HEALTH
As the City Reopens, Mental Health Clinics Keep Services at a Distance A “significant portion” of services could stay remote as clinics permanently adopt telehealth BY JIM DALEY
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n March, when the coronavirus pandemic shut down schools and businesses across Chicago, the city’s public mental health clinics also reduced walk-in services wherever possible and largely switched to providing therapy remotely via telephone or video conference. At a press conference on June 22 announcing how Chicago may ILLUSTRATION BY TURTEL ONLI
14 SOUTH SIDE WEEKLY
¬ JUNE 24, 2020
move to phase four of reopening from the coronavirus shutdown, Dr. Allison Arwady, commissioner of the Chicago Department of Public Health (CDPH), said that clinics will start to move back into seeing patients in person after the city finishes an ongoing buildings assessment and implements upgrades to protect patrons and staff.
On May 21, CDPH announced a suite of mental health initiatives, including partnerships with four community mental health organizations and $1.2 million in new funding to expand access for persons with serious mental illnesses. The expansion of services also includes a new partnership with Doxy.me to provide behavioral health services—including psychotherapy, psychiatry, case management, and group sessions—to patients via online video conferencing. The partnership will cost the city about $35,000 per year, according to an invoice reviewed by the Weekly. In an interview with the Weekly, Matt Richards, the deputy commissioner of behavioral health, said the cost covers one hundred annual user licenses, which will include all the CDPH mental health clinicians. Arwady said staff and patients have responded positively to tele-services, adding that she expects “a significant portion” of services will continue to be provided remotely even as the department begins bringing back in-person services. Richards said the department hopes to have its Doxy partnership fully rolled out by the end of the summer. Telehealth removes some barriers to accessing mental health services, but it’s not without its drawbacks: clinicians say remote sessions lack many of the subtleties and nuance in-person therapy affords. When the city’s clinics—in Englewood, Bronzeville, Gage Park, North Lawndale, Roseland, and North Park—initially shut down, behavioral therapists scrambled to continue treating their patients remotely. Clinicians told the Weekly the transition was challenging. Jay Roth, a clinical social worker at the city’s North River Mental Health Center (MHC) in North Park, said CDPH did not provide
very much technical support at first, and therapists adapted as best they could, mostly providing therapy by phone and, in some cases, improvising video-conference sessions with Zoom. “When you’re doing face-to-face therapy, you have a certain rapport and way of interacting that is really essential to the therapeutic process,” Roth said. He added that he has been cautious about using video conferencing with clients due to privacy and safety concerns. Roth also worried about the potential for a client to suddenly become distressed during a video call and drop the connection, leaving him unable to intervene. Angela Sims, a clinical therapist at the Greater Lawn MHC in Gage Park, said that when the clinics stopped offering in-person therapy, she switched to treating clients over the phone. The medium put her clinical skills to the test. “You’re having to infer a lot more by just one mode of communication,” she said. “And there are a lot of people who just don’t emote well over the phone.” Getting a sense of whether a client is really doing as well as they say they are can be tricky. During an in-person therapy session, Sims is able to use multiple senses—visual, smell, and hearing—to assess a client’s condition. Over the phone, it’s harder to make sure she’s not missing anything beyond what the client is telling her. “And that’s when they answer the phone,” she said. Some clients may not even pick up because they are preoccupied with kids or family. “There are some other folks who tend to just reach out only when they’re in crisis mode,” she said. “They’re not going to answer the phone just because you called.” An intake—during which a clinician first talks to a new client to figure out their treatment needs—was one of the hardest
