For a frequent flier population that is well-known to the New York City criminal courts, the day begins in a bed arranged by the city’s Department of Homeless Services, followed by breakfast through its program providing three meals a day.
A mobile treatment team funded by the Health Department brings psychiatric care and medication to him, buying him a phone and paying the monthly bill as well.1 A nurse accompanies him to court and helps with benefit applications. Workers help him apply for and move into publicly subsidized apartments.
This program, pioneered by NYC and called Intensive Mobile Treatment (IMT), targets people with recent behavior that is unsafe and escalating. It served 1,123 people in FY2025, with 9% enrolled for five years or more. Repeated trouble qualifies someone for more help, and justifies keeping that help in place indefinitely.
One provider describes a resident repeatedly threatening housing staff because he believed they were stealing his money.2 Staff called 911, but emergency rooms assessed and discharged him without changing his treatment.
In its own FY2025 reporting, the Health Department paints a rosy picture: the share classified as “stably housed” rose from 38% in participants’ first year to 61% in their most recent. But the report never defines “stably housed.” Further, the Comptroller’s 2024 audit had found that the department did not check providers’ monthly reports against their underlying client files—even for a sample of cases.
In this treatment model, the “service providers” have to keep finding the client, arranging his care and adapting to his behavior. The “treatment recipient” can refuse medication or threaten staff and still retain their services. The city budgeted $42 million for these teams alone in FY2025, with shelter and housing funded separately.
Jana Colton et al., “Reaching the Unreachable: Intensive Mobile Treatment, an Innovative Model of Community Mental Health Engagement and Treatment,” Community Mental Health Journal 60 (2024): 843. Under “Use of Service Dollars,” the authors describe paying for phones and monthly bills, helping clients buy holiday gifts for family members, and celebrating “birthdays, move-ins, and other accomplishments.”
Ibid., 848. The resident made “threats of violence towards housing staff”; the authors describe coordinating with residential staff so that “911 calls can be minimized.”