Explanation of Kendra's Law

Kendra's Law Overview
Guide to Kendra's Law
Uncivil Liberties: Most Important article on site
Text of Kendra's Law
300 Preventable Tragedies in NYS

Kendra's Law (New York Mental Hygiene Law § 9.60) allows courts to order certain individuals with serious mental illness and a history of Violence or multiple rehospitalizations (that is associated with not staying in treatment) to stay in treatment while living in the community. Perhaps more importantly, it allows courts to order the mental health system to provide the treatment. This court-ordered treatment is called assisted outpatient treatment (AOT).

Kendra's Law focuses on a very small population

There is a small group of mentally ill individuals who are the most seriously ill. There is a small subset of the most seriously ill who are often homeless and psychotic. Many are so ill, they don't know they are ill (anosognosia). And there is a small subset of that group who go off treatment that can prevent needless hospitalizations and/or dangerous behavior. This is the group courts can order to accept treatment. To be eligible a hearing is held where the patient has a lawyer. The court must find the individual is mentally ill and:

1. unlikely to survive safely in the community without supervision; and
2. has a history of non-compliance with treatment that has: i. been a significant factor in his or her being in a hospital, prison or jail at least twice within the last thirty-six months or; ii. resulted in one or more acts, attempts or threats of serious violent behavior toward self or others within the last forty-eight months; and
3.  be unlikely to voluntarily participate in treatment; and
4. be, in view of his or her treatment history and current behavior, in need of assisted outpatient treatment in order to prevent a relapse or deterioration which would be likely to result in:
i. a substantial risk of physical harm to the consumer as manifested by threats of or attempts at suicide or serious bodily harm or conduct demonstrating that the consumer is dangerous to himself or herself, or ii. a substantial risk of physical harm to other persons as manifested by homicidal or other violent behavior by which others are placed in reasonable fear of serious physical harm.

Legislative history

AOT was proposed in 1989, by families of people with serious mental illness who wanted better treatment for their relatives. In 1994, NYS started a pilot program at Bellevue Hospital in NYC. In August 1999, when Kendra Webdale was pushed to her death in front of a subway by someone with untreated mental illness, the public recognized that AOT not only improved care for people with mental illness, it could also increase public safety. As a result, NYS enacted "Kendra's Law. The law was renewed in 2005 and 2010. It sunsets in 2015 unless renewed or made permanent. Cracks in Kendra's Law have been identified that need closing.

Results

A 2010 Columbia University study found that individuals under Kendra's Law orders, despite greater histories of violence, were four times less likely to engage in future violence than those in a control group. Other studies show Kendra's Law reduces homelessness (74%); suicide attempts (55%); and substance abuse (48%). It keeps the public safer by reducing physical harm to others (47%) and property destruction (43%). It saves money by reducing hospitalization (77%); arrests (83%); and incarceration (87%). Other studies show Kendra's Law causes no increase in perceived stigma or coercion, and that the court orders themselves (not just the availability of high-quality services) are instrumental in the program's success.

Why should we have Assisted Outpatient Treatment (AOT) laws?

For those who suffer from an untreated severe mental illness, time is brain. With each psychotic episode they lose the brain cells they will need to recover with. To make things more complicated, a symptom of the illness (a brain malfunction in the frontal lobe) prevents those who suffer with this from being able to realize that they need help. It's called anosognia. (Insight and Psychosis by Xavier Amador & Anthony David.)

Brain & Behavior Quarterly Spring 2012 page 30, gives a simple yet important breakdown to mental health.
Step 1 Discovery: Understanding malfunctions in the brain.
Step 2 Treatment: Reducing symptoms and retraining the brain.
Step 3 Recovery: Supporting rehabilitation to enable full, productive lives

When a person suffers from anosognia they do not want Step 2 because they do not think that they are ill. Untreated, they will continue to loose brain cells. Step 3 can not happen without Step 2 for these few who have such severe symptoms. It's just common sense.

Some who have a severe mental illness but do not suffer from anosognia can get help on their own. Only a few cannot because their symptoms are so severe. Their brain disorder is so severe.

That's why we need Kendra's Law. To help those who cannot help themselves. To save lives.

Improvements Needed

Supporters

Opponents

Myths

2012 Kendra's Law News

Gun Control & Mental Illness Law NYS
Quick Summary of 9 Kendra's Law Studies
KENDRAS LAW IMPROVEMENT ACT INTRODUCED 90 Preventable Mental Illness Tragedies in NYS
Olmstead requires NYS to use Kendra's Law
Text of Bill to Improve Kendra's Law
Political Gridlock on Kendra's Law Improvement Act
Savings and Cost of Kendra's Law
Opposition Analysis: NYAPRS

Kendra's Law in Media

Recent Media
Kendra's Law editorials
Kendra Webdale's Parents (oped) (PDF)
NY Daily News Editorial
Kendra's subway pusher on Kendra's Law
NYS Chiefs of police on Kendra's Law
Times Union: Mental Health Industry Opposes Kendra's Law
Gannett: Mentally Ill Brother Killed Both Parents
Buffalo News: Kendra's Law Now
Mental Illness Policy Org on Kendra's Law
Albany Times Union (Kendra's Law Letter)
NY Post Op-ed by Kendra's Law Sponsors
NY Daily News op-ed by DJ Jaffe
Schenctady Gazette Letter supports Kendra's Law
Ithaca Journal op-ed supports Kendra's Law

Editorials
New York Times supports Kendra's Law
Daily News and Kendra's Law
NY Post supports Kendra's Law
Newsday supports Kendra's Law
Albany Times Union supports AOT
Buffalo News supports Kendra's Law
Gannett supports Kendra's Law

Op-eds
Sheldon Silver on Kendra's Law
NY Post Op-ed Supports Kendra's Law
Gannett Op-ed Supports Kendra's Law
Manhattan Institute Supports Kendra's Law
NY Daily News Op-ed Supports Kendra's LawHelp Mentally Ill Inmate
Rational Commitment Laws (NY Times)
Gannett Papers (Lower Hudson)
NY Post-Remembering Kendra Webdale
Pat Webdale on daughter Kendra
Help Mentally Ill New Yorkers
Right to Mental Illness
Michael Biasotti: Police Chief
Make Kendra's Law Permanent
Albany Times Union Mary Barber
Assisted Outpatient Treatment Works

Magazines

Rational Commitment Laws (DJ Jaffe/Rael Isaac)
Involuntary Treatment Saves Lives (Jaffe)

Online

6 new studies on Kendra's Law (2011)
Legislature makes Kendra's Law mistake (2010)
Huffington Post blogs by DJ Jaffe

NEWS

NYS Office of Mental Health: Problems and Solutions

Problems at NYS OMH
Poor Leadership
Mission Creep (NY Post)
Mission Creep (National Review)
Lack of focus on serious mental illness
Created psychiatric hospital bed shortage
Lack of Leadership (12/9)

Solutions
Merge OMH and DOH (Albany Times Union)
Eliminate OMH (1/11)
Eliminate OMH and merge with DOH 5/10
Replace Commissioner Michael Hogan 12/10
Mental Health Courts

Opposition to Kendra's Law

Mental Health Directors Wrong to Oppose Kendra's Law
Opposition Analysis: NYAPRS
Opposition Analysis: We the People
Myths about AOT
Myths about Consumers
Myths about Effect of Medications
Scientology/CCHR
Misinformed Advocates
The Belief Everyone Recovers
Scientology/Citizens' Commission on Human Rights (CCHR)
We the People (Fringe Consumers)
(Some) Civil Libertarians
NYAPRS (trade association)
NYS Community Mental Health Directors
Myths about Kendra's Law