Wednesday, April 7, 2010

Renew Kendra's Law - This Time Permanently

Kendra’s Law is a New York law that allows courts to order certain violent and/or recidivist mentally ill individuals to accept treatment as a condition for living in the community. This is called Assisted Outpatient Treatment (AOT). It also allows courts to commit the mental health system to providing the treatment.

Some people, as a result of mental illness, have great difficulty taking responsibility for their own care, and often reject outpatient treatment offered to them on a voluntary basis. These individuals often commit suicide; become homeless; end up in jail; or, on rare occasions, are involved in acts of violence. Family members and caregivers often must stand by helplessly and watch their loved ones and patients decompensate to actual "dangerousness" before they are allowed to facilitate treatment. 

Kendra's Law provides residents in New York State with a tool, Assisted Outpatient Treatment, that has proven to help in these situations.

Since its original passage in 1999 and renewal in 2005, Kendra’s Law has been the subject of several studies, which found that Kendra’s Law:
  • Helps the mentally ill by reducing homelessness (74%); suicide attempts (55%); and substance abuse (48%).
  • Keeps the public safer by reducing physical harm to others (47%) and property destruction (43%).
  • Saves money by reducing hospitalization (77%); arrests (83%); and incarceration (87%).
In anticipation of Kendra’s Law’s expiration on June 30, 2010, two bills have been introduced. The Assembly bill, A10421, introduced by Assemblymember Aileen Gunther, would not only renew Kendra's Law, but would also make it permanent.  The Senate bill, S7254, introduced by Senator Thomas Morahan, would renew Kendra's Law but allow it to expire on June 30, 2015.  

I don’t know about you, but I don’t think the problems that Kendra’s Law addresses will magically go away on June 30, 2015.  Do we want to go back to the higher numbers of homelessness, suicide attempts and substance abuse that this law has helped reduce? I don’t think so.  I think the statistics prove the worth of this law and there is no reason to have to go through another renewal process.  Kendra's Law should be made permanent.

Moreover, the Assembly bill would implement important fixes to make the current law stronger and more consistently applied; it would:
  • Close the loophole whereby a person under a court order can evade the court order by moving to a different county.  This can reduces costs and provide treatment in a timely manner.
  • Trigger an automatic review of the court order before it expires to determine if it should be renewed and establish a reporting mechanism to help the Office of Mental Health monitor these expirations.  This can prevent a lapse in treatment which can have devastating effects.
  • Provide training to judges so the law can be applied consistently.
  • Trigger an automatic review, prior to the release of patients who had been involuntarily committed to an in-patient hospital, to determine if the patient should be considered for AOT.  This can prevent a lapse in treatment, which can have devastating effects.
  • Trigger an automatic review, prior to the release from prison of inmates who received mental health services, to determine if the inmate should be considered for AOT.  This can reduce recidivism.
  • Provide a stronger mechanism for family member of the mentally ill and members of the community to petition the court to have a individual investigated for AOT. 
  • Allow courts to consider previous behavior, not just the current behavior of an individual being considered for AOT.  This is important because it can provide insight into how the individual would survive in the community with and without treatment.
  • Provide a mechanism to bring Kendra’s law to smaller communities that do not have qualified doctors.  Thus, it expands the benefits of Kendra’s Law to help all communities, not just the larger ones.
  • Require physicians to make reasonable efforts to gather useful information from the consumer’s family and significant others in order to develop a treatment plan.  Often family members can fill in gaps that the consumer does not, or is not able to, provide.
  • Incorporate research that shows treatment plans of one-year have been more useful to consumers and would allow AOT plans of one-year, not just six months, to be ordered.  This can not only improve outcomes, but also it reduces costs associated with each renewal.
  • Improve the renewal process when an otherwise qualified petitioner other than the original petitioner requests a renewal. This avoids additional court hearings, which saves money
  • Allow individuals who materially violate their order to be taken to a hospital for admission assessment without holding a new hearing that could delay treatment. (This does not mean the individual would automatically be admitted for in-patient care, rather it eliminates requiring a court order for the evaluation.)
  • Eliminate the need of having a psychiatrist testify in court if the consumer and attorney, want to stipulate to the psychiatrists findings.  This saves money.
The Senate bill has no such fixes.

The choice is obvious to me.  Not only would the Assembly bill (A10421) make Kendra’s Law permanent, it would improve the law to reach more people, improve compliance, and reduce costs. 

Please contact your state representatives and urge them to support A10421. Make Kendra’s Law permanent.

For more information, please visit the New York Treatment Advocacy Coalition website.

1 comment:

  1. Hi, I came across your site and wasn’t able to get an email address to contact you about a broken link on your site. Please email me back and I would be happy to point them out to you.


    Aaron Grey