187 million — between 2009 and 2012, enough to rank among the 10 most drastic mental health cutbacks of all states nationwide during that period.
The cuts led Chicago Mayor Rahm Emanuel to close six out of the 12 public mental health facilities throughout the city. Many of the shuttered treatment centers were in vulnerable urban communities that were already underserved.
In addition to offering mental health treatment, the Markham facility is equipped to cooperate with the judiciary at the courthouse and function as a diversion program. All detainees are screened for mental health issues, and to assess their background and the charges against them. Individuals facing low-level charges may be eligible to be diverted away from the criminal justice system to receive community-based treatment.
'You wouldn't go to jail for chemotherapy, so why are we left to rely on the jail for mental health services?'
Dart told VICE News, however, that the judiciary at the Markham courthouse has been hesitant to engage with the facility in this capacity. Officials at the Markham courthouse did not respond to VICE News' repeated requests for comment on the matter.
Illinois Governor Bruce Rauner, a Republican, has proposed an additional $87 million in cuts to mental health spending for his 2016 budget. The governor's office and the Democratic majority in the state's general assembly are currently preparing for what's expected to be a summer-long battle over the budget.
Heather O'Donnell, vice president of public policy and advocacy at Thresholds, an organization that provides mental health services in Illinois, told VICE News that resources are already scarce. "Sheriff Dart is doing all that he can do with the resources he has," O'Donnell said. "But what we really need is for the state to step up and adequately fund mental health care."
According to a May 2015 report from the National Alliance on Mental Illness of Greater Chicago, if the governor gets his way with the 2016 budget cuts, more than 16,500 individuals living with serious mental illness will lose psychiatric treatment, care coordination, evidence-based mental health services, and housing support.
Catherine Kelly, a spokeswoman for Rauner, told VICE News that the governor is attempting to balance the budget, and that federal funds will help cover some of mental health services.
"Years of fiscal mismanagement and insider dealing have put the state $6 billion in the red," Kelly said in a statement. "Many people served by the services being discontinued [for FY2016] are now covered by the expansion of Medicaid and coverage of mental health under the Affordable Care Act."
The program and facility at the Markham courthouse is currently in its pilot phase, and Dart said he expects his budget to be slashed for the 2016 fiscal year.
"We've had to be outrageously creative with our funding in the past," the sheriff said. "But the only way it won't become permanent is if we come to find out that it's not working. Otherwise, I will find the funding."
In the meantime, the Cook County Jail remains the largest mental health care provider in the state of Illinois. O'Donnell says that while the sheriff's efforts are admirable, the Markham facility is no substitute for proper mental health treatment in a clinical setting.
"The Markham facility does not take the place of a treatment facility, it's [essentially] a part of the jail" O'Donnell explained. "You wouldn't go to jail for chemotherapy, so why are we left to rely on the jail for mental health services?"
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