Expanding Kendra’s Law to Help Those Affected by Mental Illness - Psychology Today

• In 1999, New York passed Kendra's Law, allowing courts to order certain individuals with mental illness to receive Assisted Outpatient Therapy.
• However, the courts face many challenges in identifying and tracking those who are most in need of help.
• The death of Michelle Go in New York has opened up a discussion about how to improve Kendra's Law and prevent future tragedies.

The January 15th killing of Michelle Go in New York City has revived debate about expanding Kendra’s Law, which grants New York State courts the power to order people who meet certain criteria to participate in assisted outpatient treatment or AOT. As a mental health attorney, I have long been in favor of expanding the law. While it was an important step when implemented, more can be done through legal statutes to help individuals suffering from mental illness and their families.

New York State lawmakers passed Kendra’s Law in response to a tragedy that mirrored the death of Ms. Go. In 1999, a man with schizophrenia who was not taking his medication pushed Kendra Webdale in front of a subway train, which killed her. As of today, versions of the statute are in effect in 46 states.

Kendra’s Law fundamentally enhanced New York State’s mental health care system yet remains highly imperfect—both as a tool to help individuals and families affected by mental illness and as a public health measure. Its strict criteria often make it difficult for people to access and continue receiving services they desperately need.

Kendra’s Law in Action

To illustrate, the court’s power and the AOT criteria extend to individuals who are non-compliant with their prescribed treatment plan and, due to their lack of compliance, have been involuntarily hospitalized on two occasions within a 36-month period, or commit or threaten to commit an act of serious violence within a 48-month period. This is already limiting. And beyond that, the law’s language defining non-compliance is vague enough to make it challenging for courts and mental health providers to make the best decisions regarding applicability.

In addition, the duration of the court-mandated treatment period is also limited by the law to one-year periods subject to court applications for renewals. Also, if the community treatment providers are unable to locate an individual, or there is no known address when the application is made, the court-ordered community treatment may lapse or may not be brought about in the first place. This practical and legal difficulty means that some of the most vulnerable individuals who are acutely ill and “lost” on the streets will or will not have their court-mandated treatment.

What’s more, those who do well in their treatment under Kendra’s Law can reach a point in which they “graduate” from the program. This frequently serves as an unintentional consequence for individuals and families, as without the power of the court, individuals often once again stop taking their medication, decompensate, and become a risk to themselves and/or others. In this way, the law promotes exactly the kind of psychiatric “revolving door” it was looking to prevent.

Looking to the Future

A successful expansion of Kendra’s Law must fix these gaps. It must also address the lack of funding for mental health care that has severely limited the legislation’s effectiveness from the beginning. I’ve been pleased to see New York State Governor Kathy Hochul and other lawmakers acknowledge the need to increase funding for wrap-around services like case management and, crucially, supportive housing. Their ability to deliver these funds will be vital to the success of any attempts at reform and a roadmap to success.

Recognizing our society’s need to help those with mental illness and their families requires the understanding that there is no cure for these conditions. Individuals diagnosed with serious mental illnesses like schizophrenia require ongoing services and support over their lifetimes. While the expense and complexity of such long-term care might seem daunting, half measures will only result in the continuing and ineffective revolving door.

source: https://www.psychologytoday.com/us/blog/the-desk-the-mental-health-lawyer/202203/expanding-kendra-s-law-help-those-affected-mental

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