Discharge Planning

Overview

The Mental Health Project works with people with mental health concerns in inpatient psychiatric units and in NYC jails to ensure that they receive appropriate discharge planning services. Our goal is to help end the cycle of homelessness, incarceration, and hospitalization by ensuring our clients are connected to supportive housing, public benefits, and continued treatment in the community.

For people hospitalized in inpatient units, we enforce our clients’ rights to have a safe discharge plan, as required by the New York State Mental Hygiene Law (section 29.15).  Our interdisciplinary team attempts to work cooperatively with hospital discharge planners to ensure clients receive a discharge plan that is suitable for their needs.

For people incarcerated in NYC jails, we advocate for correctional health services to provide an appropriate discharge plan as required by the Brad H. settlement agreement. Discharge planning services are available to incarcerated individuals who receive ongoing mental health treatment in jail. The services include continued mental health and/or substance use treatment, assistance obtaining or maintaining Medicaid, medication and prescriptions, and DHS shelter referral. People diagnosed with a serious mental illness are entitled to additional services, including case management, assistance applying for cash assistance, SNAP, SSI benefits, and VA benefits and obtaining supportive housing, expedited placement in a DHS program shelter, and transportation.

How We Can Help

For people hospitalized in psychiatric inpatient units:

• Advocate for our clients’ rights to have a safe discharge plan as required by the New York State Mental Hygiene Law (Section 29.15).
• Collaborate with hospital discharge planners to ensure clients receive individualized discharge plans that are suitable to their needs. We communicate directly with hospitalized individuals to obtain consent to communicate with hospital staff and family or friends about their discharge planning needs.
• Assist hospital staff with supportive housing applications, and resolve Medicaid and other benefit-related issues;
• Work to delay patient’s discharge until housing is accessible or benefit-related issues are resolved, or if the hospitalized person does not feel psychiatrically stable enough to be released;
• Ensure that hospital staff make referrals to outpatient mental health providers/programs and health homes.
• Provide information about Mental Hygiene Legal Services representation and contact information for their offices to the individual who is hospitalized and family members or friends.

For people incarcerated in NYC jails:

• Discuss your right to discharge planning services.
• Educate about the discharge planning services available.
• Advocate to ensure correctional health staff provide needed individualized mental health and other medical care services.
• Follow up after release in the community to ensure needed services are available.