From Jacobin: “Police violence and lack of access to essential care services have emerged as twinned hallmarks of American life. In a nation in which people with unmet mental health needs are 16 times more likely to be killed by police, about a quarter of all people killed by U.S. police since 2015 were suffering––or were perceived to be suffering––from a mental health crisis. In Chicago, a series of killings by police since former Mayor Rahm Emmanuel closed over half the City’s public mental health centers has galvanized a movement to confront this by transforming the city’s mental health and policing systems.
Born out of the occupation of the Woodlawn Mental Health Center by community organizers after Emmanuel announced its closure in 2012, the movement has coalesced around a policy demand called Treatment Not Trauma (TNT). Chicago’s new progressive mayor, Brandon Johnson, has embraced TNT as a central policy for rebuilding the City’s public health infrastructure and addressing deep-rooted abuse and corruption in the Chicago Police Department. With a TNT working group tasked with delivering recommendations to the Mayor in advance of next year’s budget proposal, the degree to which the Johnson administration is truly committed to building TNT at scale––and not just as a symbolic gesture without serious financial investment––will soon become clear.
TNT begins from the recognition that the most important part of addressing mental health and behavioral crises is to prevent them from ever arising. It therefore calls for neither a psychiatric nor police model of mental health response––both of which are dominated by reaction rather than prevention––but instead for a public health model of community mental health.
This approach, which I have collaborated with the Collaborative for Community Wellness to design, consists of three interdependent parts. First, to relieve police of responsibilities to function as mental health workers, it calls for the Chicago Department of Public Health (CDPH) to build out a non-police mobile crisis response system for the entire city. Second, it entails reopening the network of 19 public mental health centers that CDPH operated until the 1990s to now function as crisis reception and stabilization centers as well as community hubs for everyday preventative outreach and supportive services.
Third, TNT revolves around hiring a large-scale community care worker corps comprised of lay residents from Chicago’s most dispossessed neighborhoods who are then trained and employed by CDPH in dignified, career positions (ie, with compensation, benefits, and protections parallel to those currently given to police officers) as peer support specialists working in task-sharing collaboration with supporting mental health professionals in communities with greatest unmet social, medical, and economic needs. It’s this last part––a bottom-up human infrastructure for community care that seeks “mental health for all by involving all”––that’s the most essential, transformational, and currently widely overlooked element of the TNT agenda.
If TNT succeeds in garnering sufficient financial support in ongoing City budget negotiations, Chicago will become one of the few U.S. cities to attempt to buck the lucrative American medical industry’s disastrous domination over the nation’s care systems by putting into practice a model of preventive social care that has been shown in numerous examples around the wor
TNT is, in short, exactly the kind of revamped model of demedicalized public health that this country––which is suffering from what is now without question the worst public health, safety, and healthcare among all wealthy nations––desperately needs if it is to have any chance at rebuilding health. TNT is also the kind of bold social program required to foster trust in government and between neighbors during a historical period characterized by worsening social isolation and the profoundly fragile state of US democracy. By building systems to support people in caring for one another, we are in effect also building systems with which to care for the future of democratic possibility in a world prone to self-destructive violence and authoritarianism.”
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