Trauma Ordinance Proposal

The Treatment Not Trauma ordinance, introduced in 2020 and led by Rodríguez-Sánchez, sought to formalize an alternative approach. Its premise was straightforward: mental health crises should be treated as health emergencies, not criminal incidents.

The ordinance focused on two structural changes.

First, it called for reopening and reinvesting in publicly operated mental health clinics that had been closed over previous decades. These clinics were intended to provide accessible, community-based care, including counseling, psychiatric services, case management, and follow-up. The emphasis was on continuity rather than episodic intervention.

Second, it proposed non-police crisis response teams. These teams would consist of trained mental health clinicians and emergency medical technicians who could respond to crisis calls where there was no immediate threat of violence. The goal was de-escalation, assessment, and connection to care, rather than control or detention.

Importantly, the ordinance did not promise immediate citywide transformation. It established a framework and set of priorities, leaving room for phased implementation, pilot programs, and iterative design based on evidence and operational constraints.

Coalition Building and Institutional Resistance

Treatment Not Trauma did not advance on rhetoric alone. It was shaped by years of organizing by mental health advocates, clinicians, and community groups who had documented the harms of existing practices. Rodríguez-Sánchez’s role was to translate those demands into legislative language and shepherd them through institutional processes that are often slow and resistant to change.

Resistance was real. Police unions and some city officials argued that removing officers from crisis response would endanger public safety. Others favored co-response models, where clinicians accompany police rather than replacing them. Budget officials raised concerns about costs and sustainability.

Rather than forcing a binary confrontation, proponents of Treatment Not Trauma focused on building durable coalitions. They emphasized evidence from other cities, testimonies from providers, and the lived experiences of residents. They framed the issue as one of system fit, not moral judgment.

This approach shaped the ordinance’s trajectory. Instead of immediate mandates, the City Council advanced the formation of a Mental Health System Working Group. The group included representatives from the Department of Public Health, emergency services, and the mayor’s office. Its charge was to develop detailed plans for clinic reopening and alternative response models, with attention to staffing, funding, and coordination.

The unanimous approval of this working group marked a procedural milestone. It embedded the Treatment Not Trauma framework into the city’s planning apparatus, where it could be refined rather than dismissed.

Implementation: Incremental, Measurable Steps

Progress under the Treatment Not Trauma framework has been incremental by design. That pace has frustrated some advocates, but it reflects the realities of municipal governance and the scale of the systems involved.

Several concrete developments are worth noting.

Staffing at existing public mental health clinics increased significantly, with ward reports indicating a roughly 70 percent rise from prior lows. This did not reopen every closed facility, but it reversed a long period of decline and improved capacity where clinics remained operational.

Pilot non-police crisis response programs were launched in select areas. These pilots handled hundreds of calls involving mental health crises without arrests or use of force. While limited in scope, they provided operational data on response times, outcomes, and coordination with existing emergency systems.

Public meetings and participatory budgeting processes within the 33rd Ward allowed residents to weigh in on priorities and implementation details. This feedback loop mattered. It raised concerns about language access, cultural competency, and follow-up care, shaping how programs were structured.

None of these steps constituted a sweeping overhaul. Taken together, they moved the city away from an exclusively enforcement-based model and toward a health-centered system with defined growth pathways.

Listening as a Governance Practice

One of the less visible aspects of the Treatment Not Trauma effort has been its emphasis on constituent listening before, during, and after policy development. This is not a rhetorical flourish. It is a practical requirement for sustaining public trust in programs that intervene during vulnerable moments.

Residents were not treated as abstract beneficiaries. They were engaged through ward meetings, advocacy coalitions, and feedback mechanisms tied to budgeting and service design. Providers were consulted about feasibility. Emergency responders were included in discussions about coordination and handoffs.

This process did not eliminate disagreement. Some residents worried about response times. Others questioned whether alternative teams would be available consistently. These concerns were documented and incorporated into planning assumptions rather than dismissed.

The result was not universal satisfaction, but something more realistic: a sense that the system was responding to evidence and experience rather than imposing solutions from above.

Evaluating Success Without Absolutes

Treatment Not Trauma does not lend itself to simple success metrics. It is not a pilot that can be declared complete or abandoned after a single evaluation cycle. It is a restructuring effort that unfolds over the years.

What can be assessed is the trajectory.

The number of situations handled without police intervention is rising from a baseline of near zero. Public mental health staffing has increased rather than declined. Crisis response planning is now embedded in formal city processes instead of existing at the margins.

This is where the idea of batting average becomes useful. No policy intervention in a complex urban system achieves perfect outcomes. What matters is whether the proportion of effective responses improves over time.

By that standard, Treatment Not Trauma represents upward movement. The system is not finished. It is not evenly distributed across the city. It is constrained by budgets and politics. But it is measurably different from what preceded it.

Fiscal Responsibility and Sustainability

Critics often frame care-based approaches as fiscally naive. Treatment Not Trauma has taken a different path. Its proponents have emphasized that emergency room visits, arrests, and incarceration are among the most expensive ways to handle mental health crises.

Investing in clinics and crisis teams requires upfront funding, but it also reduces downstream costs associated with emergency services and legal system involvement. By phasing implementation and grounding expansion in data from pilots, the program aligns spending with demonstrated need rather than aspirational targets.

This approach does not eliminate financial risk, but it treats public funds as instruments for long-term system efficiency rather than short-term political signaling.

What This Case Demonstrates

The experience of Chicago’s 33rd Ward under Rossana Rodríguez-Sánchez does not offer a template that can be copied wholesale, because context matters. City governance varies. Political coalitions differ.

What it does demonstrate is that progressive policy frameworks can move from advocacy into implementation when they are structured to accommodate institutional realities. Listening to constituents is not a branding exercise. It is a method for improving policy fit. Incrementalism is not a retreat from ambition. It is often the mechanism by which durable change occurs.

Treatment Not Trauma remains incomplete. It faces ongoing opposition and resource constraints. Yet it provides proof of life for an approach to governance that prioritizes people, measures progress honestly, and accepts imperfection as the cost of working within real systems.

In a political environment saturated with over-promising and under-delivery, that restraint may be its most consequential feature.