UPTOWN — Ald. James Cappleman (46th) is tired of watching mentally ill residents in his ward wind up at the county jail instead of getting the treatment they need, and said when it comes to treating mental illness, the city, county and state are close to failing.
Cappleman's comments came as Cook County assesses how to keep a neighborhood like Uptown healthy. Cook County Comissioner Bridget Gainer has been investigating Uptown's health since the fall. Her office is interviewing residents, health care providers and community groups about the challenges they face. But Cappleman is already aware of those challenges.
"I would give Cook County, and the city of Chicago, and the state of Illinois a D- on their ability to provide coordinated care for people living with chronic mental illness," Cappleman said.
The social worker-turned-politician said Cook County Jail has turned into one of the largest inpatient psychiatric facilities in the country, a claim made by Sheriff Tom Dart earlier this year.
"One of the reasons is because we place so many roadblocks to people with chronic mental illness in getting the help they need," he said, adding that the problem is evident in Uptown because the neighborhood has one of the highest concentrations of people living with mental illness in the city.
Cappleman said "a particular constituent" with bi-polar disorder had such a hard time trying to navigate local public health systems that he now faces homelessness.
The uninsured Uptown man, who Cappleman would not name, has relied on free psychiatric care and free medication from Fantus Clinic, a wing of John H. Stroger of Cook County Hospital, the alderman said. Though he qualified for federal benefits because of his condition, he struggled to apply for the aid.
"He was having a difficult time following through all the different ropes to get his SSI and Medicaid," Cappleman said. Now, the alderman said the man is going to be on the street.
Situations like these should be learning experiences for county and city officials, Cappleman said, especially because of the large number of people with mental illness who end up behind bars.
Uptown is “ground zero; we see the problem,” he said.
Gainer acknowledged flaws in the county health system and said the 2012 assessment is all about her office educating itself while preparing for the implementation of federal health care reform.
Cook County has a waiver from the federal government to begin enrolling uninsured, low-income residents in Medicaid starting in January, a year ahead of much of the country.
Gainer's office produced a health assessment in 2010 that noted mental disorders are the top reason Uptown residents are hospitalized. Most Uptown residents either don't have insurance, or rely on Medicaid, the report said. Since a city-run mental health center was shuttered in 2007, the Uptown Health Center is the only publically operated clinic on the North Side.
The report noted that while social service providers routinely sent people to Fantus Clinic, part of Stroger Hospital, many residents balked at making the trip, saying the hospital was too far away, and voicing concerns about cleanliness, difficulty in making appointments and perceptions about "unfriendly" staff.
And while there are about two dozen privately run clinics on the North Side, administrative changes has made it more difficult for some people to access mental health care.
Outpatient mental health organization Community Counseling Centers of Chicago used to be able to help people regardless of their ability to pay, according to chief clinical officer Bruce Seitzer. Now, people have to pay full price up front.
Seitzer said the organization no longer offers sliding-scale payments for treatment and has to refer more and more people to outside sources of care. He blamed a lack of funding from the city and state for the change.
"Once healthcare reform is fully implemented that should improve the picture for the low-income folks," he said. "In the meantime it's just pretty rough out there."