Let’s make Kendra’s Law permanent

New York subway train arriving
Image by Annie Mole via Flickr

I knew nothing of the Kendra’s Law until reading this article.  After reading it, though, I did have one of those “ah-ha!” moments and found myself wondering why this idea has taken so long to show up.  I love the idea of keeping people in their own communities whenever possible.  According to this article, with court mandated treatment added to the mix, it seems it is possible.

Unfortunately, the mental health patient is the type of patient who usually will not be compliant with treatment and will quit at any opportunity–quit therapy, quit medications, quit follow-up appointments.  It’s possible that all of this involves way too much and is overwhelming or disturbing, or maybe the patient believes he is cured and no longer needs help.  Whatever the reason, I like the idea of some type of court order to remain on medication and therapy as a condition to remaining at home in the community.

I know that there are those who will feel that this is controlling and harsh.  For those who feel that way, I can say I understand your concerns.  However, my experience with the mentally ill shows me that being mentally ill is not comfortable and does not feel safe to the person.  If getting medication routinely can remove the fear and the emotional pain, I believe it is the right thing to do.  Granted, this article is talking about dangerously ill and aggressive people who are untreated, so in the interest of social norms and safety I also have to agree with this idea to medicate as a condition of remaining out in the population.


First published: Wednesday, February 3, 2010

Eleven years ago, state government leaders were shocked into action by the death of Kendra Webdale. She was suddenly and intentionally pushed to her death in front of an oncoming New York City subway train by a man with schizophrenia whom the state Office of Mental Health had let go untreated.Shortly thereafter, Edgar Rivera was also pushed in front of a train by another mentally ill man whom the Office of Mental Health had let go untreated. Mr. Rivera survived, but lost his legs.

To help avoid a repeat, the state legislative leadership put politics aside and passed Kendra’s Law in August 1999. But the law sunsets this year. If the Legislature doesn’t make it permanent, 1,800 patients with mental illness — many of them with a history of violence — could become free to go off their medications.

Kendra’s Law allows the courts to commit a small group of potentially violent mentally ill individuals to accept treatment as a condition for living in the community. Equally important, it commits the Office of Mental Health to providing that treatment.

Kendra’s Law has proved to keep the public safer and patients healthier. It saves money by cutting down on hospitalization rates, length of hospitalizations, inpatient commitment rates and incarceration.

But if some state-funded providers of mental health services have their way, the law will die in June. That would be dangerous.

A 2005 Office of Mental Health study compared how seriously mentally ill people did for six months before they participated in the Kendra’s Law program and for six months while they participated. It found that while participating, 47 percent fewer harmed others, 46 percent fewer damaged or destroyed property, 83 percent fewer were arrested and 87 percent fewer were incarcerated.

A 2009 Duke University School of Medicine study showed the law has had a positive effect on the mental health system and the patients in it. The law allows patients to stay in the community — a less restrictive, less expensive, more humane setting than the alternative: inpatient commitment.

So why would anyone oppose making permanent a law that helps patients, keeps the public safer and saves money?

Making Kendra’s Law permanent does have support from groups as diverse as the National Alliance on Mental Illness and the New York State Association of Chiefs of Police. But, according to testimony in 2005 by the National Alliance on Mental Illness- New York State, “There is a movement to stop the law led by … a consortium of mental health rehab organizations…. These organizations do skills acquisition, not symptom management. To benefit from their programs, one must be stable and have insight into one’s illness.”

And therein lies the rub. These programs fear losing their ability to pick and choose easier to treat, more compliant, less ill people to participate in their programs.

Office of Mental Health Commissioner Michael Hogan is on record as favoring Kendra’s Law.

Yet, for some inexplicable reason, he has cut down on the number of people entering the program and increased the rate at which they leave. That helps neither the mentally ill nor the communities in which they live.

In 2005, the Legislature chose to renew the law, rather than make it permanent, to appease the anti-treatment advocates and to address their concerns with new studies. But the results are now in: The law works.

More studies cost money and divert resources. Not knowing whether the law will expire prevents programs that do help the seriously mentally ill from investing in the infrastructure to make it work.

Renewing the law, rather than making it permanent, will only give providers more time to develop more faux concerns and waste more government money proving what everyone knows: Treatment works.

This law should not be held hostage to those who want to kill it. Kendra Webdale died. Kendra’s Law shouldn’t. The Legislature should make it permanent now.

D.J. Jaffe is an advocate for the seriously mentally ill and a co-founder of the Treatment Advocacy Center (http://www/kendraslaw.org). His e-mail address is djjaffe@treatmentadvocacycenter.org.

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