Trilogy Bucks The Looming
Mental Health Crisis

By Thelma Walker

Amidst Illinois’ budget crisis, Gov. Pat Quinn is poised to make broad-stroke cuts in Medicaid and mental health spending.

In the proposed state budget, mental health care for individuals without Medicaid would cease –– dramatically affecting tens of thousands of citizens.

Half of Chicago’s 12 neighborhood mental health clinics are scheduled to shut down, forcing many to travel farther for their services, if they can get there at all.

And the Tinley Park Mental Health Center is set to close in early July.  Once a 150-bed facility providing 24-hours to 21-days of acute care, it now has only 50 patients due to staff cuts over the years.

John Mayes, president and CEO of Trilogy Behavioral Healthcare Inc. located in Rogers Park, says, “The Governor’s proposed disproportionate budget cuts will result in lost services that will leave many individuals and communities without essential community-based mental health services.

“For example, the planned closure of the Tinley Park state operated mental health facility will leave people without a state facility for inpatient care.

“The Governor’s budget also includes the closure of Singer Mental Health Center in Rockford and the Murray Developmental Center in Centralia.

“There are other closures and consolidations in the works to the extent that it appears as if the state of Illinois is trying to get out of the business of providing mental health services to some of its most vulnerable citizens.”

Trilogy is a not-for-profit behavioral health care organization serving individuals with serious and persistent mental illness and/or co-occurring substance use/abuse disorders. Its mentally ill population served is very diverse and reflects the community in which it is located.

In Trilogy’s last fiscal year, 548 individuals received services, 115 individuals were housed, 460 received primary health care screenings, and 411 clients were linked to psychiatric services.

The organization celebrated its 40th anniversary last year and has become one of the leading community mental health organizations on the city’s North Side.

It also recently became one of six mental health organizations across the state of Illinois selected to pilot the implementation of the Williams vs. Quinn consent decree, which was the settlement of a law suit filed against the Division of Mental Health by residents of nursing homes.

The purpose of this consent decree is to ensure that nursing-home residents with mental illness have the opportunity to receive the services they need in the most integrated setting appropriate.

The settlement also aims to promote and ensure the development of integrated settings that maximize individuals’ independence, choice, and opportunities to develop and use independent living skills, and afford the opportunity to live lives similar to individuals without disabilities.

Explaining the scope of the work that Trilogy offers the community, Mayes says, “When a client begins to receive services at Trilogy, an estimated 75 percent of them require psychiatric care, 70 percent need entitlements or some form of assistance, 40 percent are in need of medical care, and 18 percent are homeless.”

While noting that Trilogy is fortunate to have a strong, supportive board of directors led by Dr. Catherine Barnhart, and an excellent leadership team, Mayes says that it is the clinicians who have to do the direct services.

“I could not ask for a more dedicated, hardworking and caring group,” he beams.  “Our ‘Trilogy Tribe’ is made up of 105 very special employees who are helping to improve and save the lives of some of the most vulnerable citizens in our communities.”

Still, even Trilogy has not been unaffected by the budget crisis, where mental health workers across the board are feeling the impact –– in 2009, the Division of Mental Health cut Trilogy’s funding by 20 percent.

“We had to let a third of our staff go,” Mayes recounts.  “Those were tough times.  Other cuts and changes followed as we struggled to keep our doors open.”  He called partnerships and collaborations a key to his organization’s survival.

John Mayes and U.S. Rep. Jan Schakowsky

Integrated Health Care Partnerships

In October 2010, Trilogy Behavioral Healthcare and Heartland International Health Centers joined forces and resources and submitted a proposal to the U.S. Substance Abuse and Mental Health Services Administration for a clinic that would integrate behavioral health and primary care.

As a result, they were awarded a multi-year federal grant to expand Trilogy’s fledgling clinic and increase access to primary health care and behavioral health services for all of Trilogy’s clients with mental illnesses, substance abuse disorders, and other medical needs.

Clients with such health conditions as high blood pressure, metabolic disease, and diabetes can also receive services on site and learn to manage their health challenges.

This model of service –– a new holistic model for treating people with mental illness and primary health issues within the same multidisciplinary team, right in the community –– has been widely embraced by the medical and mental health communities and other advocates.

It is a model that best serves the client and the community in order to help reduce barriers to primary health care, to improve the overall quality of life for the people served by the organization, and to reduce costs for the entire health system.

U.S. Representative Jan Schakowsky and Dr. Bechara Choucaire, commissioner of the Chicago Department of Public Health, are big advocates of the integrated health care model, and there are hopes that Trilogy may serve as a model for other collaborations, thus enabling other community mental health organizations to better meet the needs of underserved groups.

Another of Trilogy’s successful collaborations is with Rush University College of Nursing.  Under the leadership of Alice Geis, Trilogy’s Director of Integrated Healthcare, Trilogy has been a practicum site for Rush for four years, offering placements and training for more than 160 nursing students since 2008.

Nursing students are given the opportunity to work with persons with serious mental illness.  Given the shortage of nurses in general, this positively impacts workforce development because there are few places where nursing students can actually work at this level with this population.

Of the partnerships, Mayes says, “We will continue to seek more collaboration, but, only if it makes sense. For instance, our partnership with Heartland International Health Center is a key component of our wellness efforts.

“The mission of another one of our partners, Chicago House, is to provide housing and supportive services to HIV-affected and HIV-at risk families and individuals who may also be impacted by poverty, homelessness, substance abuse, and mental illness.”

Mayes and Trilogy Board Chairman Dr. Catherine Barnhart

Where’d This Guy Come From?

You might call it serendipity that a 17-year-old high school dropout would convince his mother to co-sign so that he could enlist in the Marines and get off the dead-end streets of Fontana, at the time a small town in southern California.

But, that’s just what John Mayes did…and he credits that decision with saving his life, or at the very least, with creating broader possibilities.

Enlisting in March 1964, Mayes spent three years on active duty with the Marines.  In boot camp he also had an opportunity to take a GED test.

Mayes spent 13 months of his enlistment with the 3rd Marine Division at the Da Nang Air Base, Vietnam.  Although the Marines of the 3rd Division were the first American combat troops to be sent to Vietnam –– to protect the Da Nang airport, a major air base that was used by both the South Vietnamese and United States air forces –– John, a member of the Communications Battalion, worked in the communications center.

When time came for his return to the United States, Mayes requested to be stationed somewhere as close to the East Coast as possible. He was rewarded with an assignment to Camp Lejeune near Jacksonville, North Carolina, where he served the last nine months of his enlistment.

While at Camp Lejeune, John made friends with Marines from Chicago and Detroit.  Subsequently, after his discharge in early 1967, he lived in Detroit for a short period, then jumped for the opportunity to visit Chicago.

He was only supposed to stay in Chicago for one weekend, but was convinced by a friend’s family to remain. Except for brief periods of time in California and Oregon, Mayes has called Chicago home ever since.

Over the proceeding years, he worked a variety of jobs; first with the Curtis Candy Company, then after only a few weeks, he joined AT&T to make use of the communications skills he had developed as a Marine.

He also worked as a doorman, bartender and nightclub restaurant manager during this time. Then he entered what he likes to refer to as the “missing years,” a time of searching and trying to find some purpose and balance in his life.

It was the turbulent early 1970s, in a landscape of hippies, war protests, and Black power.

James Brown said Make It Funky, Aretha was waiting Until You Come Back To Me, Kool and the Gang wanted folks to Jungle Boogie, and John was working as a children’s attendant at the Cook County Temporary Juvenile Detention Center, commonly referred to as the “Audy Home.”

He worked there for eight years, but “early on, I noted the high rate of recidivism of the children and got this idea that if I could only work with some of these kids in the community, I might be able to help break this cycle,” he recalls.

“I soon discovered that it would take more than a GED test to make that happen. After some exploration and feeling a little hopeless, I found a program at Loop City College (now Harold Washington) where you did not have to have a high school diploma or have completed a GED program to attend.”

While continuing to work full time at the Audy Home, he started college classes and completed his associate’s degree in three years, graduating at the top of his class.

After a couple of false starts with private universities, Mayes enrolled at the University of Illinois at Chicago (UIC) to complete his undergraduate studies.  He majored in psychology and criminal justice and graduated with high honors and departmental distinction in criminal justice.

By this time, Mayes had decided he would rather work with adults. This led him to UIC’s Jane Addams School of Social Work, which had a criminal justice specialization program that would qualify him to work in the federal probation and parole system.

As he advanced in the program, however, he decided to take a generic tract in social work. He also sought and was accepted in an intern position with Thresholds, one of Illinois’ leading providers of mental health services, because he could walk there from his home in Chicago’s Old Town Triangle.

Toward the end of his second year of grad school, Thresholds offered Mayes an opportunity to create a new residential crisis program in Chicago’s Austin community. He accepted the position and ultimately worked at Thresholds for 21 years.

During that time he created many programs and services, and eventually joined the executive staff as an Associate Director. At the time of his departure, he was responsible for most of Thresholds’ programs on Chicago’s South and West sides and the Near-West suburbs.

Mayes also was responsible for the creation and development of the organization’s highly acclaimed staff training, orientation and development program.

Such is the simplistic version of how John Mayes, LCSW, CADC, entered his profession and ultimately became president and CEO of Trilogy Behavioral Healthcare, Inc.

Trilogy Heartland Clinic

An Award Of Note For Trilogy

Next Monday, April 16 at 6 p.m. at the Hilton Chicago, Trilogy is receiving the Reintegration First Prize Award in Clinical Medicine for its Integrated Healthcare Program.

The honor will be presented at the National Council for Community Behavioral Healthcare’s 42nd Conference on Mental Health and Substance Abuse.

The national Reintegration Awards, sponsored by Eli Lilly and Company, celebrates “the achievements of those in the community who dedicate themselves to improving the lives of individuals with serious mental illness.”

(For information and tickets, visit www.thenationalcouncil.org.)