KENDRA”S LAW DISCUSSION PAPER
Issue: Research shows there are three giant cracks in the NYS system involving the most seriously mentally ill and these cracks are putting patients, public, police and families at risk:
Why Do The Cracks Exist? No one wants responsibility for closing them
Since no one wants responsibility, individuals with serious mental illness are being sent to the streets, jails, prisons and morgues instead of treatment.
Solutions: Kendra’s Law reduces violence, arrest, incarceration, hospitalization, homelessness and suicide when used, but is not used for the most seriously ill because neither hospitals, prisons, jails, mental health directors of NYS OMH wants to accept responsibility. Here are ways to see it is used:
1. Put burden on hospitals and corrections: Require hospitals to evaluate involuntarily committed patients before discharges and corrections to evaluate mentally ill prisoners prior to discharge and file petitions themselves. Or…
2. Put burden on Mental Hygiene Directors: Have hospitals report involuntarily committed patients who are being released; and correction officials report mentally ill prisoners being released; and families report dangerous loved-ones to Mental Hygiene Directors and have Mental Hygiene Directors file the petition, if needed, themselves. Or,
3. Put burden on NYS OMH, Have reports of hospitals, corrections, and families go to OMH who can file petitions.
All these proposals have been rejected by the organizations that don’t want responsibility.
Providing services to the most seriously ill should be, the core function of mental hygiene directors and the office of mental health. Their raison d’etre. Unfortunately, this core function of providing services to the most seriously ill is often ignored in favor of providing services to others. This approach sends the most seriously ill to jails and prisons and puts public and police at risk. To counteract this, improvement of care for the most seriously ill almost always and exclusively has to be obtained by legislation or law suits. Kendra’s Law is one such piece of legislation. It not only allows courts to commit the seriously ill to accept treatment, it commits the mental health system to meeting their core responsibility of providing it. The Local Mental Hygiene Directors receive over $1 billion in aide to localities (ck) and have no obligation to spend it on most seriously ill. (“Funded Unmandate”). So the legislature could justify not providing additional funds. This would help reorient the system towards the most seriously ill but cause dissent among those who benefit from the status quo.
B. The legislature could provide additional funding which could sweeten the pot which would lessen objections to accepting responsibility.
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