The elimination of 50 beds and 47 employees last month from Chicago-Read Mental Health Center was only the beginning of sweeping changes state health officials are planning in the Chicago area.
June 15 marked the official date when Chicago-Read, 4200 N. Oak Park Ave., changed its admissions procedures. Now all patients are referred through a contact center based at Madden Mental Health Center in Maywood. Accompanying shifts in the geographical areas served by Chicagoland's three state mental-health hospitals - which also include the south suburban Tinley Park Mental Health Center - will mean that many Chicago-area residents no longer will be served by the only such facility actually located within city limits.
When the transition is complete, Chicago-area residents, including those from Morton Grove, Skokie and Lincolnwood, who previously would have been admitted to Chicago-Read for emergency stabilization and treatment for acute mental-health episodes instead will be cared for at Madden.
The Illinois Department of Human Services had already begun implementing the changes. Dr. Chris Fichtner, director of the Division of Mental Health, said the new procedures are part of a broad effort by the state to incorporate community hospitals as the first point of contact for people who need immediate inpatient psychiatric services. State facilities increasingly will be reserved for those in need of more intensive treatment, who will be referred by the community hospital where they first seek help.
"It's not to say the other sites are out of commission," Fichtner said. "It's just that we've shifted the burden to Madden."
Fichtner said the consolidation of services is both a response to ongoing trends in this and other states and to limited funds amid steady demand in a flat-budget year. Community hospitals with which the state contracts for inpatient care must apply for public insurance, such as Medicaid, for their patients. If a patient is turned down, the state picks up the bill; if the person is approved, the federal government picks up half of the average $500-a-day cost of treatment.
While Madden will be farther away from home for some area residents, the hospital is more centrally located in terms of the entire metropolitan area, Fichtner said.
Opponents to the state's plans contend the reductions and boundary realignment will dilute and delay treatment for patients at the moment they are most vulnerable.
"Their typical patients are folks who are really in the throes of a severe mental-illness episode," said Anders Lindall, a spokesman for the state-workers union, AFSCME Council 31, adding that those patients frequently are without health insurance, family support or social networks. "They really may be relying on public mental-health centers like Read as their last safety net between them and homelessness, between them and the criminal-justice system."
Treatments for psychological disorders, Lindall insisted, are more effective when patients are treated closer to their homes. "That's a travesty to take someone in a mental-health crisis and tell them, 'We can't serve you because you live in the city of Chicago,' " he said.
In a letter to the editor appearing May 22 in the Chicago Sun-Times, Cook County Commissioner Larry Suffredin, 13th District, opposed the cuts, saying they would place an unfair burden on county taxpayers. "After all, when those who need hospitalization can't find a bed, they usually go without care until they end up in the wrong place: one of our three county hospitals, or worse, Cook County Jail," Suffredin wrote.