To initiate an emergency psychiatric transport in New York under Mental Hygiene Law Section 9.45, you contact your county’s Director of Community Services, describe what you have observed, and — if the reported facts show the person appears to have a mental illness likely to cause serious harm — the Director or a designee signs OMH Form 474A/476A-2 directing police, peace officers, or an ambulance to take the person to a psychiatric emergency facility.1New York State Senate. New York Mental Hygiene Law 9.45 – Emergency Assessment for Immediate Observation, Care, and Treatment; Powers of Directors of Community Services The form is not something a family member fills out. You are the reporter. The Director is the decision-maker and the signer.
Who Can Request a 9.45 Transport
The statute limits reporters to two groups: people close to the individual, and certain professionals with direct knowledge of the situation.1New York State Senate. New York Mental Hygiene Law 9.45 – Emergency Assessment for Immediate Observation, Care, and Treatment; Powers of Directors of Community Services
Family and related parties who qualify:
- Parent
- Adult sibling
- Spouse
- Domestic partner (as defined under New York Public Health Law)
- Child of the person
- Legal guardian or court-appointed committee
Professionals who qualify:
- Licensed physician
- Licensed psychologist
- Registered professional nurse currently providing treatment
- Certified social worker currently providing treatment
- Supportive or intensive case manager assigned through an OMH-approved program
- Health officer
- Peace officer or police officer
Note the qualification attached to nurses, social workers, and case managers: they must be currently responsible for the person’s treatment, or assigned through a program approved by the Office of Mental Health. A nurse who treated the person years ago does not qualify. Neither does a case manager from an unapproved program.
How to Reach the Director of Community Services
Every county in New York has a Director of Community Services, sometimes called the Local Governmental Unit Director, who coordinates local mental health, substance use, and developmental disability services. The office is usually housed in the county’s Department of Mental Health or Community Services division. In New York City, each borough has its own office.
There is no single statewide number. You contact your county’s office directly, which is typically listed on the county government website under mental health or behavioral health services. If you cannot find it, call 988, the Suicide and Crisis Lifeline; counselors there can connect you with local resources, including mobile crisis teams that may work alongside the DCS. For substance use emergencies, the state also operates the HOPEline at 1-877-8-HOPENY.
When you call, describe what you have observed. The Director or a designee decides whether the reported facts justify signing the form.
What the Form Contains
The official document is OMH Form 474A/476A-2, titled “Custody / Transport to §9.39 Emergency Department or CPEP on Request by a Director of Community Services (DCS) or Designee.” The Director’s office completes it based on what you report.2New York State Office of Mental Health. MHL 9.45 OMH Form 474A-476A-2 It captures:
- The subject’s last name, first name, middle initial, gender, and date of birth.
- Whether the signer is the Director of Community Services or a designee, and the jurisdiction they serve.
- The basis for the directive. The signer checks one or more of three boxes: danger to self, danger to others, or inability to meet essential needs due to mental illness. A “Describe” field follows for the specific reported facts.
- The reporter’s name and relationship to the person, with checkboxes for every eligible reporter category in the statute.
- Whether peace or police officers are directed to take custody and transport, or whether an ambulance service is being asked to do it, and the name of the destination facility.
- Signature, date, and time.
The “Describe” field carries the weight of the report. Vague statements like “he seems off” or “she hasn’t been herself” do not support a finding of serious harm. Give specific dates, times, and observed behaviors: what the person said or did, when it happened, and why it points to imminent risk. The stronger the factual detail, the stronger the foundation for the Director’s decision.
The Legal Standard the Director Is Applying
The Director can only sign the form if the reported facts meet a specific legal threshold: the person appears to have a mental illness that is likely to result in serious harm to themselves or others. Section 9.39 defines that standard with three prongs, and the form’s checkboxes map directly to them.3New York State Senate. New York Mental Hygiene Law 9.39 – Emergency Admissions for Immediate Observation, Care, and Treatment
- Danger to self. A substantial risk of physical harm shown by suicide threats or attempts, serious self-injury, or other conduct demonstrating the person is dangerous to themselves.
- Danger to others. A substantial risk of physical harm to others, shown by homicidal or other violent behavior that puts others in reasonable fear of serious physical harm.
- Inability to meet basic needs. A substantial risk of physical harm because the person’s mental illness makes them unable or unwilling to provide for essential needs: food, clothing, necessary medical care, personal safety, or shelter.
The third prong is the one most families do not know about. A person who is not threatening violence but has stopped eating, refuses medical treatment for a serious condition, or is living exposed to the elements because of a psychiatric condition can still meet the standard.
This is not a criminal proof standard. The Director does not need proof beyond a reasonable doubt. The question is whether the reported facts, taken at face value, describe a situation that fits one or more of the three prongs. The Director still exercises judgment, and a report amounting to “my brother is acting strangely” with no concrete details will not produce a signed form.
Who Carries Out the Transport, and Where
Once the form is signed, peace officers acting in their official capacity and police officers have a legal duty to assist in taking the person into custody and transporting them to the designated facility.1New York State Senate. New York Mental Hygiene Law 9.45 – Emergency Assessment for Immediate Observation, Care, and Treatment; Powers of Directors of Community Services The Director can also request an ambulance service to handle the transport instead.
The form names a specific destination. The statute allows two types of receiving facility:
- A hospital approved under Section 9.39, meaning a facility the Commissioner of Mental Health has authorized to receive and retain emergency psychiatric patients.
- A Comprehensive Psychiatric Emergency Program (CPEP), a specialized facility in urban areas providing round-the-clock psychiatric emergency services, including triage, crisis intervention, and extended observation beds for up to 72 hours.4New York State Office of Mental Health. New York State Office of Mental Health CPEP Annual Report
The signed form must travel with the person and be presented on arrival. Without it, the receiving facility has no legal basis to hold the individual under this section.
What Happens After the Person Arrives
The transport order is only the entry point. What follows depends on where the person is taken.
At a Section 9.39 Hospital
The hospital can hold the person for up to 15 days for observation, examination, and treatment.3New York State Senate. New York Mental Hygiene Law 9.39 – Emergency Admissions for Immediate Observation, Care, and Treatment Two checkpoints fall within the first 48 hours:
- A staff physician must examine the person and confirm they meet the Section 9.39 criteria before the hospital director admits them.
- Within 48 hours, a second physician on the hospital’s psychiatric staff must independently examine the person and confirm the first physician’s finding. Without that confirmation within 48 hours, the person cannot be held further under this section.
If at any point during the 15-day period the hospital determines the person no longer meets the criteria, the person must be released, unless they agree to stay voluntarily. Continued involuntary treatment beyond 15 days requires a separate court-authorized retention process with its own notice, hearing, and legal representation.
At a CPEP
The observation period is shorter, up to 72 hours.5New York State Senate. New York Mental Hygiene Law 9.40 – Emergency Observation, Care and Treatment Three outcomes are possible during that window:
- If the person no longer needs emergency observation and does not need involuntary hospital care, they are released.
- If they still require observation beyond 72 hours, they are transferred to a Section 9.39 hospital for continued care.
- If they consent to treatment, they can be admitted to an appropriate hospital as a voluntary or informal patient.
The Person’s Rights Once Detained
A 9.45 transport is involuntary. The person does not consent to being taken to the hospital or CPEP, which is why the legal protections built into the process matter.
The Mental Hygiene Legal Service (MHLS), a state agency attached to New York’s court system, represents people receiving mental health services in state-operated or licensed facilities.6New York State Unified Court System. Mental Hygiene Legal Service MHLS attorneys inform patients about their rights, assist with matters related to admission, retention, discharge, care, and treatment, and represent patients in court, including hearings to seek release or to challenge involuntary treatment over the patient’s objection.7Appellate Division – First Judicial Department. Mental Hygiene Legal Service – First Department
Once a person is detained under this process, they have the right to be examined by a physician promptly upon arrival, the right to have MHLS notified of the admission, the right to communicate with an attorney, and the right to a court hearing if the hospital seeks to retain them beyond the initial emergency period. If the hospital wants to administer medication over the patient’s objection, that requires a separate legal proceeding.