>>> MAYOR BRANDON JOHNSON IS VOWING A DIFFERENT RESPONSE TO MENTAL HEALTH CARE THAN HIS TWO PREDECESSORS.

HE SAYS HE WILL REOPEN SIX PUBLICLY RUN MENTAL HEALTH CLINIC THAT CLOSED MORE THAN A DECADE AGO.

HERE HE IS AT HIS INAUGURATION YESTERDAY.

>> LET'S BRING TOGETHER THE PRIVATE SECTOR, THE PUBLIC SECTOR, THE COUNTY, THE STATE, AND THE FEDERAL GOVERNMENT TO FIND THE BEST SOLUTIONS FOR DELIVERING THE SERVICES, INCLUDING REOPENING OUR MENTAL HEALTH CARE CENTERS ACROSS THE CITY OF CHICAGO.

>> JOINING US ARE DR. ERIC REINHARDT AND PSYCHOANALYST OF NORTHWESTERN UNIVERSITY AND ARTURO , DIRECTOR OF HEALTH AND VIOLENCE PREVENTION AT BRIGHTON PARK NEIGHBORHOOD COUNCIL OF THE COLLABORATIVE FOR COMMUNITY WELLNESS.

WE ALSO REACHED OUT TO THE CHICAGO DEPARTMENT OF PUBLIC HEALTH TO JOIN THIS CONVERSATION BUT THEY DECLINED.

TONIGHT WE DO APPRECIATE BOTH OF YOU BEING HERE.

FIRST WITH YOU, DR. REINHARDT.

EXPLAIN FOR US THE MENTAL HEALTH CARE STRUCTURE THAT THE CITY HAS IN PLACE NOW.

AT LEAST THE PUBLIC INFRASTRUCTURE.

>> RIGHT NOW THERE ARE FIVE CITY RUN MENTAL HEALTH CLINICS.

THE VAST MAJORITY OF MENTAL HEALTH STRUCTURE IN CHICAGO IS PRIVATE.

SOME OF THAT STRUCTURE IS FEDERALLY QUALIFIED.

NONPROFIT ORGANIZATIONS.

CLINICAL INFRASTRUCTURE.

WHAT WE LACK IS AN INFRASTRUCTURE TO RESPOND TO PEOPLE WHO HAVE THE GREATEST NEED WHO DON'T NECESSARILY HAVE GOOD ENOUGH INSURANCE TO GET INTO A LOT OF THOSE PROVIDERS.

>> THAT WAS GOING TO BE MY NEXT QUESTION FOR YOU.

GIVEN THE LOOSE NETWORK OF NONPROFITS OR FEDERALLY QUALIFIED HEALTH CENTERS THAT EXIST NOW, ARE THERE BARRIERS FOR THE AVERAGE CHICAGOAN WHO MIGHT WANT TO ACCESS THIS HEALTHCARE?

>> YES.

ABSOLUTELY.

WE SEE LONG WAGES FOR SERVICES.

WE SEE A LOT OF GAPS IN COVERAGE.

UNFORTUNATELY WHAT WE SEE ALSO IS A LACK OF ACCOUNTABILITY.

WE REALLY DON'T KNOW WHAT TYPES OF SERVICES AND TYPES ARE .

>> ACCORDING TO CHICAGO DEPARTMENT OF PUBLIC HEALTH, THERE ARE STILL FIVE CITY RUN MENTAL HEALTH CENTERS THAT ARE OPEN.

THEY ONLY SEE A VERY SMALL FRACTION OF THE TOTAL NUMBER OF PATIENTS THAT THE CITY SEES.

THEY GO TO SOME OF THOSE OTHER ORGANIZATIONS.

SO WHAT IS THE ARGUMENT THEN FOR REOPENING THOSE MENTAL HEALTH CLINICS?

>> YOU HAVE TO PUT THIS IN HISTORICAL PERSPECTIVE.

OVER THE LAST 40 YEARS SINCE RONALD REAGAN AND THEN BILL CLINTON, WE HAVE HAD A DEFAMATION OF OUR PUBLIC HEALTH INFRASTRUCTURE OF THE U.S.

IT USED TO BE UNDER HAROLD WASHINGTON.

THE CITY OF CHICAGO IS ONE OF THE BIGGEST PROVIDERS OF AMBULATORY CARE SERVICES IN CHICAGO.

THAT HAS ALL GONE AWAY.

THAT DOES NOT EXIST AT ALL ANYMORE.

ALL THE MONEY THAT USED TO BE GIVEN TO PUBLIC INFRASTRUCTURE TO PROVIDE FOR PEOPLE'S NEEDS HAVE GONE TO NONPROFIT ORGANIZATIONS, SOME OF WHICH DO EXCELLENT WORK , BUT AS DR. JUST SAID, THERE ISN'T AN ACCOUNTABILITY INFRASTRUCTURE.

WHAT YOU HAVE IS LAYERS AND LAYERS OF GRANTMAKING WHERE YOU HAVE A WHOLE BUNCH OF REALLY SMART PEOPLE SPENDING ALL OF THEIR TIME TRYING TO GET GRANTS.

HUGE AND EFFICIENCY.

TRYING TO PRIORITIZE THEIR OWN ORGANIZATIONAL REPRODUCTION AND BUDGET OVER PROVIDING CARE TO PEOPLE .

NOT THROUGH ANY FAULT OF THEIR OWN.

THAT IS JUST WHAT THE STRUCTURE AND FORCES ON THEM.

WHEN YOU HAVE A PRIVATE HEALTHCARE INFRASTRUCTURE , YOU HAVE A HORRIFIC OUTCOME.

WE HAVE THE WORST HEALTHCARE SYSTEM IN THE ENTIRE PUBLIC WORLD.

DEVELOPED WORLD.

THIS IS A CONSEQUENCE OF DECADES OF --.

THE ARGUMENT FOR REBUILDING PUBLIC INFRASTRUCTURE NOW IS, LOOK AT WHAT WE HAVE.

IT IS AN ABSOLUTE FAILURE.

WE HAVE TO BUILD ANOTHER KIND OF MODEL.

YOU HAVE SEEN IT BEFORE IN THE U.S.

THIS IS A MODEL WHERE YOU CAN TAKE PUBLIC DOLLARS AND MAKE SURE THEY ARE GOING TOWARD PROVIDING SERVICES TO PEOPLE WHO NEED THEM MOST.

>> AS YOU SAID, HAVING THE CITY HAVE SOME ACCOUNTABILITY FOR THE OUTCOMES RATHER THAN THROWING MONEY AT AN ORGANIZATION AND NOT KEEPING TRACK OF WHAT HAPPENS.

ARTURO, GIVEN THE BARRIERS WE TALKED ABOUT AND GIVEN SOME OF THE ISSUES THAT DR. REINHARDT BROUGHT UP, HOW WOULD REOPENING MENTAL HEALTH CENTERS RUN BY THE CITY HELP SOLVE SOME OF THESE THINGS IN YOUR EYES?

>> THE ADMINISTRATION REALLY SET UP A HOUSE OF CARDS.

WHAT WE SEE WITH THIS LACK OF ACCOUNTABILITY IS THAT THE CONTRACTS THAT ARE PROVIDERS -- WE ARE LOOKING AT ACTUAL NUMBERS FROM FISCAL YEAR 2022.

THEY HAVE AN ABSURD RANGE.

ANYWHERE FROM 16 PEOPLE TO OVER 4000 PEOPLE.

SO EVEN THOUGH THE CITY TOUTED THAT IT WAS SERVING THOUSANDS OF PEOPLE, WE DON'T KNOW WHAT THOSE SERVICES ACTUALLY PROVIDED.

WORSE YET, THAT FUNDING ALL GOES AWAY WHEN FEDERAL RELIEF EXPIRES IN A YEAR OR TWO.

FOR US, BUILDING THIS PERMANENT INFRASTRUCTURE AND BUILDING IT INTO THE CITY AS PART OF A PERMANENT STRUCTURE OF SERVICE OF CARE FOR THE COMMUNITY RATHER THAN THROUGHOUT THE ENTIRE CITY IS AN EXCITING OPPORTUNITY THE ADMINISTRATION NOW HAS TO MAKE THEM A RESOURCE FOR EVERYBODY JUST LIKE WE HAVE CURRENTLY WITH LIBRARIES AND PARKS THAT ARE AVAILABLE AND ACCESSIBLE TO EVERYONE IN THE COMMUNITY.

WE HAVE THAT OPPORTUNITY NOW.

PART OF THE NONPOLICE CRISIS RESPONSE PROGRAM THAT CAN BE ESTABLISHED AND ROLLED OUT CITYWIDE.

>> SOME OF THOSE PLACES LIKE LIBRARIES AND PARKS ARE OFFERED AS MENTAL HEALTH SERVICES.

MAYOR RAHM EMANUEL SIDE OF THE COSTS AS BEING A REASON FOR NOT SUSTAINING THE CENTERS.

WHAT WOULD IT COST?

>> IT WOULD COST A LOT OF MONEY, FRANKLY.

CARING FOR PEOPLE COSTS MONEY.

BUT IF THERE'S ANYTHING THE GOVERNMENT SHOULD BE INVESTING MONEY IN, IT IS CARING FOR THE POPULATION.

WHAT WE HAVE IN CHICAGO AND PLACES AROUND THE U.S. IS A CHOICE TO PRIORITIZE PUNISHMENT AND REACTION THROUGH HEALTHCARE TREATMENT, WHICH IS REACTING , OR THAT CAN BE THROUGH POLICING AND RESPONDING TO VIOLENCE THAT HAS ALREADY OCCURRED.

WE HAVE SYSTEMATICALLY FAILED TO INVEST IN PREVENTATIVE STRUCTURE.

IT WILL BE EXPENSIVE.

>> THESE ARE ARGUMENTS OF THE