Illinois’ healthcare system must expand to include evidence-informed services, specifically for young adults

Illinois’ current system of care has not adapted to meet the mental health needs of today’s youths and young adults.

A vast and increasing number of 26 year-olds are still financially dependent on or living with their families. Similarly, the average age of marriage is 29 years old and increasing, signifying youth reaching their traditional adult achievements later in life. It is clear that the typical developmental periods of childhood, adolescence, and adulthood have changed over time and have given way to a new developmental age between approximately 16 and 26 years old, characterized as emerging adulthood, young adulthood, or transition-age youth. This is a critical time when, more than any other developmental period, young people are moving around, experimenting with their careers, and engaging in an increased number of sexual and social relationships.

The young adulthood phase is also when we see the highest prevalence rate of onset of mental illnesses. Yet, this group is the least likely to seek mental health services.

At the time when life may be most confusing and services are needed most, our Illinois service system is also most fragmented. Caught in between two worlds, with two service systems in Illinois that do not connect well with each other, our system of care has not caught up to this critical period of young adulthood that has life-long implications for health. Young people lose their eligibility for youth services, and do not connect well with adult-based services that are principally built for older generations with chronic mental and physical health needs.

Unable to get the services they need, young adults often fall off the transition cliff. Without proper access to treatment, there is a critical lapse in care, resulting in another generation of adults with increasing mental health and substance use issues. Ultimately, the system forces these young adults to seek treatment through self-medication, costly psychiatric hospitalizations, or incarceration.

We can end this cycle. Focusing on community-based services specifically geared toward young people at the earliest signs of mental health struggles can make the difference between a life of chronic hardship and need and a life on track to succeed.

There is no better opportunity to help young people get on track for adulthood than during their late adolescence/young adult years. In adult mental health services, we embrace the concept of “recovery” from mental illness. Young people who are just experiencing these issues do not identify with that concept. Instead, we need to embrace the concept of “discovery” for young adults. We have a golden opportunity in these transition years to build self-discovery that can last one’s entire life by helping young people to answer questions such as, “What works best in managing my mental health symptoms, who in my life are my best supporters, what kind of work/school environment best fits me, and will my symptoms define my whole life?” Having a team of dedicated service providers paired with a young person and their family to navigate their transition to adulthood builds the self-discovery, successful treatment, and support to change the trajectory so young people stay on track for success in adulthood.

At Thresholds, this type of early intervention is provided by a team of dedicated service providers, a young person, and their family through a program called “Emerge.” These teams are built using evidence-based approaches specifically dedicated to young adults with mental health challenges, with specialization in creatively engaging young people at their earliest point of need. The staff on these teams work in the communities, in homes or sometimes in offices-wherever the young person and their family feel most comfortable. Emerge provides coaching around all social determinants of health, often multiple times a week. This includes creative therapy approaches to manage symptoms and trauma; care coordination to build goals and life skills; supported employment and education to get back on track with vocational success; medication monitoring, community activities to build socialization and friendship bonds, peer supports to reduce stigma so young people and families don’t have to feel like they are alone, and more.

Programs like Emerge and others around the country have demonstrated success, yet are not part of Illinois’ system of care.

In the absence of adequate treatment, we know all too well of the crippling life-long toll mental illness will exert on young people and families. We know the massive costs that accompany high end, life-long treatment. We also know the services that work best for young adults to interrupt this trajectory, yet our Illinois funding models do not support these services. By investing in services at the earliest signs of serious mental health needs for young adults which cost a fraction of deep end care, we can successfully save dollars and save lives.

Marc Fagan, Psy.D. is the Vice President of Clinical Operations and Youth Services at Thresholds, overseeing comprehensive programs for youth and young adults with serious mental health needs. Dr. Fagan provides consultation and training locally and nationally to audiences regarding best practices with young adults, and participates in numerous work groups dedicated to improving outcomes for young people in care. 

Report: Illinois’ mental health crisis will linger until investments are made in mental health and substance use treatment services

Medicaid revisions – including early treatment for youth, and access to affordable mental healthcare and addiction treatment – are necessary to combat the state’s deadly substance use and mental health crisis.

In a report released today, Thresholds, the state’s largest provider of community mental health services, makes several recommendations for the path Illinois must take to address its long-standing mental health crisis.

The report outlines concrete recommendations for the early treatment of youth with serious mental health conditions. These recommendations have the potential to reduce suicide rates, prevent disability, and decrease the likelihood of addiction as a method of self-medication.  A standout proposal on early treatment is the creation and coverage of youth-focused treatment models tailored specifically for adolescents and young adults, as this is often the age range when mental health symptoms first appear. This type of treatment can prevent a lifetime of disability and reliance on public support. Yet Illinois’ adult-focused system prevents many youth from receiving necessary treatment until they are experiencing debilitating and irreversible illness.

The report also includes recommendations on growing access to both mental health and substance use treatment services, which is crucial as the state grapples with the increasing number of opioid overdose deaths. The state must revise Medicaid reimbursement rates to allow for the growth of treatment services. Unless this step is taken, thousands across Illinois will be forced to go without treatment, and overdose deaths and suicide rates will continue to rise unabated.

The report also addresses expanding the mental health workforce through the creation of a number of incentives for the practice of mental health and substance use treatment in workforce shortage areas.
The investments outlined in the report could save the state an estimated $1.9 billion annually if enacted, as well as save thousands of lives through early treatment.

We hope the report will help guide Illinois lawmakers as they consider how to address Illinois’ mental health crisis.


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About Thresholds
Established in 1959, Thresholds provides healthcare, housing, and hope for thousands of persons with mental illnesses and substance use conditions in Illinois. Through research, employment, advocacy, care, and housing, Thresholds assists and inspires individuals to reclaim their lives.

Media Contact
For more information, contact Emily Moen, Director of Public Relations and Marketing, at 773.572.5172 or

Thresholds response to Governor Rauner’s annual budget address

Illinois’ budget must put the state’s opioid epidemic and mental health crisis front-and-center in more than name only

CHICAGO, IL – Yesterday, Governor Rauner outlined spending priorities in his proposed budget for the next fiscal year. While we were pleased that the Administration’s priorities include combating opioid addiction and addressing systemic challenges in access to mental healthcare, the overall proposed budget does not support these priorities. In fact, it undermines them.

As this year’s state budget process gets underway, we call on the Governor and the General Assembly to work together to develop a responsible budget that fosters strong communities by investing in the public services that Illinoisans want and deserve, including mental health and substance use treatment services.

Well-supported public services are the cornerstones of healthy, vibrant communities. The introduced budget would harm access to healthcare and human services by cutting funding for substance use prevention, mental healthcare, supportive housing, and Medicaid. Illinoisans deserve better.

We are also alarmed by the Governor’s proposal to cut state revenue by rolling back tax rates. Returning Illinois’ income tax rate to near 2014 levels was a bi-partisan measure aimed at restoring fiscal stability and preserving vital programs. Even under current tax rates, Illinois does not generate sufficient revenue to support essential programs Illinoisans count on like healthcare, social services, and public education – the building blocks of strong communities. Illinois must maintain all current revenue sources to preserve support for needed public services.

As communities across our state struggle to combat an unspoken mental health crisis and increasingly lethal opioid epidemic, ensuring access to treatment must be a top priority – now more than ever. The proposed state budget should support these priorities in more than name only.

We urge Governor Rauner and the General Assembly to take the opportunity before them to design a state budget that reflects the priorities of Illinoisans and adequately and sustainably funds critical public services that equip our communities to stay healthy and thrive.

Media Contact: Emily Moen, Director of Public Relations and Marketing, 773-572-5172

Thresholds’ Response to Governor Rauner’s State of the State Address

CHICAGO, IL – This afternoon, Illinois Governor Bruce Rauner delivered the annual State of the State address. He began today’s speech by referencing Jane Addams as one of the noteworthy Illinoisans upon whose shoulders we stand as we look to build a better future for our state. As the mother of social work, Addams worked to empower people and connect them with what they needed to live their best lives. In staying true to her legacy, it is incumbent upon our leaders that they do the same by ensuring access to community-based healthcare and human services that equip Illinoisans to live well and prosper.

To end a terribly destructive budget impasse, last year lawmakers from both parties came together and voted to restore the state income tax rate. This move has allowed the State to begin collecting revenue that is sorely needed to pay for public services, including mental health and substance use treatment, as well as to pay the billions of dollars owed to organizations who provide these services to the community.

As the State begins to turn the page on a challenging chapter, now is not the time to reverse course and strip resources from the vital programs and services. In fact, the restoration of the income tax rate to 2014 levels still does not address the State’s structural deficit. Illinois must still find a way to make the necessary investments in the services residents want and need, including public education, healthcare, and human services.

We commend the Governor for reiterating his commitment to reducing opioid overdose deaths and for the initial steps that his administration has taken to address an epidemic that has gripped our state and the nation. However, Illinois cannot battle one of the most pressing public health crises in a generation without expanding access to substance use treatment. Adequately and sustainably funding community-based services, preserving the Affordable Care Act and Medicaid expansion, and protecting against barriers to healthcare like Medicaid work requirements are foundational to ensuring access to much needed care. Prioritizing policies like these will help the Governor make good on his goal of preventing opioids from tragically claiming even more lives.

Governor Rauner called on his counterparts in Springfield to work across party lines to tackle some of Illinois’ biggest challenges. We echo the Governor’s call for state leaders to come together and do the tough work of rebuilding our state – including making the appropriate investments in critical services that allow Illinoisans to stay healthy and thrive.

Media Contact: Emily Moen, Director of Public Relations and Marketing, 773-572-5172

Donor Spotlight: Boeing

Donor Spotlight: Boeing

Chicago-based Boeing is the world’s largest aerospace company and leading manufacturer of commercial jetliners and defense, space, and security systems. The company prides itself on investing in efforts that build, enhance, and contribute to the social fabric of society.

Since 2010, Boeing has generously donated more than $250,000 to the Thresholds Veterans Project, which provides comprehensive services to veterans experiencing mental illnesses and substance use disorders.

Most recently, Boeing made a $115,000 gift that will allow the Veterans Project to introduce two new therapies – Acceptance and Commitment Therapy (ACT) and Dialectical Behavioral Therapy (DBT) – into its regular programming. Thanks to Boeing, Thresholds’ veteran clients can now access an expanded array of resources designed to help them on their road to recovery, specifically depression and PTSD.

As a long-time partner of Thresholds, Boeing has provided thousands of veterans experiencing mental health and substance use conditions with hope and practical support. We are grateful for Boeing’s partnership and could not do this work without them!

Thresholds opposes Medicaid work requirements and other barriers jeopardizing access to healthcare

CHICAGO, IL – Thresholds opposes any changes to Medicaid which create unnecessary barriers to accessing healthcare, including work requirements. Recently, the federal government issued a notice encouraging states to consider imposing additional restrictions in order to qualify for healthcare through Medicaid – namely work requirements.

Medicaid is a health program funded in partnership by the state and the federal government to ensure that low income Americans have access to the care they need to stay well and thrive. More than 3 million Illinoisans have health coverage through Medicaid including children, pregnant women, seniors, and the disabled. Those who have lost employment or who are unable to work due to chronic conditions or other circumstances beyond their control should not be punished by losing access to healthcare.

According to the Kaiser Family Foundation, 80% – the vast majority – of Illinoisans with insurance through Medicaid are already in working households. Through supported employment programs, many living with mental health and substance use conditions are able to prepare for interviews, match their skills with employers’ staffing needs, and receive ongoing support both before and after the hiring process. Unfortunately, these types of evidence-based programs are underfunded, limiting the number of people who are able to benefit from the program and successfully connect with gainful and meaningful job opportunities.

Under the Affordable Care Act (ACA), Illinois and states around the nation witnessed historical lows in the uninsured rate. However, data for 2017 suggests that rates of coverage are being negatively impacted by the federal government’s reduction in funds for marketing and threats to end subsidies, cut Medicaid, and repeal the ACA. Creating new, onerous Medicaid eligibility criteria would only exacerbate this loss in coverage and make it more difficult for thousands of Illinoisans to access healthcare, including mental health and substance use treatment.

As opioid fatalities skyrocket, both federal and state leaders have recognized we are battling a public health crisis. Now is not the time for more red tape that puts treatment even further out of reach when it is so desperately needed.

This federal proposal is ill-informed, inhumane, and disregards the urgent healthcare needs of communities across our state. Public policy must promote the well-being of the people, not stand in the way of it. We join the call for Governor Rauner and his administration to denounce this radical departure from the purpose of Medicaid – to expand healthcare access for low income people.

Media Contact: Emily Moen, Director of Public Relations and Marketing, 773-572-5172

Donor Spotlight: Chicago Blackhawks

Donor Spotlight: Chicago Blackhawks

Chicago Blackhawks Charities, the official charity of the Chicago Blackhawks, supports programs and institutions throughout Illinois that create a better tomorrow. To do so, the organization focuses on health and wellness, education, and housing with the constant goal to serve local youth and their families.

 This past fall, the Chicago Blackhawks Charities made a $20,000 grant to Thresholds’ Homeless Families Program, which supports families with parents who are experiencing mental illnesses and homelessness. The program works to address each family’s immediate needs by linking them to an array of resources including: rapid, emergency housing followed by transitions into longer-term, family-friendly affordable housing; psychiatric care; integrated health care; childcare and child therapy; and Supported Employment services. By focusing on home, health, and hope, Thresholds Homeless Families Program helps break the cycle of homelessness, restores families, and places our clients on a solid path to recovery.

We are grateful to the Chicago Blackhawks Charities for their generous support. Thank you for believing in our work and, most importantly, in the people we serve.

Thresholds statement on House tax plan passage

Financing a Tax Plan by Cutting Healthcare for Millions is Unacceptable and Immoral

US CongressAccess to affordable healthcare should be a basic human right.

Yet today the U.S. House of Representatives passed a tax plan which usurps that right – the bill will leave 13 million Americans without health coverage and looks to Medicaid and Medicare as a way to fund tax cuts. Cutting healthcare for millions to finance tax cuts is simply wrong.

Under the Affordable Care Act, more than 93% of Illinoisans have health coverage, an all-time high. This is historic progress toward ensuring that all people have access to comprehensive healthcare – but this tax bill puts all that progress at risk.

As communities across our state and nation battle a lethal opioid epidemic and mental health crisis, the passage of this tax bill undermines the ability of thousands of people to get the treatment they need to recover and get well. Now is not the time to curtail access to mental healthcare and substance use treatment; it is the time to increase it to address these crises.

We are deeply disappointed with the House’s irresponsible, short-sighted, and politically-motivated action. Our elected officials are charged with preserving and protecting the public’s health and well-being, not putting care out of reach for millions of Americans.

In spite of this set back, Thresholds remains committed to ensuring that all people have the healthcare they need to thrive. With our partners, we will continue to advocate for policies and programs that equip us all to lead full and healthy lives.

Media contact: Emily Moen, Director of Public Relations and Marketing, 773-572-5172

Statement from Thresholds, NAMI-Chicago, and The Kennedy Forum Illinois on withdrawn City countersuit in Quintonio LaGrier case

Our hearts go out to Quintonio LeGrier’s family. Their continued exposure to trauma surrounding his tragedy is incomprehensible. We are relieved that Mayor Emanuel retracted the law department’s proposed countersuit, which was ill-conceived, insensitive, and a terrible waste of resources. Instead, the City should be investing deeply in community mental health services, an issue we have all championed as part of the Mayor’s Citywide Mental Health Crisis Steering Committee.

The Kennedy Forum Illinois

Thresholds Veterans Project Assists Chicago Veterans with Mental Health, Housing

The Thresholds Veteran Project

This Veterans Day, we salute those who have served our country. The Thresholds Veterans Project employs veterans who serve their peers, giving our Chicago-area veterans the care and resources they need to recover from mental illness, PTSD, and traumatic brain injury.

Approximately 11% of the entire population in the United States are veterans experiencing homelessness. Of that population, 50% are also living with a serious mental illness, and 70% are struggling with a substance use disorder.

The Thresholds Veterans Project can help. Integrating our award-winning, evidence-based practices and strategic partnerships, the Veterans Project includes homeless outreach, housing services, supported employment, peer-driven supports, substance abuse treatment, integrated physical and mental health services, and trauma-based therapies

Last year, they successfully provided 81% of clients with permanent housing. An estimated 70% of clients in the Veterans Project with a substance use disorder reported a “positive change in use” in the last 12 months.

Thresholds is proud to serve more than 300 veterans through our Veterans Project – a number that continues to increase each year. We believe in serving those who have served us, and that everyone deserves to live their fullest lives, regardless of their past experiences; and we know that recovery is possible!

Lisa’s Story

After returning from the military, veteran Lisa* did not have anywhere to go. She was pregnant, living in her car, and living with a mental illness. As a survivor of sexual trauma, she was feeling lost and hopeless for her future. Then she found Thresholds. Within a week’s time, she became a client of the Thresholds Veterans Project, received the support she was missing, and a home of her very own. Lisa is now open to receive the recovery treatment and services she needs.

As a senior veteran, Lisa was having a hard time managing her mental illness and substance use disorder on her own. Since coming to Thresholds, she has received supports such as housing, money management, medication education, and treatment services unique to her needs. She is a frequent participant in the Thresholds Veterans Project program and activities, and her quality of life has greatly improved.

Support the Thresholds Veterans Project

If you would like to financially support the Veterans Project, please visit our donation page. If you are a veteran from any war having a hard time coping with your mental illness, trauma, or issues such as homelessness, substance abuse, etc., please contact Fernando Valles, Director of the Veterans Project, at (773) 537-3154.

*Name changed per client request