NYC comptroller’s audit reveals flaws in mental health program

Nearly 40% of IMT participants receive insufficient psychiatric consultations

February 8, 2024 Robert Abruzzese, Courthouse Editor

Comptroller Brad Lander's audit revealed critical gaps in New York City's mental health program management.
Photo courtesy of NYC Comptroller’s Office

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New York City Comptroller Brad Lander released an audit on Wednesday that claims to uncover significant management deficiencies in the Department of Health and Mental Hygiene’s (DOHMH) Intensive Mobile Treatment (IMT) program.

Initiated in 2016, the IMT program was designed to provide comprehensive support to New Yorkers grappling with severe mental health challenges, histories of homelessness, substance abuse, and frequent interactions with the criminal justice system.

The audit highlights that, despite the program’s potential, there are critical gaps in oversight, coordination and the establishment of effective performance metrics. Additionally, there’s been a notable decline in the program’s success in securing stable housing for its participants.

“We need the IMT program to work — to help mentally-ill and homeless New Yorkers get the treatment they urgently need,” said Lander. “Unfortunately, poor management and coordination mean the program is increasingly failing to help participants get off the street into stable housing — and we don’t know whether or not it’s working to keep IMT clients and other New Yorkers safe.”

The audit revealed that while client retention rates within the program are high, this does not necessarily translate into consistent treatment or reduced incarcerations, partly due to poor coordination with the Department of Correction (DOC).

A striking finding from the audit is that a significant portion of program participants did not consistently receive psychiatric care, with 38 percent meeting with a psychiatric care practitioner less than half the time they were enrolled, and 25 percent not seeing a psychiatric care practitioner at all for extended periods.

The audit also criticizes the DOHMH for not having established “Key Performance Indicators” to measure the program’s effectiveness, particularly in crucial service areas such as substance abuse intervention and vocational services.

The audit also observed a worrying trend in the program’s ability to provide housing stability for its clients, a problem that has grown worse over time with significant decreases in the percentages of clients obtaining and retaining stable housing over the past two years.

The report highlights examples of people whose mental health needs were not adequately met, despite being placed with an IMT team after an arrest. This led to repeated emergency room visits, assaults, and periods of jail time and homelessness for various participants.

The Comptroller’s Office has recommended developing clear treatment targets, improving coordination with the DOC and hospitals, and identifying dedicated housing vouchers for IMT participants.