Five case studies exploring mental health issues in low-income neighborhoods

When Jonathan Foiles was a graduate student in social work, he had to choose between a mental health or policy track. But once he began working, he found it impossible to tell the two apart. While helping poor patients from the South and West sides of Chicago, he realized individual therapy could not take into account the importance unemployment, poverty, lack of affordable housing and other policy decisions that impact the well-beings of both individuals and communities. It is easy to be depressed if you live in a neighborhood that has few supportive resources available, or is marred by gun violence. We are able to diagnose people with depression, but how does one heal a neighborhood? This City Is Killing Me: Community Trauma and Toxic Stress in Urban America, brings policy and psychology together. Through a remarkable set of case studies, Foiles opens up his therapy door to allow us to overhear the stories of Jacqueline, Frida, Robert, Luis, Anthony, and other poor Chicagoans. As we listen, Foiles teaches us how he diagnoses, explains how therapists before him would analyze these patients, and, through statistics and the example of Chicago, teaches us how policy decisions have contributed to these individuals’ suffering. The result is a remarkable, unique work with an urgent political call to action at its core.
Jonathan Foiles weaves together psychology and public policy, exploring the trauma underlying urbanization in a book Kirkus Reviews calls an “urgent call for reform.”

When Jonathan Foiles was a graduate student in social work, he had to choose between specializing in either mental health or public policy. But once he began working, he found it impossible to tell the two apart. As he counseled poor patients from Chicago’s South and West Sides, he realized individual therapy couldn’t account for all the ways unemployment, poverty, lack of affordable housing, and other policy decisions impacted the well-being of both individuals and communities.

Through a series of beautifully written and accessible case studies, Foiles lets us in on the stories of individual poor Chicagoans. He teaches us how he makes diagnoses, explains how therapists before him would analyze his patients, and teaches us about the profound ways that policy decisions contribute to individual suffering.

A remarkable, unique work of medical writing that serves as a call to action, this report by an experienced mental health professional is a must-read for anyone interested in the overlaps between mental health, public policy, and urbanization.