What's Going on in Chicago?
My perspective from the frontlines of community mental health.
Posted Aug 08, 2018
In a seven-hour period this past Sunday morning, 41 people in my hometown of Chicago were shot. Over the course of the weekend, a total of 74 people were wounded, and 12 of them died. Chicago’s homicide rate is down overall compared to this point last year, or in 2016, when Chicago saw a record 764 murders, but once again we found ourselves in the news for all the wrong reasons.
There has been no shortage of public figures offering their opinion as to what is 'really' going on here. Attorney General Jeff Sessions has blamed a consent decree banning stop-and-frisk practices as well as our city’s sanctuary status. Mayor Rahm Emanuel has called for more police and an “attitudinal change” within communities. President Trump has opined that the city’s leaders are not doing their jobs, referencing a mystery cop who told him that the violence could be ended immediately “if we let them do their jobs.”
I work in community mental health in Chicago. My clinic is located on the West Side, and most of my clients live in the South and West Side neighborhoods that have suffered the most from gun violence. I don’t believe any of the above theories adequately explain our murder rate; researchers who have examined Chicago’s violence closely have concluded that it is due to a variety of factors, the precise mixture of which is impossible to determine. Violence is ultimately a mental health problem because some of those who survive being shot, as well as those who witness them being shot or live in communities where shootings happen on a regular basis, find their way into my office or one very similar. Worse, most aren’t aware that such services exist or are simply unable to access them, whether due to distance, insurance, or a lack of resources.
Chicago’s community mental health safety net is badly frayed. As I’ve written elsewhere, Emanuel closed half of the city-run mental health centers, most of which were located in communities grappling with gun violence, and has done little to make up the difference. There are clinics like mine, but not enough of them. Until we hired a few new therapists recently, our waiting list topped out at over 180 people. It’s down for the moment, but we receive over 100 new clients a month, so in due time it will rise again.
Children of Holocaust survivors are more prone to developing PTSD. We know that trauma can be transmitted generationally. I often think of the countless children of patients I’ve treated who aren’t allowed to go outside and have minimal contact with their peers outside of school, not because their parents are neglectful but because they are trying the best they can to keep their children alive.
Recently I was interviewing a new patient at our clinic who told me about losing most of his friends and a few family members to gun violence. This is sadly common; it’s relatively rare for me to meet an incoming patient who doesn’t know a friend or relative who has been murdered. At some point he looked up through tears and asked me, “Have you ever lost anyone?” I was caught off-guard. I stammered something about losing a few great-grandparents and a grandparent, as well as an aunt to cancer, but I knew that wasn’t what he meant. “No, I don’t know anyone who has been killed,” I answered.
Complex problems require complex solutions. I don’t have all the answers for how to solve Chicago’s violence and I would never pretend to, but I think it looks something like community reinvestment, police reform, and restoring adequate funding for public schools and mental health centers. Mental health is one of the few jobs one can have where one dreams of becoming obsolete. We know too much about the genetic roots of mental illness for this to ever be the case, of course, but we as a society can take some hard but necessary steps to end the blood flow in Chicago and thus reduce some of the pervasive trauma taking place in too many neighborhoods. Knowing and doing are two different things, of course.
Chicagoans are a resilient people. The Kedzie Center, which opened a few years ago, was approved by local residents who agreed to a raise on their property taxes to fund a community mental health clinic offering time-unlimited therapy to anyone who resides in the area. Another such clinic will be opening soon, and a third was just approved by voters. Residents of Woodlawn, who lost their only mental health clinic due to Emanuel’s cuts, recently opened a “Healing Village” in an unoccupied area in the neighborhood. The area's self-proclaimed “gangster” alderman is pushing to evict it, however. Such gestures give me real and lasting hope, but they only address the problem after it’s occurred. We need city leaders brave enough to work on the root causes of violence, to stop acting like it is inscrutable but rather the result of a parade of policy decisions. Until then, my colleagues and I will continue working alongside the brave men and women who live here to work towards healing and hope.