Good news is hard to come by these days at Chicago's mental health clinics. That's why it was encouraging to see Joanna Broder's piece in the Tribune earlier this week about the Community Mental Health Council Inc. on the city's South Side. After losing about $2.3 million in state funding in 2009 (15 percent of its budget), the council petitioned the feds and received $350,000, which they plan to use for testing and personal care:

The new funds will pay the salaries of two postdoctoral clinicians, who will supervise eight graduate student interns. The students bring something beyond the skills to conduct testing, White said.

They "have a lot more time to engage and slow things down and provide that one-on-one connection that some of us aren't able to do," he said. "That piece, in turn, creates that connection ... that helps people get better."

Before we get too excited, let's not forget that the only reason the council asked for assistance in the first place was because the state's appropriation for mental health services is paltry. Specifically, they pointed to a 2009 report from the National Alliance on Mental Illness that gave Illinois a "D"  for failing to deliver basic services, in part because the state ranks 30th nationwide in per capita mental health spending. And that ranking does not reflect the cuts required under the current budget strain. Nor does it take into account the current and future cuts at the city level, the result two-year-old, $16 million billing boondoggle.

Even worse, the city still hasn't attempted to explain or fix the underlying billing problems that have frustrated mental health providers. As a result, 108 staffers have already been laid off and 4,000 patients have lost access to care. Trying to computerize the city's billing system to increase efficiency is understandable. But there are lots of risks if it's not done right. The big problem at the Chicago Department of Public Health, according to documents obtained by journalist Alex Parker, is that the software was not programmed to work correctly with Springfield’s billing system. As a result, claims and service reports were never accepted. Because the coding in the software is proprietary, meaning it can not be modified in-house, clinicians have been unable to adapt. For more on the dangers of using these locked programs, check out Philip Longman's article last year in the Washington Monthly:

Why did similar attempts to bring health care into the twenty-first century lead to triumph at Midland [Memorial Hospital in Texas] but tragedy at Children’s [Hospital of Pittsburgh]? While many factors were no doubt at work, among the most crucial was a difference in the software installed by the two institutions. The system that Midland adopted is based on software originally written by doctors for doctors at the Veterans Health Administration, and it is what’s called "open source," meaning the code can be read and modified by anyone and is freely available in the public domain rather than copyrighted by a corporation. For nearly thirty years, the VA software’s code has been continuously improved by a large and ever-growing community of collaborating, computer-minded health care professionals, at first within the VA and later at medical institutions around the world. Because the program is open source, many minds over the years have had the chance to spot bugs and make improvements. By the time Midland installed it, the core software had been road-tested at hundred of different hospitals, clinics, and nursing homes by hundreds of thousands of health care professionals.

The software Children’s Hospital installed, by contrast, was the product of a private company called Cerner Corporation. It was designed by software engineers using locked, proprietary code that medical professionals were barred from seeing, let alone modifying. Unless they could persuade the vendor to do the work, they could no more adjust it than a Microsoft Office user can fine-tune Microsoft Word. While a few large institutions have managed to make meaningful use of proprietary programs, these systems have just as often led to gigantic cost overruns and sometimes life-threatening failures. Among the most notorious examples is Cedars-Sinai Medical Center, in Los Angeles, which in 2003 tore out a "state-of-the-art" $34 million proprietary system after doctors rebelled and refused to use it.

Cerner, by the way, designed the dysfunctional software used by CDPH.