4. Child and Adolescence Mental Health Service

1) Intervention and Referral

The following services are available for families with children/adolescents who are experiencing mental health crises. Note: A "crisis" situation is one that requires prompt attention, but is not immediately life threatening. In cases of life threatening emergencies, persons should call "911".

(1) Walk-In Clinics

Three (3) municipal hospitals operate child/adolescent mental health walk-in clinics where parents can bring their children who are experiencing symptoms of mental illness. These clinics operate during regular business hours, and no appointments are needed. Walk-in clinics are available at Kings County Hospital (Brooklyn); Elmhurst Hospital Center (Queens); and Jacobi Hospital (Bronx). During evening and weekend hours services are available at the Comprehensive Psychiatric Emergency Programs (CPEPS) located in each borough. CPEPS operate seven days per week, 24 hours per day.

(2) LifeNet

(3) Mobile Crisis Teams

2) Residential Treatment Facilities

(1) Hospital Inpatient Services

Every effort is made to assist children and adolescents who have mental illnesses to remain in the community. In those instances when hospitalization is required, seven (7) municipal and voluntary hospitals provide services for children and adolescents. There is at least one acute inpatient unit in each borough, with the exception of the Bronx. In the Bronx, acute and intermediate care is available in the Bronx Children's Psychiatric Center which is operated by the State Office of Mental Health. Evaluation for inpatient admission is usually made at the walk-in clinics or comprehensive psychiatric emergency programs described above.

(2) Community Residences

Community residences provide a therapeutic residential program in a community setting for seriously emotionally disturbed youth who are unable to reside with their families. Programs provide structured daily living activities, problem-solving skills training, behavior management and caring, consistent adult relationships. Each community residence is linked with one or more day treatment and/or special education program. Children are placed either by their parents or by the local social services district, depending on custody.

3) Outpatient Services

(1) Clinic Treatment Programs

Clinics are widely used community-based treatment programs that offer a variety of interventions. Clinic programs often are used in combination with other community support, emergency services and other children's educational and social services. Treatment modalities include individual, group and family therapy, crisis intervention, case management, psychological and educational testing, and psychiatric consultation. Clinic programs must hold an operating certificate from the State Office of Mental Health, and are licensed under Part 585 of the State mental health regulations which define standards of care, range of services, staffing levels, documentation and facility requirements.

(2) Day Treatment Programs

Day treatment programs provide the most intensive non-residential mental health services currently available. These programs are characterized by a blend of mental health and special education services including speech therapy, as well as social work, psychological, psychiatric and neurological services. Day treatment programs work closely with families and other community-based support services. Programs are required to have a valid operating certificate issued by the State Office of Mental Health, and are licensed under Part 585 of the State mental health regulations which define standards of care, range of services, staffing levels, documentation and facility requirements.

4) Assertive Community Treatment (ACT) Teams

Assertive Community Treatment Teams, know as ACT teams, are small, community-based mental health treatment teams that provide a full range of psychiatric treatment, as well as psychosocial and rehabilitation services to persons with serious and persistent mental illness. This innovative program, modeled on ACT teams in several other parts of the country, was introduced into the New York City system in 1995. ACT is designed to assist persons who have had difficulty in engaging in more traditional outpatient mental health services. ACT team treatment services are provided on a long-term, intensive basis to clients in their own homes and communities. Staff work closely and individually with clients to help them learn skills to maintain stability and optimize functioning in the community. ACT teams are usually composed of five to six mental health professionals, serving 35-60 persons, a client-staff ratio significantly lower than other outpatient models. Teams operate on a 24-hour, seven-day per week availability. An ACT team specifically targeting children was started in 1998.

5) School-based Mental Health Services

These are programs that provide mental health services to seriously emotional disturbed children and adolescents, and those children and adolescents at-risk of such disturbances. Services provided include brief interventions with a student or group of students, linkage with families, assessments, screening, crisis intervention, referrals, linkage with community-based programs, consultation and technical assistance for teachers and principals. Clinical staff in school-based programs are out stationed in the schools by community-based mental health service agencies through an agreement between the Board of Education, the Department of Mental Health and the community-based mental health agencies. This model permits services to be provided on-site in the schools, and also makes available the full resources of the community-based mental health agency to students and their families.

6) Support Services

(1) Case Management

Case management program activities are aimed at linking the recipient to the service system and coordinating the various services in order to achieve a successful outcome. In the child and adolescent system there discrete are intensive case management and supportive case management programs. Additionally, certain clinic and day treatment programs provide case management services within the programs.

(2) Vocational Services

Vocational programs, which are part of some day treatment programs for adolescents, are designed to provide work training and clinical support services for older adolescents with poor academic performance and social adjustment problems.

(3) Family Support Services

These services include family support groups, advocacy, respite and after school, summer, family recreation programs for families in which there is a seriously emotionally disturbed child or adolescent.

7) Home and Community-based Waiver Programs

The Home and Community-based Services Waiver program is a model whose goal is to support seriously disturbed children and adolescents and their families in staying together in their homes and communities. Without the services offered through the waiver program these children would most likely require long-term care in a residential treatment facility or intermediate inpatient facility. Six core services are provided: crisis response, family support services, respite, intensive in-home, skill building and individualized care coordination. Waiver programs enable providers to "waive" the parents' resources and income, thereby treating the child as a family of one for purposes of determining eligibility for Medicaid-reimbursable services.
For additional information about mental health services for children and adolescents, call the Bureau of Children and Adolescent Services at (212) 219-5365.

8) Early Intervention Program

On September 17, 1992, Governor Cuomo signed the Early Intervention Bill (Chapter 428 of the Laws of 1992). This landmark legislation requires localities to offer early intervention services to infants and toddlers with developmental disabilities or delays. The Early Intervention Program is part of a national effort initiated by Congress in 1986 through the passage of the Individuals with Disabilities Education Act (Public Law 99-457). The law created an entitlement to a wide range of rehabilitative services for infants and toddlers from birth through age two. The New York City Department of Health and Mental Hygiene is the lead City agency; the New York State Department of Health coordinates the statewide network of services. Early Intervention is a comprehensive interagency program that supports infants and children with developmental delays in their efforts to realize their full potential. It reduces the likelihood of delays among at-risk children, assists and empowers families to meet their child's and their own needs, and entitles children, regardless of race, ethnicity or income, to services through the program.
Who is Eligible?
Infants and toddlers from birth through age three, who live in New York City and who have a diagnosed physical or mental condition that has a high probability of resulting in a developmental delay, or who are suspected of having a developmental delay or disability are entitled to a developmental screening or a comprehensive evaluation to determine eligibility for additional early intervention services. Delays may be in one or more of the following areas of development: cognitive, physical, communication, social/emotional, and/or adaptive. Children at risk of a disability are eligible for initial screening, and will receive periodic screenings through the New York City Infant Child Health Assessment Program.
Note: For information about early intervention services elsewhere in New York State, call the Growing Up Healthy 24-Hour Hotline 1-800-522-5006.
What Kinds of Services Are Available?
Children referred to the Early Intervention Program receive a comprehensive developmental evaluation. Every family is assigned a service coordinator who works with them to select an appropriate evaluator. After the evaluation an Individual Family Service Plan is developed to address the specific needs of each child and family that qualifies for services.
Services may include: Special Instruction
Occupational Therapy
Speech Therapy
Physical Therapy
Psychological Services
Family Training
Counseling
Assistive Technology
Respite Services
Who Will Pay For the Services?
• Initial evaluation services are provided at no cost to the family.
• Additional services are provided for eligible children at no cost to the family.
How Are Children Referred to the Program?
Infants and toddlers through age two can be referred by their doctors, child care agencies, and other social services workers or community-based agencies. Most important, parents can call the program themselves for information and a referral.
The HOTLINE is open Monday through Friday, 9 am - 5 pm. Call: 1-800-577-BABY (2229)