Mental Health Gaps in Illinois Are Costing Lives | Image Source: chicago.suntimes.com
CHICAGO, Illinois, April 11, 2025 – Illinois’s mental health care system is entering its core, and the consequences are felt in the streets of the city, courtrooms and prison cells. A recent six-part Chicago Sun-Times survey reveals disturbing trends: a small but deeply visible group of people with severe mental illness have repeatedly crossed legal and medical systems without ever receiving the long-term care they need. Despite expert warnings and the growing number of lives, taxpayers’ money and social protection, the structure of Illinois’s mental health system remains dangerously fragmented.
According to the research, there is no single agency responsible for coordinating mental health services in the state. This has reduced the number of gaps in care, particularly for the homeless, who have recently been removed from hospitals or participated in the criminal justice system. The former professor of law at the University of Chicago, Mark Heyrman, who spent more than four decades studying the mental health system, summed up the question: “If you failed in the previous download plan, we should say, ‘Why did you fail?’ Usually it’s not ‘you failed’, but ‘we failed’
Why do the mentally ill fall into cracks?
Heyrman’s point is not just philosophical – it’s convenient. Many patients with severe mental illness are released with minimal follow-up support. They are often given a bottle of medication and told to report to a clinic, without guaranteeing that they will have accommodation, transportation or even the ability to move on. This failure of the so-called “hot demonstration” often leads to a return to crisis, sometimes with tragic consequences.
One of the most alarming findings of the Sun-Times report is the frequency with which people with untreated mental illnesses are victims and perpetrators of crimes. Although they are statistically more likely to be victims, a visible minority of people with mental disabilities – often without stable support networks – commit violent acts after long-term systemic abandonment. The cases of Henry Graham, Tony Robinson and Joseph Guardia, among others, illustrate this cycle of lost opportunities and growing public danger.
What happens when the treatment is too late?
The failure of the system was costly. Each of these individuals had a documented history of serious mental illness and multiple interactions with law enforcement agencies or mental health institutions. For example, the Guard had been diagnosed with bipolar disorder and had already been hospitalized for suicidal thoughts. In 2022, however, he burned Joseph Kromelis, 75, sleeping in a downtown street.
These tragic cases are not isolated – they are emblematic of a model. Asked about the state’s mental health infrastructure, Cook County Sheriff Tom Dart described his prison as a de facto psychiatric centre. “On average, I have 3,000 people with undiagnosed mental illness in my care
he said, expressing frustration at a system that continues to default to incarceration over treatment.
How much does it cost to divert mental health?
The price of this crisis is incredible, not only in human suffering, but in dollars. According to government data cited in the report, Illinois spent $49,271 per person per year in prison in 2024. Meanwhile, mental health services based on the “mural” cost of the community range from $15,000 to $35,000 per client per year, according to the estimates of the largest service providers in Chicago. In other words, we pay up to 70% more to lock people up than to help them stay healthy and get out of jail.
These figures are not abstract accounting figures. They represent a misalignment of priorities. Imprisonment is not treatment. Yet, a broken system forces law enforcement and prison officials to manage the fall of untreated psychiatric diseases – roles that have never been trained to accomplish.
What are the barriers to access to treatment?
One of the most striking problems is the shortage of psychiatric beds. Illinois has about 1,200 psychiatric beds – unfortunately insufficient for a population of nearly 13 million. With cuts that refer more and more people to state hospitals, waiting lists have been dropped. In early 2024, 23 persons found unfit for trial remained in prison for more than 50 days each, pending their transfer to a public hospital. Four of them waited more than 100 days.
Meanwhile, these persons were kept in Cermak hospital inside the prison, which cannot provide the same level of psychiatric care as a specialized public institution. The situation in Cook County is reflected in rural Illinois, where inmates may not be treated. This often leads to further psychiatric deterioration, creating more dangerous situations for all concerned, including other detainees, prison staff and the public.
Is there a better way to go?
There he is. Community experts and advocates point out that community-based treatment teams are one of the most effective interventions. These are mobile units of mental health professionals who provide intensive and personalized care, including medication management, housing assistance and crisis response, outside hospital settings.
Organizations like Thresholds and Trilogy run several ACT teams in Chicago and its suburbs. It aims to keep people healthy and engaged in their communities rather than isolated or institutionalized. But these facilities are limited in number, underfunded and often stretched. The former threshold clinician Debbie Pavick claims that finding staff engaged for such a demanding job is one of the greatest obstacles to climbing the model.
Thresholds Managing Director Mark Ishaug is the lead: “We know that the cost of a few nights in prison and a few years in prison is exorbitant. It doesn’t lead to recovery. The magic ball is a very good use of resources at the front.”
What legal tools are available but under-used?
The State of Illinois Act permits civilian outpatient engagement, a court-ordered treatment plan in the community for people who pose a danger to themselves or others. However, this tool is rarely used. A new federal government grant will help educate stakeholders and simplify the process to manage at least 50 cases per year in Cook County. Scott Block, Director of Behavioural Health, said this approach could prevent the “rotating door” of arrests, prison stays and untreated diseases.
However, the State ‘ s capacity to maintain and expand these services is of concern, given the imminent threats to funding. The Medicaid cuts proposed by the Trump administration and the cancellation of $153 million in federal donations, including $28 million for behavioural health, have cast the shadow on already tense suppliers. Illinois and other states challenge the judicial restraints, and a federal judge temporarily blocked them in early April.
What is the role of local authorities in mental health reform?
Municipal and state governments are trying to make incursions. Chicago Mayor Brandon Johnson has reopened several mental health clinics closed in previous years, bringing the number to seven. The city also deployed CARE teams, mobile crisis response units, in seven police districts. These teams are composed of mental doctors and emergency teams that respond to psychiatric emergencies rather than police.
However, even municipal officials warn that these CARE teams are a solution for all. Dr. Miao “Jenny” Hua, Acting Assistant Commissioner of Behavioural Health in Chicago, said: “CARE will not be able to implement the full range of services needed for the most at risk.”
Experts agree that stable housing must be the foundation upon which all other services are built.
Betty Bogg of Connections for the Homeless of Evanston said clearly: “We put Band-Aids there and send them back.” Without permanent housing, no treatment plan can be effectively implemented.
Ultimately, experts advocate a paradigm shift: from pay to recovery. This means investing in people before they become cases. This means recognizing that public safety and public health are inextricably linked. And above all, it means accepting that when we neglect the most vulnerable among us, we all pay the price.
As the doctor says. Stephen Dinwiddie, former director of the Elgin Mental Health Center: “If there had been the capacity to adequately treat mental illness, which was the driving force behind other actions, the tragedy would not happen. »
The tragedy is not just in the crime, but in the system’s failure to act before it happens.
