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PR- 221-08
June 12, 2008


Implementation of Recommendations from State/City Panel Will Improve the Quality and Consistency of Care for Those with the Most Serious Mental Illnesses and Reduce the Risk of Violence to Themselves or Others

Governor Announces Legislation to Authorize Intensive Case Reviews as Recommended by the Panel

Mayor Michael R. Bloomberg and Governor David A. Paterson today announced plans to implement a comprehensive set of recommendations from a joint New York State (NYS)/New York City (NYC) Mental Health-Criminal Justice Panel to improve the quality and consistency of care given to individuals with serious mental illnesses.  By examining several cases of violent incidents involving individuals with serious mental illnesses, comprehensively assessing the current mental health and justice systems, and by consulting with national experts in mental health and violence, the Panel identified many opportunities to improve mental health service delivery and improve public safety.  The Panel identified four areas where improvements were needed, and recommended specific measures to address these challenges.  These challenges include: (1) poor coordination, fragmented oversight and lack of accountability in the mental health system; (2) inconsistencies in quality of care within the mental health treatment system; (3) limited capacity to share information within and between the mental health and criminal and juvenile justice systems; and (4) insufficient training, supports and tools to identify and engage individuals with mental illnesses in the criminal and juvenile justice systems.

"We took a hard look at the facts and made common sense recommendations that will both improve the quality of care for people with the most serious mental illnesses and also improve public safety," said Mayor Bloomberg.  "While you can't predict every violent incident, by implementing these recommendations we strengthen our system and offer a coordinated response to those who need it most."

"This collaborative effort by officials from State and City mental health and criminal justice agencies has resulted in recommendations for real reforms that will help to enhance public safety and avoid future tragedies," said Governor Paterson.  "Taking a hard look at what may have gone wrong in particular cases is a necessary first step toward improving the care and treatment of those with serious mental illnesses - both in the mental health care system and when those persons become involved with the criminal justice system - and the State is prepared to move forward in implementing the Panel's recommendations."

"After careful study, we find that several aspects of the issue are clearer," said NYS Office of Mental Health Commissioner Michael F. Hogan. "First, considering the fact that mental illness touches every extended family, these incidents are surprisingly infrequent. Second, in cases we considered, uncoordinated care in a fragmented system was a factor in tragic outcomes. Our mission - and we have accepted it - is to improve care to improve safety. There are no quick fixes or easy solutions, but we will not accept failure."

"Our work on the Panel brought together representatives from city and state agencies which, historically, were not at the same table looking at this complicated issue through the same lens," said NYC Deputy Mayor for Health and Human Services Linda Gibbs. "The recommendations are both ambitious and practical and will increase our ability to anticipate problems before they escalate."

"The Panel brought together top policy advisors from the State and City to identify concrete ways we can improve our response to persons with serious mental illness, both in the mental health treatment arena and by law enforcement agencies," said NYS Division of Criminal Justice Services Commissioner Denise O'Donnell.  "The recommendations in the report provide significant steps forward in improving collaboration with the criminal justice agencies in responding to the needs of individuals with mental illness when they come into contact with the criminal justice system."

"Studies have shown that as many as 15 percent of those in the criminal justice system are persons with serious mental illness," said John Feinblatt, the Mayor's Criminal Justice Coordinator. "The series of improvements we are announcing today will use the leverage of the criminal justice system to get these individuals the treatment they need, reducing the risk to public safety.  These changes will allow us to identify those with serious mental illnesses at critical stages, such as when they call 911, appear in a courtroom, or meet with probation officers."

Highlights of the recommendations described below will improve the way the State and City's mental health, criminal justice and juvenile justice systems work with individuals with the most serious mental illnesses.

Improvements to the Adult Mental Health Treatment System

In New York City, new "Care Monitoring Teams" will oversee both mental health services offered to high-need individuals and the providers that offer high-intensity programs to improve both treatment and services.  A database will allow care monitoring teams to monitor the care provided to high-need adults with the most serious mental illnesses, giving staff the ability to take action if there is an interruption in service or an escalating need for care.  The recommendations of the State Offices of Mental Health and of Alcoholism and Substance Abuse Services will be implemented, improving access to care for individuals with co-occurring mental health and substance abuse disorders.  Legislation will be proposed authorizing OMH to conduct intensive case reviews of critical incidents involving individuals with mental illnesses, with relevant state and city officials participating, for the purpose of reducing care errors and improving public safety.  Standards of care for mental health clinics serving adults will be issued and enforced, to improve treatment and require regular risk assessment for violence to self or others.

Improvements to the Adult Criminal Justice System

A pilot program for sharing information with appropriate patient consent between the criminal justice and mental health treatment systems will identify people with serious mental illnesses who may benefit from alternative to incarceration programs.  A New York City alternative-to-detention pilot program will provide assessment, case management, supervision and community-based treatment to individuals with mental illnesses who might otherwise be detained while their cases are moving through court and who do not pose a high risk of recidivism or flight.  A dedicated mental health unit at the New York City Department of Probation will establish relationships between probation officers and probationers' mental health providers and assist probationers in receiving appropriate services.  Training for 911 call takers and dispatchers will be improved to better elicit information about whether an incident involves an individual with mental illness.

Improvements to the Juvenile Justice System

Clinical interventions for youth with serious emotional disturbances (SED) in the custody of New York City Department of Juvenile Justice or State Office of Children and Family Services will be enhanced to ensure that adolescents in State or City custody have appropriate supports, including improved discharge planning, and that crucial mental health information follows the youth throughout transitions.  Family Care Coordinators will help families navigate the juvenile justice, mental health and other service systems; facilitate information sharing among providers and families; and arrange for family case conferences that assist youth and their families in getting care and support, especially during transitions. Coordinators would use their own experiences negotiating the mental health system and other systems to empower families to advocate for their own needs.

New Legislation Proposed

The Governor is proposing legislation to implement one of the Panel's recommendations.  The Governor's Program Bill allows the Commissioner of OMH to convene quality assurance review panels that include relevant state and local officials to examine incidents occurring in the community in which persons with serious mental illness are harmed, cause harm to others, or become involved in violent criminal incidents.  This will lead to both improved quality of care and enhanced protection for the public.    

The NYS/NYC Mental Health and Criminal Justice Panel was convened by NYS Secretary for Health and Human Services Dennis Whalen and NYC Deputy Mayor Gibbs.  It was co-chaired by OMH Commissioner Hogan, Deputy Mayor Gibbs, DCJS Commissioner  O'Donnell, and NYC Criminal Justice Coordinator John Feinblatt.  Members of the Panel included top State and City officials in mental health, substance abuse, criminal justice and adolescent services.

The Panel's full report, including the entire list of recommendations, is available at,, and


Jim Anderson/Dawn Walker   (212) 788-2958

Marissa Shorenstein (Paterson/NYC)   (212) 681-4640

Errol Cockfield (Paterson/Albany)   (518) 474-8418

More Resources
Download the report (in PDF)