Referral Guide for Providers
and Professionals:
Mobile Crisis Teams
1-800-LIFENET
LifeNet is a service of the Mental Health Association of
New York City, Inc. in collaboration with The New York
City Department of Health and Mental Hygiene.
50 Broadway, 19th Floor
New York, NY 10004
www.800LifeNet.org
Contents
WHAT IS A MOBILE CRISIS TEAM? ........................................................................................................... 3
LIFENET MOBILE CRISIS REFERRAL CENTRAL ..................................................................................... 3
Who can request assistance from Mobile Crisis Teams? ............................................................................. 3
What services do Mobile Crisis Teams provide? .......................................................................................... 4
ENHANCED SERVICES FOR MOBILE CRISIS TEAMS ............................................................................. 5
Need Adapted Mobile Crisis Teams ............................................................................................................. 5
NA MCT Crisis Respite Centers.................................................................................................................... 5
Children’s Rapid Response Team ................................................................................................................ 5
Automatic Referral Group for MCT ............................................................................................................... 6
Mobile Crisis Team Referral Criteria ............................................................................................................. 6
Children’s Rapid Response Team Referral Criteria ...................................................................................... 7
Needs Adapted Mobile Crisis Team (Parachute NYC) Referral Criteria ...................................................... 7
HOW TO MAKE A PROVIDER FASTRACK MCT REFERRAL ................................................................... 8
Provider Fastrack Referral Process .......................................................................................................... 8
Hospital Discharge Planner Referrals ........................................................................................................... 8
ALTERNATE SOLUTIONS WHEN MCT IS NOT APPROPRIATE .............................................................. 9
FREQUENTLY ASKED QUESTIONS ........................................................................................................ 10
Service Cost ............................................................................................................................................ 10
Catchment ............................................................................................................................................... 10
Response Time ....................................................................................................................................... 10
Medication ............................................................................................................................................... 11
Anonymity................................................................................................................................................ 11
Current Treatment ................................................................................................................................... 11
Involuntary Psychiatric Evaluation .......................................................................................................... 11
PROVIDER REFERRAL FORM.................................................................................................................. 13
...................................................................................................................... Error! Bookmark not defined.
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WHAT IS A MOBILE CRISIS TEAM?
A mobile crisis team is an interdisciplinary team of mental health professionals (e.g., nurses, social
workers, psychiatrists, psychologists, mental health technicians, addiction specialists, peer counselors).
Teams operate under the auspices of voluntary agencies and municipals hospitals. They respond to
persons in the community, usually visiting them at home, although their mandate allows them to make
contact at other locations. The Rapid Response Mobile Crisis Team for Children and Adolescents is a
team of social workers and family advocates available to respond to youth specifically in the Bronx,
Brooklyn and Queens community, including schools.
Mobile Crisis Teams are also referred to as CPEP and Non-CPEP teams. The CPEP acronym stands for
Comprehensive Psychiatric Emergency Program. A Non-CPEP team is defined under the guidelines of
the aforementioned heading in our overview section titled: What is a Mobile Crisis Team?
A CPEP team also known as: CPEP Crisis Outreach is a mobile crisis intervention component of the
CPEP offering crisis outreach and interim crisis service visits to individuals outside an emergency room
setting, in the community in natural (e.g. homes), structured (e.g., residential programs), or controlled
(e.g., instructional) environments. Crisis outreach service visits are emergency mental health services
provided outside an emergency room which include clinical assessment and crisis intervention treatment.
Interim crisis service visits are mental health services provided to individuals who are released from a
CPEP for the purpose of facilitating the individual’s community tenure while waiting for the first post-CPEP
visit with a community-based mental health provider.
CPEP crisis outreach and interim crisis service visits are Medicaid reimbursable.
LIFENET MOBILE CRISIS REFERRAL CENTRAL
LifeNet is New York City's only multicultural crisis center operating 24/7 with mental health professionals
providing free behavioral health assessments, interventions, and support in English, Spanish, Cantonese,
and Mandarin. LifeNet is the go-to source for New Yorkers seeking information and referrals to the vast
and complex behavioral health treatment and social support services network.
The New York City Department of Health and Mental Hygiene (NYCDOHMH) has mandated that as of
January 14, 2013 all requests for a Mobile Crisis Team (MCT) in New York City that come from the
community, i.e. family members, neighbors, friends, landlords, clergy, service providers to those who
assist person(s) with a mental health issue, or other person(s) concerned about an individual, will begin
with a call to the LifeNet (1-800-543-3638) hotline through the Mental Health Association. A LifeNet Crisis
Counselor will then determine if the situation meets criteria for the services of a MCT.
Who can request assistance from Mobile Crisis Teams?
Mobile crisis teams serve any person in New York City who is experiencing, or is at risk of, a
psychological crisis, and who requires mental health intervention and follow up support to overcome
resistance to treatment. Family members, neighbors, friends, landlords, school personnel, clergy or other
person(s) concerned about an individual often call mobile crisis teams in addition to concerned service
providers
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What services do Mobile Crisis Teams provide?
Mobile Crisis Team staff provides a range of services including assessment, crisis intervention, supportive
counseling, information and referrals, linkage with appropriate community based mental health services
for ongoing treatment.
Effective May 2013 all Mobile Crisis Team will provide Follow-Up Care: Follow-Up Care consists of
mental health services provided to individuals who are released from an urgent level of care such as a
Comprehensive Psychiatric Emergency Program (CPEP Emergency Room, Inpatient Unit), Medical
Emergency Unit and or are being followed by a Psychiatric Discharge Monitoring Program (Koskinas) for
the purpose of facilitating the individual’s community tenure while waiting for the first post-discharge visit
with a community-based mental health provider.
What if the Mobile Crisis Team determines that the individual in crisis needs to go to the hospital
psychiatric emergency room for further evaluation?
Teams will arrange to transport individuals to emergency rooms if further psychiatric and/or medical
assessment and care is indicated. If the individual in crisis does not agree to go to the hospital willingly,
and meets the specified legal standards (i.e., has a mental illness [or, in some instances appears to have
a mental illness] and presents a danger to self or others), mobile crisis teams can direct the police to
involuntarily transport such persons to the psychiatric emergency room for further evaluation and possible
hospital admission. In most instances the police will direct the ambulance services operated by the City's
Emergency Medical Services to provide actual transport. The Mobile Crisis Teams' authority to direct the
involuntary removal of persons to the emergency room is provided by the NYS Mental Hygiene Law,
Sections 9.37 and 9.58.
What other kinds of services do Mobile Crisis Teams provide?
In recent years, the Teams also have become an integral part of the Department of Health and Mental
Hygiene’s disaster response network. They have conducted crisis counseling to victims in the aftermath
of disasters, such as plane crashes, building collapses, major fires and explosions.
Crisis Plan
A Crisis Plan is a document that is developed to address actions that need to be taken in the event that
the person is experiencing a behavioral health crisis.
Psychiatric Advance Directives
A Psychiatric Advance Directive (PAD) is a legal document written by a currently competent person who
lives with a mental illness. It describes the person’s mental health treatment preferences, or names an
agent to make treatment decisions for the individual, should he or she become unable to make such
decisions due to psychiatric illness. There are two kinds of PADs:
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Instructive PADs, in which an individual gives instructions about the specific mental health
treatment desired should the individual experience a psychiatric crisis.
Proxy PADs, in which the individual names a health care proxy or agent to make treatment
decisions when the individual is unable to do so.
ENHANCED SERVICES FOR MOBILE CRISIS TEAMS
Need Adapted Mobile Crisis Teams (NAMCT)
On February 15, 2013 NYC DOHMH began providing Need Adapted Mobile Crisis Team (NA-MCT)
services: NA-MCTs are enhancements to existing Mobile Crisis Teams. The NAMCT’s are targeted to
individuals who are experiencing an affective or non-affective psychosis related crisis or, for Brooklyn
residents, are experiencing a first-episode of Severely Mentally Ill (SMI) category: Schizophrenia,
Schizophreniform, Psychosis NOS, Schizoaffective Disorder, Bipolar Disorder and Major Depressive
Disorder In addition to providing standard mobile crisis services, the NA-MCT will offer psychotherapy,
peer support and family therapy as often as needed for up to one year for those people who are
interested in and eligible for their services. In contrast with MCTs, NA-MCTs provide treatment, including
medication, therapy and support. Therefore, if a person is already well engaged with treatment, they may
not want to change their provider to the NA-MCT. However, if a person is tentatively or poorly engaged in
treatment, they may find the NA-MCT model and approach more attractive and may wish to change
providers. This decision is up to the person. Therefore, LIFENET need not consider a person’s current
connection to treatment when making a referral.
Each borough’s NAMCT varies slightly in its eligibility criteria.
The NAMCT is trained in the Need Adapted Treatment Model (NATM) and Intentional Peer Support (IPS).
They use peer specialists in tandem with behavioral health professionals to work with people and their
family of choice in their home and/or community to develop trustful relationships and support networks
that will help the person get through the current crisis, manage future crises and move towards recovery.
NA MCT Crisis Respite Centers
All Need Adapted Mobile Crisis Teams provide Respite Centers – LifeNet can provide caller with the phone
number to the Respite Center. The Respite Center will screen the client for intake to the Center.
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Residents of Staten Island can use Manhattan & Brooklyn Respite Center as there is
currently no Respite / NA-MCT in the borough of Staten Island.
Children’s Rapid Response Team
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Children’s Rapid Response Teams provide rapid response and short term crisis management for
children and adolescents in active crisis situations. To meet the criteria for the Children’s Rapid
Response Teams, the child’s presenting problem should be acute rather than an ongoing
concern. Some examples that would be considered are a recent change in functioning or
behavior, out of character sadness, current suicidal ideation, or destructive/aggressive behavior
within the last two days. Children’s Teams respond to school or home in the Bronx, Brooklyn
and Queens. Teams provide crisis de-escalation, psychosocial assessment, initial prevention
planning and collaboration with educators. Children’s Teams also provide support to families
and caregivers by providing appropriate referrals, literature and education about how to
prevent future crisis situations.

Teams respond to the school or home within 2 hours of receiving the referral from LifeNet
and are available 24 hours a day, 7 days a week. During non-business hours, the team
will respond via phone call.
Automatic Referral Group for MCT
The Automatic Referral Group (ARG) is a group of providers who practice at urgent levels of care. Due to
the nature of the services they provide, these levels of care are eligible for MCT referrals regardless of
whether or not they meet the standard criteria.
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Comprehensive Psychiatric Emergency Programs (CPEP)
Medical and Psychiatric Emergency Rooms
Non-CPEP Mobile Crisis Teams
CPEP Mobile Crisis Teams
Inpatient Psychiatric Units
Bellevue and St Luke’s Crisis Clinics
Psychiatric Discharge monitoring Programs, Koskinas (HHC)
Human Resources Administration (HRA) Visiting Psychiatrist Program
Collyer’s Mansion type referrals from NYPD or FDNY
Department of Homeless Services (DHS) for shelter or DHS Housed clients
Mobile Crisis Team Referral Criteria
Referral Criteria for MCT:

The client or caller is experiencing or is at risk of experiencing a psychiatric or psychological crisis
requiring mental health intervention and

The client is currently not engaged in mental health treatment and is unwilling or unable to seek
psychiatric services on his/her own or with the aid of a family member or friend or
o
The client has been discharged from an urgent level of care such as a Comprehensive
Psychiatric Emergency Program (CPEP Emergency Room, Inpatient Unit), Medical
Emergency Unit and or are being followed by a Psychiatric Discharge Monitoring
Program (Koskinas) and requires mobile crisis services for the purpose of facilitating the
individual’s community tenure while waiting for the first post-discharge visit with a
community-based mental health provider.
And the case does not qualify as being at “immediate risk” that would require an EMS
referral.

The client is experiencing or is at risk of experiencing a psychiatric or psychological crisis
requiring mental health intervention and is currently non-compliant with mental health treatment
and is unwilling or unable to continue obtaining psychiatric services on his/her own or with the
aid of a family member or friend
And the case does not qualify as being at “immediate risk” that would require an EMS
referral.
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Children’s Rapid Response Team Referral Criteria
Referral Criteria for Children’s Rapid Response Team:
Children ages birth through just prior to 17.11 months
Child or adolescent must be experiencing a behavioral or mental health issue:
o
o
o
o
o
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Behaving in threatening manner:
Experiencing a current psychiatric crisis
Displaying active symptoms of depression
Suspected of drug abuse with above situations
Suspected of being bullied or perpetrator of bullying
Experiencing, or is at risk of, a psychological crisis
Reside in the assigned Community Districts in the Bronx, Brooklyn or Queens
o
Bronx Children Rapid Response: Responds to entire Bronx Community & every
public school in Bronx, NY (Charter schools as well).
o
Brooklyn & Queens: Child must reside in the Community District or the Public
School must be within the assigned Community District
o
Manhattan Child must reside in the Community District
o
Staten Island (Coming soon)

Child can be already connected to mental health services
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Verbal or written parental consent

If provider wants Team to visit a school, the school must call in the referral to give consent
for Team to enter their building and provide intervention.
Need Adapted Mobile Crisis Team (Parachute NYC) Referral
Criteria
REFERRAL CRITERIA FOR NEEDS ADAPTED MCT:
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Experiencing a psychosis-related crisis (affective or non-affective)
o
For Parachute NYC Brooklyn – (Not available in Brooklyn at this time)
o
For Parachute NYC Bronx – The client must be 18-65 years old
o
For Parachute NYC Manhattan – The client must be 18-65 years old
o
For Parachute NYC Queens – The client must be 18-64 years old.
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Resident of Borough that NA-MCT is located (Manhattan, Queens, Bronx)
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Voluntarily seeks or accepts services (LifeNet can still make referrals for clients who are
unwilling and consent will be established by NA-MCT)
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Has permanent housing (not homeless)
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Is able to have a family member (including close friend) engage in treatment with them.
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Medically stable, not have Dementia, Traumatic Brain Injury (TBI) or Organic Brain
Disorder
* NOTE: Though the client may not be eligible for NA MCT, they may still be eligible to make
use of Respite Center’s.
HOW TO MAKE A PROVIDER FASTRACK MCT REFERRAL
Provider Fastrack Referral Process

Provider Fastrack MCT referrals will ONLY be reviewed when received Mon- Fri 9am4:30pm. Outside of these hours, call 1800LIFENET to make an MCT referral.
Provider Fastrack MCT referrals must be typed into the provided fillable form. The MCT Worksheet
can be found on the MHA website.
http://www.mhaofnyc.org/crisishotlines/
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Fastrack is available Monday- Friday 9am-4:30pm. Fastrack is NOT available
weekends and Holidays* Call 1-800LifeNet outside these hours to make a MCT
referral.
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Fully complete all requested information in the fillable MCT Worksheet form.
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Fax referral to 1 646 514 9310
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All referrals are pending until reviewed and approved by LifeNet
 You or your designee must be available to answer any questions
LifeNet may have within 1 hour of transmitting your fax

IF your referral is incomplete, LifeNet staff will contact you and let you know what is missing.
You will be asked to update the MCT Worksheet and refax to LifeNet.
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If referral is accepted, LifeNet will contact you within 1 hour to provide the name and details
of the MCT
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If the referral is declined, LifeNet staff will contact you within 1 hour to discuss alternatives
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Please email Gail Bower, LMSW GBower@mhaofnyc.org and Lynn Kaplan, Psy.D.
LKaplan@mhaofnyc.org if you have not heard back from LifeNet within an hour to make
sure that your fax was received.
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Holidays include New Year’s Day, President’s Day, Dr Martin Luther King Jr Day, Memorial Day, July
4th, Labor Day, Columbus Day, Veteran’s Day, Thanksgiving Day, Day after Thanksgiving, Christmas
Day. For Holidays falling on weekend days, Fastrack will be closed on the Holiday’s observance day.
(Cal 1-800 LifeNet for MCT on these days)
Hospital Discharge Planner Referrals
IF YOU ARE A DISCHARGE PLANNER CALLING FROM THE HOSPITAL FOR PURPOSES
OF REFERRING A CONSUMER TO THE PARACHUTE NYC NA-MCT PROGRAM:
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Please note that we will give you the direct number to the appropriate NA-MCT; LifeNet
will not be doing the referral.
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The NA-MCT will speak with you and determine appropriateness of referral, and will follow
through as needed.
ALTERNATE SOLUTIONS WHEN MCT IS NOT APPROPRIATE
THE FOLLOWING PROVIDER REFERRALS WILL NOT BE ACCEPTED BY LIFENET.
ALTERNATIVES WILL BE PROVIDED TO THE CALLERS.
REFERRALS NOT MEETING MCT ACCEPTANCE CRITERIA/ LIFENET ALTERNATE SOLUTIONS
Psychiatric evaluation only
Referral source cannot locate client
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The LifeNet Crisis Counselor can provide
suggestions or alternatives on clinics to
contact.
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If the caller is in crisis; LifeNet will
conduct crisis counseling and risk
assessment.
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If the caller is calling for a Psychiatric
Evaluation LifeNet will recommend to
caller to call a psychiatrist through their
insurance or an outpatient clinic.
MCTs are not designed to provide client
locater services. Callers will be advised to
call in a missing persons report.
Case management needs (not at risk; If the referral source indicates that client is
not at risk but needs to be linked to case
linkage to treatment only)
management services, LifeNet will provide
referrals for case management programs.
Client needs prescription
LifeNet will encourage the caller to go to their
nearest psychiatric ER if they are about to
run out of medications. If caller/client does
not have health insurance, LifeNet will
encourage caller to go to a HHC (Health and
Hospital Corporation) hospital where they
can receive services regardless of insurance
status.
Client cannot get an appointment
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This may be due to significant waiting
lists at clinics. Teams are not capable of
bypassing a clinic’s waiting list.
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Where possible, LifeNet Crisis Counselor
will provide caller with information for
clinics with walk in times.
Chronic problems – not mental health LifeNet Crisis Counselor will provide
appropriate referrals (ex: rehabilitation)
related
FREQUENTLY ASKED QUESTIONS
Service Cost
Most MCT services are free, however there are MCT’s who do bill clients for their services. Most of these
are the teams associated with the Comprehensive Psychiatric Emergency Program (CPEP). The teams
that do bill for their services will be indicated in their respective team profile. The teams will bill Medicaid,
the client’s insurance company, or the client. In most instances, if the client does not have health coverage,
collection is not enforced. If Medicaid, Medicare, or private insurance covers the client, obtain appropriate
member #’s and names of companies and submit it to the MCT with the referral information. If a client
expressed financial concerns, let them know the team will always work something out, and they must visit
regardless of a person’s ability to pay.
Catchment
While each MCT is assigned to a specific catchment area, there are several MCTs whose catchment
areas overlap. Deciding on which team to refer the caller will depend on their specific needs. Each MCT
should be evaluated in terms of:
1. The team's hours - if one of the teams works weekends and the referral comes in on a
Thursday or Friday, this team should be selected
2. Languages served
3. If the client is geriatric, a child/adolescent, or Orthodox Jewish community there are
teams that specialize in those populations.
There are instances when a team’s catchment area is the whole borough and other times where MCTs
cover neighborhoods in the exact same borough. There are also teams whose catchment areas overlap.
While at first this seems confusing, it can actually work to both the team’s and client’s advantage. A team
that has a smaller catchment area will probably be less burdened and be able to more efficiently serve the
client. It is a good habit to cross check the client’s CD against all the MCTs catchment areas in the borough.
Response Time
Effective January 2014 all mobile crisis teams (CPEP & Non-CPEP) are required to respond to referrals
within 24-48 hours *(For differences in CPEP & Non CPEP teams please refer to pg. 1 – What is a Mobile
Crisis Team). Where they are available, the Rapid Response Mobile Crisis Team for Children and
Adolescents responds to calls within 2 hours of receiving a crisis referral from LIFENET. Consent and
involvement from the minor’s family is an important component of the crisis service. MCTs visits are
dependent on both the client’s and their own availability. Most teams do not call prior to making a visit but
may accommodate requests to do so. The team might attempt to schedule an appointment with the
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client, but often they make an unscheduled visit, especially if they cannot reach the client by phone.
Realize that they are attempting to see clients who are unable/ unwilling to participate in treatment, so
they don’t often call and ask if they can come. If a referral source asks that the team schedule an
appointment, or would like to be present to help facilitate the referral, you must include this in your
documentation. The team will do their best to accommodate, but we cannot promise this to the referral
source. We cannot request that an MCT hold off on making a visit. They are a crisis service and are
mandated to take action – not wait until a later time.
Medication
Each team handles the issue of medication differently. Some teams will distribute medication (possibly
samples) while others provide prescriptions only. Many of the teams that are connected to hospitals will
allow the client to fill the prescription at the hospital for a low fee. The best way to accurately inform a
client about getting medication from a team is to tell them, “Each team deals with the issue of medication
differently. They will come and talk to you about how you are feeling, and what your treatment options
are. I will include your medication history in my referral, and they will be prepared to discuss that with
you”.
Anonymity
The caller/ referral source cannot remain anonymous. There have been rare occasions where
someone (a neighbor, friend, family member) has requested that the client not be told that they made the
referral. The MCT has to be able to make the client aware of who called the team. It is unfair to the
team if they show up at the client’s home, and are unable to state the purpose of their visit. The client also
has a right to know who has phoned the team on their behalf. If the caller has concerns about their
identity being revealed to the client, let them know you can make the referral, and they can discuss their
concerns with the team, prior to their making a visit. The caller can withdraw the referral before the visit, if
they change their mind after speaking to the team. Be sure to include these concerns in your referral, but
do not promise the caller that their anonymity can be protected, that is not the case.
Current Treatment
Current treatment status does not define eligibility for MCT services; Presenting Problem should
determine need for said services. If a caller, however, indicates that they have not been maintaining
appointments a referral may be appropriate and this should be indicated clearly in your call
documentation. If you receive an indirect call from, for example, a parent or friend of someone in possible
need of an MCT referral, this individual must contact the treatment provider first regarding their concerns.
If this has already been attempted with little resolution an MCT referral may be appropriate. Again this
must be clearly indicated in the call documentation.
Involuntary Psychiatric Evaluation
The Mobile Crisis Teams' authority to direct the involuntary removal of persons to the emergency room is
provided by Article 9 of the New York State Mental Hygiene Law (NYS MHL). Article 9 contains several
sections that govern the decision by clinicians and police/peace officers to involuntarily remove
individuals. The law defines the standards that must be met, as well as who is authorized to take such
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action. Below are brief descriptions of relevant sections. Mobile Crisis Teams typically operate under
sections 9.37 and 9.58.
Section 9.45:
A Section 9.45 removal order is issued by the Department's Commissioner directing the police to
transport an individual to the emergency room when a treating clinician is able to demonstrate that this
individual has a mental illness and presents a danger to self or others. Department guidelines require that
a qualified clinical reporter (licensed M.D. or licensed psychologist, registered nurse or certified social
worker treating the individual) provide the Office of Crisis Intervention Services with all the necessary
information needed to establish that the client is mentally ill and presents a danger to self or others.
Requesting a 9.45 order is not appropriate if the client is an immediate danger to self or others. In such
cases, Department guidelines direct the clinician to call "911".
Section 9.37:
The Department Commissioner is empowered to designate board-certified psychiatrists who are part of
mobile crisis teams, or who work in other key emergency arenas, to order the involuntary removal to a
psychiatric emergency room of an individual who has a mental illness and presents a danger to self or
others. The 9.37 designation is not available for emergency room doctors.
Section 9.58:
Section 9.58 of the State mental hygiene law was enacted in 1995. It extends the authority to order the
involuntary removal of an individual to the psychiatric emergency room to specified staff (i.e., M.D.s,
licensed psychologists, registered nurses and certified social workers) who are part of approved mental
health mobile crisis teams, ACT and Homeless Outreach teams. The individual subject to involuntary
removal must appear to have a mental illness and present a danger to self or others.
In New York City, all 9.58 eligible mobile crisis workers must complete a special training sequence
developed by the Department before they can receive the 9.58 designation. 9.58 provide an alternative to
the 9.45 and 9.37 orders.
Section 9.43:
A 9.43 involuntary removal order is a civil order issued by a judge when he or she is presented with
evidence that an individual has, or may have, a mental illness, and presents a danger to self or others
(often referred to as a Mental Hygiene Warrant). A 9.43 order may be requested by a treating clinician or
family member. A 9.43 order also can be issued by a judge in criminal cases when the individual
appearing before the judge appears to have a mental illness and presents a danger to self or others, and
the court determines either that the crime has not been committed or that there is not sufficient cause to
believe that such a person is guilty of the crime.
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PROVIDER REFERRAL FORM
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