Research from the ten independent studies conducted over ten years on NYS Assisted Outpatient Treatment (Kendra’s Law)
“Kendra’s Law” is New York State’s version of “Assisted Outpatient Treatment” (AOT). AOT allows courts to order certain historically and potentially violent people with mental illness to stay in treatment as a condition for living in the community. It not only ‘commits’ the individual to accept care, it ‘commits’ the mental health system to providing it. Following is a summary of research on the effectiveness of Assisted Outpatient Treatment.
|May 2011 Arrest Outcomes Associated With Outpatient Commitment in New York State Bruce G. Link, et al. Ph.D. Psychiatric Services||For those who received AOT, the odds of any arrest were 2.66 times greater (p<.01) and the odds of arrest for a violent offense 8.61 times greater (p<.05) before AOT than they were in the period during and shortly after AOT. The group never receiving AOT had nearly double the odds (1.91, p<.05) of arrest compared with the AOT group in the period during and shortly after assignment.”|
|March 2005 N.Y. State Office of Mental Health “Kendra’s Law: Final Report on the Status of Assisted Outpatient Treatment. “||Danger and Violence Reduced |
Consumer Outcomes Improved
Consumer participation and medication compliance improved
Consumer Perceptions Were Positive
Effect on mental illness system
· Improved Access to Services. AOT has been instrumental in increasing accountability at all system levels regarding delivery of services to high need individuals. Community awareness of AOT has resulted in increased outreach to individuals who had previously presented engagement challenges to mental health service providers.
· Improved Treatment Plan Development, Discharge Planning, and Coordination of Service Planning. Processes and structures developed for AOT have resulted in improvements to treatment plans that more appropriately match the needs of individuals who have had difficulties using mental health services in the past.
· Improved Collaboration between Mental Health and Court Systems. As AOT processes have matured, professionals from the two systems have improved their working relationships, resulting in greater efficiencies, and ultimately, the conservation of judicial, clinical, and administrative resources.
|July 2013: The Cost of Assisted Outpatient Treatment. Can it Save States Money? American Journal of Psychiatry|| |
In the New York City net costs declined 50% in the first year after assisted outpatient treatment began and an additional 13% in the second year. In non NYC counties, costs declined 62% in the first year and an additional 27% in the second year. This was in spite of the fact that Psychotropic drug costs increased during the first year after initiation of assisted outpatient treatment, by 40% and 44% in the city and five-county samples, respectively. The increased community based mental health costs were more than offset by the reduction in inpatient and incarceration costs. Cost declines associated with assisted outpatient treatment were about twice as large as those seen for voluntary services.
|October 2010: Assessing Outcomes for Consumers in New York’s Assisted Outpatient Treatment Program Marvin S. Swartz, M.D., Psychiatric Services||Consumers who received court orders for AOT appeared to experience a number of improved outcomes: reduced hospitalization and length of stay, increased receipt of psychotropic medication and intensive case management services, and greater engagement in outpatient services.|
|February 2010 Columbia University. Phelan, Sinkewicz, Castille and Link. Effectiveness and Outcomes of Assisted Outpatient Treatment in New York State Psychiatric Services, Vol 61. No 2|| |
|October 2010: Changes in Guideline-Recommended Medication Possession After Implementing Kendra’s Law in New York, Alisa B. Busch, M.D Psychiatric Services||In all three regions, for all three groups, the predicted probability of an M(edication) P(ossesion) R(atio) ≥80% improved over time (AOT improved by 31–40 percentage points, followed by enhanced services, which improved by 15–22 points, and “neither treatment,” improving 8–19 points). Some regional differences in MPR trajectories were observed.|
|October 2010 Robbing Peter to Pay Paul: Did New York State’s Outpatient Commitment Program Crowd Out Voluntary Service Recipients? Jeffrey Swanson, et al. Psychiatric Services||In tandem with New York’s AOT program, enhanced services increased among involuntary recipients, whereas no corresponding increase was initially seen for voluntary recipients. In the long run, however, overall service capacity was increased, and the focus on enhanced services for AOT participants appears to have led to greater access to enhanced services for both voluntary and involuntary recipients.|
|June 2009 D Swartz, MS, Swanson, JW, Steadman, HJ, Robbins, PC and Monahan J. New York State Assisted Outpatient Treatment Program Evaluation. Duke University School of Medicine, Durham, NC, June, 2009||We find that New York State’s AOT Program improves a range of important outcomes for its recipients, apparently without feared negative consequences to recipients. |
|1999 NYC Dept. of Mental Health, Mental Retardation and Alcoholism Services. H. Telson, R. Glickstein, M. Trujillo, Report of the Bellevue Hospital Center Outpatient Commitment Pilot|| |
|1998 Policy Research Associates, Inc. Research study of the New York City involuntary outpatient commitment pilot program.|| |