As the city prepared to close three more mental health clinics Monday, Chicago mental health advocates protested outside Mayor Rahm Emanuel’s City Hall office.

According to the Mental Health Movement, the coalition leading ongoing protests against the mayor’s clinic consolidation plan, Chicago’s City Hall will close earlier than usual — at 4:30 p.m Monday — ahead of a press conference advocates had slated for 5:15 p.m. The group instructed those interested in participating in the press conference to arrive before 4:30 and proceed to the building’s fifth floor.

(Follow Monday’s occupation live here.)

The group reports that one demonstrator was arrested earlier Monday during the demonstration in the lobby outside the mayor’s office. WGN notes that protesters have said they are prepared to stay put in City Hall for days to bring additional awareness to the city’s plan. They are demanding that the city clinics remain open, public and fully funded.

Earlier Monday, the group protested outside both Illinois Gov. Pat Quinn’s office and President Obama’s 2012 campaign headquarters in downtown Chicago.

Outside Obama’s Prudential Plaza campaign office, some four dozen advocates protested and delivered a leader to the president seeking a “pardon” from the cuts they say will have a devastating impact on the clinics’ clients. The clinics are slated for closure by the end of the day Monday.

“Shame on Rahm Emanuel for possibly hurting the president’s plans for universal health care, by him denying health care to the poor and the mentally ill,” N’Dana Carter, a protester and clinic of a city-run clinic, told CBS Chicago.

Emanuel has been unrelenting in his consolidation plan, which the city claims will save it some $3 million, with one minor exception. Progress Illinois notes that the mayor’s office confirmed Monday that the Woodlawn Mental Health Center would now remain open — though only as a “satellite office” staffed by two therapists.

That change may have come after several individuals in the city for the World Summit of Nobel Peace Laureates visited the Woodlawn clinic, the site of an ongoing protest against the cuts, last Thursday morning.

Ingeborg Breines, co-director of the Nobel Prize-winning International Peace Bureau, and Shan Cretin, chair of the Nobel Prize-winning American Friends Service Committee, both urged the city to halt its clinic closure plan.

“Chicago is able to raise the funds to sponsor showcase events like the Nobel Laureate Summit or the upcoming NATO meeting,” Cretin said. “I urge the mayor to be equally energetic in finding the funds to support the community mental health centers.”

After a series of protests before the closures, Mental Health Movement activists barricaded themselves inside the Woodlawn clinic as its shutdown deadline neared. After police secured the clinic, the protest moved outside, where demonstrators have been camped for 14 days, despite pressure from police to leave. Thirty arrests were reported during the occupation.

Dr. Bechara Choucair of the Chicago Department of Public Health, has argued that all displaced patients will continue to have access to quality care, but the Mental Health Movement said the consolidations will prevent some people from seeing their doctors or getting their medications. Further, they argue that the cuts have already meant that 18 patients who no longer can receive mental health care in their neighborhoods have been hospitalized or admitted to the psychiatric ward.

Last Tuesday, Emanuel claimed that the cuts will actually improve the mental health services Chicago offers, and the city will offer a CTA card for the first month to help ease the financial burden of longer commutes to access services.

“We’re actually adding patients who were denied service because we didn’t have the resources,” Emanuel told the Chicago Sun-Times. “Now, I understand peoples’ protests. They have a right to do that. If there was an arrest dealing with trespassing for other issues, I’ll look into it. But, I want people to remember: I take the issue of providing benefits and care to those who need mental health benefits seriously.”

WATCH mental health advocates speak with Chicago police during the Woodlawn clinic occupation earlier this month:

See photos from the Woodlawn Mental Health Center occupation, below, courtesy of Margo Elena Mejia and HuffPost blogger Mark Cassello:

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A new study by Connie Wanberg, Associate Dean at the University of Minnesota’s Carlson School of Management and three other academics, takes a look at what happens to people’s mental health when they lose their jobs, and how their mental states fare in the 20 weeks that follow. From a low right after getting laid off, most people experience a steady improvement in their sense of well-being. Then, if they haven’t found a job 10-12 weeks into their search, the trend reverses and they start feeling rejected and depressed.

Wanberg tracked 177 unemployed  people over the course of 20 weeks by sending them weekly online surveys. Those who engaged in more intense job searches exhibited better mental health than those who were more relaxed about looking for work. The researchers measured mental health by asking respondents to rate themselves on a six-point scale in response to questions like, “have you felt downhearted and blue?”

The study underlines what is most difficult about looking for a job. It is a lonely, unpredictable process with no rules, no guarantees, no supervision and a huge amount at stake. As Professor Wanberg writes in the paper, “Looking for a job is an unfolding task that is highly autonomous, self-organized, loosely structured, and ill-defined. Individuals must decide on their own how and how often to search, and they rarely receive feedback about the effectiveness of the job-search activities and the strategies they are using.” In other words, both motivation and reward must come from within. When rejections start to pile up, it can be incredibly difficult to keep slugging.

One intriguing statistic from the study: Though career professionals say that job seekers should treat their search like a full-time job, participants in the study spent only 17 hours a week on their search at the outset. That declined to 14 hours a week at week 15, and then ticked up slightly after that. The lesson here, say the researchers: Track the amount of time you spend on your search and bump up your effort if you find it lagging.

A piece of good news: even in this depressed job climate, 128 or 72% of the study participants found a job within the 20-week study period.

The biggest lessons from the study: Not only is finding a job in your own hands but so is your mental health, which is directly linked to your ability  to push ahead with your job search. Though looking for a job can be one of the toughest tasks in life, especially when you’re feeling down, it’s incredibly important to soldier on. Remaining jobless and not trying to find work takes a toll on self-esteem and overall mental health. Networking and going on informational interviews is horribly tough when you’re feeling low, but it pays off in self-esteem and ultimately, in your ability to land a job.

As I’ve written many times, job seekers should limit their time online and make an effort to get out and meet people face to face. Most people still find work through people they know.

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New benefits depends on continuation of federal healthcare reform

By Mary Flynn, California Health Report

While the heated national debate about healthcare reform continues, many health communities in California are quietly making changes to prepare for the Affordable Care Act’s implementation. Federal funding is available to help community clinics transition towards what they will resemble in 2014.

One important change that’s taking place: community clinic are moving towards becoming ‘medical homes,’ or centers of care. That means qualifying low-income patients have access to primary care, pharmacy services, or specialty care (by referral). And especially exciting to health specialists is the new availability of mental health and substance abuse services, which are being included at clinics for the first time.

“For years, we separated out those conditions as if they were somehow different from a heart condition or an ulcer or if you have diabetes,” said Leslie Tremaine, the Mental Health Director for Santa Cruz County. “But in fact, what we know is that mind and body are completely connected; “health” needs to incorporate all of those needs.”

Mental health issues affect a significant number of people. According to a 2009 report, an estimated 45 million adults suffer from sort of mental illness each year, including issues with depression or anxiety, but of that population, only approximately 38% of them receive any sort of treatment for mental illness.

In Santa Cruz, behavioral health specialists are now able to seeing patients at community clinics. “Our staff are going to those sites and integrating what we do with what you go to the doctor for,” Tremaine said.

During a check-up, the primary care doctors conducts an assessment that indicates whether a patient is suffering from a mental health issue or has a substance abuse problem. If it appears the patient has a problem, they can seek treatment inside their own clinic.

“The provider can walk down the hall to office and introduce the patient to that clinician right there,” said Lynn Harrison, a Behavioral Health Program Manager. She said it is called a ‘warm handoff,’ and when this introduction happens, it significantly increases the chance the patient will continue to seek care.

Harrison explained that the county does not have enough specialists to staff each of the four clinics full-time, but they try to do a warm handoff as much as possible.

In the past, a patient would have to request an appointment with a mental health or substance abuse specialist for a different date and place. Leslie Tremaine said that simply locating behavioral health clinicians in the same building makes a difference in whether a patient will continue to seek treatment.

“For a lot of people just getting to another place is too confusing or too hard to do, and maybe they’re embarrassed about the idea of having a mental health problem so going to see a ‘shrink’ is something they wouldn’t do,” she said, “But they’d see somebody right inside their own health provider’s office.”

Additionally, unless the person was severely mentally ill, or required psychiatric observation or medication, the cost of the care would not be covered. So those suffering from mild to moderate mental conditions, such as depression or anxiety, would be less likely to receive care.

“We can see people who would otherwise not have been seen or not have met the system of care,” Harrison said.

In the past behavioral health had been largely excluded from patient care, but for Tremaine and other mental health care workers, the future of healthcare reform appears much brighter. “What we’re excited about is that healthcare reform is based on the notion that mental health and substance abuse are part of the whole picture of health,” Tremaine said.

In January of this year, four clinics in Santa Cruz County – MediCruz North County Clinic, MediCruz South County Clinic, Salud Para La Gente, and Santa Cruz Women’s Health Center – began offering a pilot public health program, called Medicruz Advantage, that expanded Medicaid eligibility.

Medi-Cruz is the name given Santa Cruz County’s Medicaid program (while Medi-Cal is the name of California’s Medicaid program). This program, whatever the name, provides necessary health care services for low-income individuals with specific diseases such as breast cancer or HIV/AIDS.

Medi-Cruz Advantage is an expansion of Medi-Cruz where patients no longer need to have a specific condition to receive care. As long as an applicant meets the eligibility requirements – resident of the county, is a legal resident, and has an income at or below 100% of the federal poverty level – they can qualify for comprehensive care.

Leslie Goodfriend, the MediCruz Advantage Manager for Santa Cruz County Health Services Agency, said that before under MediCruz, someone with a specific medical need could apply for care from the county and potentially receive care for specific services related to their condition for a few months.

“It’s what we consider ‘band-aid’ care,” she said.

“The intention behind the medical home is that people can see a doctor, not just when they’re at death’s door or when they have an acute situation, “ she said. The medical home provides patients not only with preventative wellness care, but a primary care person to contact if they have a question or an issue, rather than crowd inside emergency rooms.

”These folks did not have that before,” she said, “and they would certainly not get mental health or substance abuse services.”

The Medicruz Advantage program is not the only one of its kind. In other counties in California, it is called the Low Income Health Program (LIHP), a pilot program between now and 2014 that gives counties an opportunity to see how healthcare reform might work for them.

Fourteen counties have been authorized their own version of the LIHP in California, while another 13 are pending. Eligibility for the program varies from one county to the next, but each is part of the Affordable Care Act’s “bridge to reform” that provides heath coverage to low-income legal residents of California.

Through the program, the federal government matches what the county spends on healthcare. “Where we paid 100% of the cost before, we’d now only pay 50% and get federal reimbursement for the cost,” Tremaine said.

“The feds have made it financially advantageous to participate in the program and that helped us bring some staff on to do this,” she said.

However, whether healthcare reform will continue, and its corresponding flow of federal funding, depends largely on what the Supreme Court decides. Tremaine said that although they will continue to work towards integrating behavioral health with clinical care, access and comprehensive coverage would be hindered by the loss of federal support.

“The whole community benefits when we all have access to health care, and that health care includes mental health and substance abuse,” she said. “Healthy people make healthy communities.”

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