The Intervention: Mobile treatment in the community for especially high-risk men and women
Who is Served: People posing significant risk for public safety due to histories of significant community dysfunction
According to the NYC Mayor’s Office, “the City’s mental health system has been neglected for decades.”1 As a result, a subpopulation of people with serious mental illness and a history of significant dysfunction in the community has become severely marginalized, lacking access to consistent care to prevent crises and the potential for violence. These men and women typically have current or previous contact with multiple government agencies, including the City’s Departments of Homeless Services and of Health and Mental Hygiene. Too often these contacts with service agencies are isolated, and an individual passes between intermittent services that if coordinated might help them begin to achieve recovery and avoid causing harm to the community.
The IMT Approach
As part of the NYC Safe Initiative, Mayor de Blasio announced a new $22.4 million annual commitment in 2015 to improve public safety by providing better care for people whose mental illness may place others at risk.2 This funding includes support for three Intensive Mobile Treatment (IMT) Teams to provide 75 people identified as “high concern” by City agencies with mobile, intensive treatment in the community. To address these individuals’ untreated serious mental illness and high risk of violence, IMT Teams focus on continuous engagement of the client through direct contacts in the community. Based in Brooklyn, CASES IMT Team serves a caseload of 25 people. The program includes a full range of community-based clinical treatment, psychosocial rehabilitation, and peer support services available 24 hours a day, seven days a week. CASES IMT also helps participants to access ongoing services in the community including supported housing, appropriate public assistance, and primary and specialty health care.
As described in the City’s announcement of the IMT Teams, “untreated mental illness can increase the risk of violent behavior in some individuals . . . prevent[ing] them from leading a fulfilling life. This initiative brings mental health teams closer to the ground, to reach people who need this connection to care but face challenges engaging in adequate treatment.”3 This unprecedented initiative will deploy “the appropriate, real-time, muscular public safety and public health responses to the few individuals who could pose a threat to themselves or others.”4