# Reaching the Unreachable: Intensive Mobile Treatment, an Innovative Model of Community Mental Health Engagement and Treatment

## TL;DR

The paper introduces a new mental health model called Intensive Mobile Treatment to help people who are often missed by traditional systems.

## Contribution

The novel contribution is the development and description of the Intensive Mobile Treatment model for community mental health engagement.

## Key findings

- IMT helps individuals with complex trauma histories and distrust of treatment systems.
- The model emphasizes long-term therapeutic relationships and non-billing approaches.
- It aims to empower practitioners to adapt the model in different settings.

## Abstract

In this paper we introduce the Intensive Mobile Treatment (IMT) model, which arose from a 2016 New York City initiative to engage individuals who were “falling through the cracks” of the mental health, housing, and criminal justice systems. People who are referred to IMT often have extensive histories of trauma. They experience structural racism and discrimination within systems and thus can present as distrustful of treatment teams. We detail the structure of the program as we practice it at our non-profit agency and outline the psychodynamic concepts that inform our work with challenging populations. We acknowledge IMT’s role in engaging in advocacy and addressing social justice in our work. We also discuss how through this model we are able to both mitigate and tolerate risk in participants with difficult-to-manage behaviors. This is typically a long-term, non-linear process. We address how this impacts the team dynamic as a whole and explain how with long-term, trusting therapeutic relationships, participants can change and grow over time. We also explain the ways in which our non-billing model plays an integral role in the treatment we are able to provide and identify several challenges and areas for program growth. In outlining our model and its methodology, we hope to empower other practitioners to adapt IMT to other settings beyond the New York City area.