Earlier this year, the Institute on Social Exclusion at Chicago’s Adler School of Professional Psychology unveiled the results of recent applications of its Mental Health Impact Assessment (MHIA) on the decision-making processes of U.S. communities.
Lynn Todman, Ph.D., executive director of the school’s Institute on Social Exclusion, says that MHIAs are designed to complement more common health impact assessments (HIAs), which consider the likely impacts of public policy decisions on overall public health. Building on the HIA model, the MHIA offers a systematic method for considering the mental health implications of public policy decisions.
”Three years ago, many HIAs did not consider mental health at all,” Todman said. “While there was sometimes a reference to depression or stress, as a rule, the focus was on physical health outcomes. The MHIA has been designed in a very rigorous and comprehensive way to integrate mental health considerations into the established practice of HIAs.”
In Englewood, a low-income and predominately black Southside Chicago neighborhood, teams of researchers used the MHIA to measure resident concerns over proposed changes to anti-discrimination policy guidance promulgated by the U.S. Equal Employment Opportunity Commission (EEOC). The teams, which included members of the community and partner organizations, w wwww ere led by the School’s ISE and supported by its Institute of Public Safety and Social Justice. The use of the MHIA was potentially important because although the EEOC typically studies the interests of employers in its rule-making process, the impact of new EEOC rules on the mental health of would-be workers and entire communities is generally not systematically evaluated.
In Englewood, the MHIA sought to explore the mental health implications of employment discrimination, unemployment, and income insecurity as experienced by minority populations. In doing so, it used statistics related to law enforcement methods as a key variable in the long-term wellbeing of Englewood residents. Specifically, the MHIA found that heavy policing of Englewood—large sweeps and mass arrests—were causing unexpected employment problems for area residents.
Statistics demonstrated that Englewood residents were being arrested at rates two to three times the national average due to law enforcement’s sweep-style methods. And, although most of these detentions did not result in criminal charges or convictions, they nevertheless left many residents with arrest records. And, in a local job market where 7 of 10 employers used arrest records—not felony convictions—as a screen for potential hires, the MHIA found that many residents had lost even the hope of employment.
Importantly, the MHIA concluded that amendments to EEOC policy guidance that curbed the practice of disclosing local arrest record information would potentially improve employment prospects for Englewood residents who had never been convicted of crimes. Among behavioral health experts, the MHIA’s most compelling finding was that amendments to the enforcement guidance that EEOC provides to employers might assuage what ISE Project Manager Tiffany McDowell called “a state of communal mental un-wellness.”
“Residents talked so much about this lurid hopelessness that it just seemed to permeate the community,” McDowell said. Residents who responded to surveys described the hopelessness engendered by the likelihood of long-term unemployment and poverty: high levels of stress, anxiety, and depression — persistent mental health concerns that the community was ill-equipped to address.
In fact, Englewood’s mental health challenges, and the policies that compounded them, are quite common in vulnerable urban communities across the United States. Moreover, they strongly correlate to the social issues which have confounded policy makers for decades.
Persistent hopelessness encourages an informal economy and factors into the prevalence of violent crime in surrounding neighborhoods. While policies have long sought to assuage the physical health challenges posed by issues of violent crime, urban blight and chronic poverty, few policy debates have considered or sought to address the underlying mental health issues of vulnerable populations as a factor that contributed to such social environmental instability.
“Our findings showed that there is a need to be systematic when approaching these issues.” McDowell said. “We need to look beyond what we can do for individuals and look at what can be done to fix the systems that support communities like Englewood.”
With the MHIAs, mental health professionals may now have a way to do that. Already, the ripple effects of the tool’s use in Englewood study may be seen throughout the country. New EEOC guidance regarding the use of arrest and conviction records in employment — guidance that encourages the hiring of individuals with arrest records — was issued in late April. One expert called the guidance a demonstration of “tremendous leadership and courage” by the EEOC in addressing criminal-record based employment discrimination which, he said, “serves as a surrogate for race-based discrimination.” In August, New York City agreed to expunge the names of individuals arrested, but not convicted, from a database of information collected in the NYPD’s controversial “stop and frisk” program.