Division of Mental Hygiene

Adult Mental Health Services

Page Contents

• • Roles And Functions
• • Outpatient Treatment Services
• • Adult Single Point Of Access (SPOA)
• • Case Management And Assertive Community Treatement (ACT) Services
• • Assertive Community Treatment (ACT) Teams
• • Support Services

Related Pages

• • Mental Health Services
• • Child and Adolescent Services

Roles And Functions

The Division of Mental Hygiene’s (DMH or Division) Office of Adult Services is responsible for planning, funding, and overseeing much of New York City's comprehensive network of community-based adult mental health programs. The Division contracts with a wide range of community organizations, including hospitals that provide a variety of services to adults with mental illness. These services reflect a wide range of program models which are designed to meet the varying treatment and support needs of New York's diverse population. Included in the service mix are different categories of outpatient care, case management, vocational and rehabilitation services, supported housing, assertive community treatment (ACT) teams, programs serving the geriatric community, and crisis intervention services. (Specialized mental health services for children and adolescents are described in the section on the Office of Child and Adolescent Services).

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Outpatient Treatment Services

Based on an assessment of service needs, psycho-social history, and other factors, different consumers require different levels of care. Several distinct program categories have been devised to make available treatment as individualized as possible. All outpatient mental health treatment services in New York City are required to have a valid operating certificate issued by the New York State Office of Mental Health (SOMH). SOMH certification regulations (Part 587) define the service types and specify minimum requirements for the various programs, such as the range of available services, consumer-staff ratios, treatment planning/review, psychopharmacology, discharge planning and space requirements.

Most licensed outpatient treatment programs are supported through a combination of revenue from several sources including Medicaid, Medicare, managed care plans, private insurance, self-pay, and deficit funding provided by the Division.

Clinic Treatment Programs for Adults

Clinic programs provide treatment designed to reduce symptoms, to improve functioning, and to provide ongoing support. Services include assessment, health screening and referral, verbal therapy, medication therapy, medication education, symptom management, crisis services and psychiatric rehabilitation-readiness determination, and referral. Mental health clinics can either be set up as free standing programs by community mental health agencies or operate under the auspices of a hospital (hospital-based).

Continuing Day Treatment Programs

Continuing day treatment (CDT) programs provide a planned combination of assessment, treatment and rehabilitation services for individuals with mental illness for the purpose of developing, maintaining, or restoring the skills necessary for community living. Services are provided in a structured environment through the use of supervised activities and extensive recipient-staff interactions.

CDT programs provide active treatment designed to maintain or enhance current levels of functioning and skills, maintain community living, and to develop self-awareness and self-esteem through the exploration and development of strengths and interests. Eligibility for admission to a continuing day treatment program is based on a designated mental illness diagnosis and a dysfunction due to mental illness. Services include assessment and health screening and referral, medication therapy, medication education, case management, rehabilitation readiness development, psychiatric rehabilitation readiness determination and referral, and symptom management.

Partial Hospitalization Programs

Partial hospitalization programs provide active treatment designed to stabilize and ameliorate acute symptoms, to serve as an alternative to inpatient hospitalization, or to reduce the length of a hospital stay within a medically supervised program.

Eligibility for admission to a partial hospitalization program is based on a designated mental illness diagnosis that has resulted in dysfunction due to acute symptomatology and requires medically supervised intervention to achieve stabilization and which, but for the availability of a partial hospitalization program, would necessitate admission to or continued stay in an inpatient hospital. Services include assessment, health screening and referral, symptom management, medication therapy, medication education, verbal therapy, case management, psychiatric rehabilitation readiness determination and referral, crisis intervention services, activity therapy, and clinical support services.

Intensive Psychiatric Rehabilitation Treatment (IPRT) Programs

Intensive psychiatric rehabilitation treatment (IPRT) programs are time limited programs with active psychiatric rehabilitation designed to assist persons in forming and achieving mutually agreed upon goals in living, learning, working, and social environments, and to intervene with psychiatric rehabilitation technologies to overcome functional disabilities and to improve environmental supports.

Eligibility for admission to an IPRT program is based on a designated mental illness diagnosis, a dysfunction due to mental illness, which is likely to continue for a prolonged time, readiness to participate in a designated intensive psychiatric rehabilitation treatment program, and referral, by a psychiatrist. Services include psychiatric rehabilitation readiness determination, psychiatric rehabilitation goal setting, psychiatric rehabilitation functional and resource assessment, psychiatric rehabilitation skills and resource development, and psychiatric rehabilitation support services.

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Adult Single Point Of Access (SPOA)

Single Point of Access (SPOA) expedites access to case management and Assertive Community Treatment (ACT) services for adults diagnosed with serious and persistent mental illness (ages 18+) who require these intensive services in order to remain healthy and stable in communities throughout the five boroughs of New York City.

The adult SPOA is operational through Center for Urban Community Services (CUCS). ACT teams, intensive case management (ICM) services, supportive case management (SCM) services, and blended case management (BCM) services can only be accessed through SPOA by completing a universal referral form (URF) and supplying CUCS with required clinical documentation.

Based on established eligibility criteria and identified need, SPOA will make referrals to appropriate programs. Authorized petitioners for court-ordered Assisted Outpatient Treatment (AOT) must go through SPOA in order to identify which ACT team or case management program will be included on the court-ordered treatment plan.

CUCS, in collaboration with the NYC DOHMH and the New York State Office of Mental Health (SOMH/NYC field office), also provides training for referral sources and case management/ACT providers on all aspects of the case management/ACT referral process. To reach SPOA and for all referrals call 1-212-801-3343 where you will be referred to an appropriate CUCS borough consultant, a NYCDOHMH representative, or a SOMH representative; or you may visit their website at www.cucs.org.

Please note that there is also a housing SPOA that may also be accessed at www.cucs.org.

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Case Management And Assertive Community Treatement (ACT) Services

Case management and ACT are designed to assist people with serious and persistent mental illness to achieve the goals of illness management, to increase self-sufficiency, as well as to increase the appropriate utilization of community-based services. Case management and ACT services are mobile and individually tailored to the consumer and have a rehabilitation approach. Case managers facilitate mental health and medical service delivery by helping consumers make and keep appointments (escorting if necessary), advocating, and assisting individuals to gain access to entitlements and health care services. Case managers also provide education and training in the areas of money management and health/medication compliance.

Supportive Case Management Programs

The supportive case management model, as described in a 1995 State Office of Mental Health report, is designed to coordinate services and supports for people diagnosed with mental illness to enable them to live successfully in the community.

Consumers of supportive case management programs, in general, are enrolled in community mental health programs (e.g., outpatient programs), and have some functional disability that requires support or intervention to live independently. Services are individually tailored to the circumstances, needs and desires of each person and use a rehabilitation-oriented approach. Among the services provided are 1) the facilitation of service delivery, including helping individuals make and keep appointments, escorting individuals to appointments as needed, and arranging mental health, medical and psychiatric rehabilitation services; 2) advocating and assisting individuals to gain access to entitlement and other health services (e.g., Medicaid, food stamps, educational services, etc.); 3) assisting consumers to learn how to use fiscal resources; and, 4) providing health promotion services or arranging for medication education that will help the consumer to understand the importance of taking prescribed medication.

Blended Case Management

The blended case management program is a team approach to case management services that combines the caseloads of intensive case managers (ICMs) and supportive case managers (SCMs). Services are tailored to individual needs. Individuals can fluctuate between intensive and supportive levels of service as needed without severing ties with familiar case managers.

Intensive Case Management

Intensive case management programs were developed to assist persons with serious, persistent mental illnesses who have not successfully engaged in community based mental health services. Eligible consumers must have a diagnosable mental illness that impairs functions in several essential areas of life, including self-care, social functioning, activities of daily living, economic self-sufficiency, self-direction, and concentration. Target groups include (1) high risk/heavy users of inpatient units, emergency, and crisis centers, (2) extended care state psychiatric center patients, and (3) individuals with serious, persistent mental illnesses who also are homeless. Other subpopulations include mentally ill chemical abusers, forensic patients and persons with combined mental illness and mental retardation. Services are individually configured and geared to the circumstances, needs, and desires of each person.

Intensive case management services are delivered in the community, and programs have a low staff to client ratio. Services are not time-limited. Intensive case managers conduct outreach to engage clients; monitor and coordinate the delivery of evaluations and assessments, and participate in the development of an individualized, goal-oriented services plan; provide assistance in crisis intervention and stabilization; assist clients through on-going support, training, and assistance in the use of personal and community resources; assist in developing a range of community and family supports; advocate for changes in the system. Intensive case management services are available 24 hours a day, 7 days a week, 365 days a year.

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Assertive Community Treatment (ACT) Teams

Assertive community treatment teams, called ACT teams, are small community-based mental health treatment teams designed to decrease the need for hospitalization for individuals with mental illness who would not usually get involved in treatment programs. The programs are based on an assertive outreach approach, with hands-on assistance provided to consumers in their homes and neighborhoods rather than at an agency or office, and are provided on a long-term, intensive basis.

ACT teams offer a full range of psychiatric, psychosocial, and rehabilitation services, and are provided by multi-disciplinary teams that include a psychiatrist, nurse, social worker, and case manager. Services include crisis intervention, medication monitoring, social supports, assistance with everyday living needs, access, to medical care, psycho-educational supports, and employment assistance. Priority is given to individuals with continuous high service needs that are not being met in more traditional service settings.

ACT is a mobile treatment model which provides comprehensive and flexible services to individuals who have not successfully maintained mental health treatment within the traditional service delivery system. ACT teams have a shared caseload. All team members share responsibility for all consumers in the program. ACT team members meet at least once daily to review the individuals served by the team.

In order to begin the process of obtaining case management or ACT services, a case management application should be completed and submitted with accompanying current mental status, psychosocial, and physical examinations.

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Support Services

Psychosocial Clubhouses

Advocacy Services

Advocacy services include activities, which complement traditional mental health treatment programs for people with psychiatric disabilities. They are intended to promote recipient rights and access to mental health, health, social, residential, and other support service programs.

Advocacy services include information and referral, prevention, consultation and education, and issue-specific recipient actions including legal services and activities on behalf of the general target population. Such activities may include efforts to: (1) increase the availability, quality, and appropriateness of mental health services; (2) encourage non-mental health agencies to develop programs which recognize and serve the needs of people with psychiatric disabilities; (3) assure fair and equal treatment under entitlement programs; (4) increase access to housing and compliance with tenant rights, and (5) generally assure the respect of recipient civil rights.

Bridger Programs

Bridger programs are designed to assist in transitioning individuals who reside at State psychiatric center inpatient units back to the community. The Bridger program provides supports to link individuals to appropriate community services.

Self-Help Programs

Self help programs provide recovery-oriented and support activities based on the principle that people who share a common condition or experience can be of substantial assistance to each other. These programs may take the form of mutual support groups and networks, or they may be more formal self-help organizations offering specific educational, recreational, social, or other program opportunities.

Employment Programs

Integrated employment services promote the principles of recovery by providing innovative means to enhance and improve outcomes for persons with mental illness. Work in America is both society- and self-defining: work is about independence, sense of worth, social accountability, and personal development. By being able to successfully contribute to the work force, one’s opportunities to live a fulfilling and productive life despite illness may be advanced.

Employment programs place an emphasis on flexible, individualized, accessible, and consistent supports. Models of employment services include assisted competitive employment, transitional employment, enclave in industry, affirmative business/industry program, and peer run services.

Crisis Support and Referrals

For services related to crisis intervention please click here.

For additional referrals to mental health (and substance abuse) treatment services, consumers may also contact LIFENET:

LIFENET: 1-800-LIFENET (1-800-543-3638); 1-877-AYUDESE (en Espanol); and 1-877-990-8585 (Asian-speaking populations) are toll-free, confidential help lines that provide callers with information on and referrals to mental health and substance abuse resources throughout the New York City area. LIFENET operates 24 hours per day / seven days per week. For more information on LIFENET, click here.

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