Changes to Kendra’s Law would aid more who need it

Ithaca Journal May 18, 2012
By DJ Jaffe

There’s a serious attempt in Albany to pass “The Kendra’s Law Improvement Act” to help people with serious mental illness stay in treatment so they don’t put themselves or the public at risk. Ithaca Assemblywoman Barbara Lifton is on the key Assembly Mental Health committee that is preventing passage and, unfortunately, she has not signed on as a co-sponsor. It is unclear whether she intends to be part of the solution.

Most people with serious mental illness do not become violent. But there is a subgroup who are so seriously ill that they can not recognize they are ill. As a result of their untreated illness, they don’t “think” they are the Messiah — they “know” it. More voluntary services are not the answer, because they refuse voluntary services.

To keep these individuals and the public safer, in 1999, legislators passed Kendra’s Law. It allows courts — after extensive due process — to order a narrowly defined group of seriously ill individuals to accept treatment as a condition of living in the community. It’s been a huge success. A recent study found people with serious mental illness in Kendra’s Law — although more violent to begin with — were four times less likely than a control group to commit serious violence. It also reduced hospitalization and homelessness in addition to arrest and incarceration. Eighty percent of the individuals in the program say it helps them get well and stay well.

So what’s the problem? Kendra’s Law has major cracks in it that need closing. These cracks prevent those who could benefit from it from gaining access. Every day, seriously mentally ill prisoners are being discharged into communities without seeing if they need treatment to stay safe. Involuntarily committed psychiatric patients who already have been dangerous are also being discharged to communities without evaluating them to understand the consequences. Seriously mentally ill individuals put under court ordered treatment as a result of past violence are having their orders expire without anyone reviewing to see if it is appropriate. When individuals under court-ordered treatment move to a new county, they lose the court ordered treatment. That puts them and the public at risk.

To address these dangerous conditions, Assemblywoman Aileen Gunther and state Sen. Catherine Young, proposed the “Kendra’s Law Improvement Act.” The theory behind it is that if county mental health commissioners like newly appointed Tompkins County Commissioner Dr. Sue Romanczuk-Smelcer knew about those who may need help, they could do a better job at helping. So the bill requires prisons that are releasing mentally ill prisoners and hospitals that are releasing involuntarily committed psychiatric patients to notify the county mental health commissioner so they can determine what, if anything, to do. It would also require county mental health commissioners to review orders that are about to expire and to accept reports from family members of mentally ill relatives who may be becoming dangerous.

As incredible as it seems, the county mental health commissioners, those who provide services to people with mental illness, and even the state Office of Mental Health oppose the bill. They don’t want to know about people with serious mental illness in the community who may be becoming dangerous. Why? Because if officials know about them, they might have to treat them. Right now, the mental health system focuses most of its efforts on the worried well and moves the seriously ill to shelters, jails, prisons and morgues. Kendra’s Law not only allows courts to require patients to accept treatment, it allows courts to require authorities to provide it. It eliminates their ability to cherry-pick the easiest to treat for admission to their programs. They claim they have no money to treat the seriously ill, yet treating the most seriously ill should be their core function.

County mental health commissioners, the state Office of Mental Health and local mental hygiene directors have great sway over the Assembly’s mental health committee. They have used their influence to stop this legislation. The improvements suggested by this bill are vigorously supported by the National Alliance on Mental Illness of New York State, which wants better treatment for their mentally ill loved ones, and by the New York State Association of Chiefs of Police, who want to send people with mental illness back to the mental health system rather than jails.

We hope Lifton will listen to those trying to solve the problem, rather than those who can’t even see it.

DJ Jaffe is Executive Director of the non-partisan Mental Illness Policy Org., and author of Insane Consequences: How the Mental Health Industry Fails the Mentally Ill. He is a critic of the mental health industry for ignoring the seriously ill, and has been advocating for better treatment for individuals with serious mental illness for over 30 years. He has written op-eds on the intersection of mental health and criminal justice policy for the New York Times, Wall St. Journal and the Washington Post. New York Magazine has credited him with being the driving force behind the passage of New York’s Kendra’s Law and Congress incorporated ideas proposed by DJ in the Helping Families in Mental Health Crisis Act.