New: Instructions & Forms to access Kendra’s Law; ThriveNYC White Paper; 3/26/2020 New ThriveNYC Plan Fails; 1/2018: New data on Kendra’s Law shows outstanding results. We respond in Daily News and in City Journal to Cuomo’s statement on mental illness. …Oped in Daily News on police training….Excellent Manhattan Institute Forum on Serious Mental Illness (video). DJ Jaffe on NY-1 on Kendra’s Law….
Kendra’s Law Overview
Kendra’s Law (New York Mental Hygiene Law § 9.60) allows courts to order certain individuals with serious mental illness to stay in treatment for up to a year while continuing to live in the community. Simultaneously, the court orders the mental health system to provide the treatment, thereby overcoming its reluctance to serve the most seriously ill (cherry-picking). The generic name for Kendra’s Law is “Assisted Outpatient Treatment” (AOT). It is less restrictive, expensive and more humane than the alternatives: inpatient commitment or incarceration.
Kendra’s Law is only for a very small population
It is only for those seriously mentally ill who already accumulated multiple episodes of homelessness, arrest, incarceration or hospitalization due to their failure or inability to stay in treatment that was offered to them voluntarily.
Process
Multiple individuals and organizations are authorized to start the process by filing a petition with the court. A hearing is held where the patient has a lawyer. The court can order an examination of the individual.
Requirements
In order to enroll him or her in Kendra’s Law 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.
What services are included for how long?
Individualized treatment plans are prepared. Everyone in Kendra’s Law is mandated to have a case manager to monitor their compliance with treatment. Non-compliance can trigger an investigation to determine if the individual needs inpatient evaluation or commitment. Medications are included in most treatment plans. Other services can include substance abuse counseling, individual or group therapy, day treatment, educational or vocational training and other services appropriate to the individual. The court order is for no longer than 12 months and can be renewed if needed.
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 helped people with mental illness, it could increase public safety. NYS fixed some of the problems with the Bellevue Pilot Program and enacted “Kendra’s Law.” It sunsets in 2017 unless renewed or made permanent. Cracks in Kendra’s Law have been identified that need closing.
Results
The Kendra’s Law results have been outstanding. This is good news because Kendra’s Law serves only the most hard-to-treat individuals. Studies show 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. Kendra’s Law reduced 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 reduces hospitalization (77%); arrests (83%); and incarceration (87%). 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. By reducing incarceration and hospitalization, Kendra’s Law saved taxpayers 50% of the cost of care.
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. Some seriously ill have anosognosia, (possibly a brain malfunction in the frontal lobe) that prevents them from recognizing that they are ill. Instead of ‘knowing’ they are ill, they may ‘know’ they are the Messiah, or “know” the FBI planted a transmitter in their head. They are unlikely to volunteer for treatment on their own. Treatment can restore their insight and restore their ability to voluntarily engage. Kendra’s Law is not an alternative to community services, it is a way to see those services get utilized by those too sick to voluntarily access them.
Kendra’s Law Info and Studies
Kendra’s Law Instructions & Forms
New May 2017: Making Kendra’s Law Permanent
Our NYS & Kendra’s Law Facebook Page
Kendra’s Law Studies
Summary Chart: 10 Kendra’s Law Studies (PDF)
2018 Kendra’s Law results are in!
Kendra’s Law Studies by Outcome
2017- Manhattan Institute Report on Success
Kendra’s Law cuts costs in half
Calculation: Savings and Cost if Kendra’s Law implemented
Research: Kendra’s Law Reduces arrests and violence
Research: Kendra’s Law Reduces Crime
Research: Kendra’s Law Reduces arrests
Research: Kendra’s Law Reduces hospital admissions
Research: Kendra’s Law Increases Medication compliance
Research: Kendra’s Law Nondiscriminatory
Research: Kendra’s Law Improves Mental Health System
Research: Kendra’s Law increased mental health system’s capacity
Research: Kendra’s Law: Favorable Impact on Consumers
Research: Kendra’s Law has long-term positive impact
Supporters
Selected National AOT supporters
Treatment Advocacy Center (TAC)
SAMHSA
National Alliance on Mental Illness (NAMI)
American Psychiatric Association (APA)
American Psychiatric Nurses Association
National Sheriffs Association (NSA)
National Crime Prevention Council (NCPC)
International Assoc. of Chiefs of Police
Selected Statewide Supporters
National Alliance on Mental Illness (NAMI-NYS)
Hospital Association of State of NY (HANYS)
Public Employees Federation (PEF)
Manhattan Institute
NYS Sheriff’s Association
NYS Association of Chiefs of Police (NYSACOP)
District Attorney’s Association of State of NY (DAASNY)
Selected Regional/Local Supporters
Harlem Alliance for the Mentally Ill
NAMI/Familya of Rockland County
NAMI Orange County
NAMI Madison County
NAMI of Buffalo and Erie County
NAMI of Montgomery, Fulton, Hamilton Counties
NAMI Chataqua County
Albany County Forensic Task Force
NAMI Schenectady
NAMI/Albany Relatives
NAMI-Friends of NYS Psychiatric Institute
NAMI Champlain Valley
NAMI of NYC/Staten Island
NAMI Huntington
NAMI Syracuse
NAMI North Country
Citizen’s Crime Commission of NYC
Westchester County Police Association
Orange County Police Chiefs Association
Mid-Hudson Chiefs of Police Association
New Windsor Police Department
Town of Chester, NY Police Department
Town of Mechanicville, Police Department
Town of Cornwall Police Department
Village of Trumansburg Police
Town of Lloyd Police Department
Town of Lowville Police Department
Port Washington Police District
Elmira Heights Police Department
City of Olean Police Department
Highland Falls Police Department
City of Cohoes Police Department
Ardsley Police Department
Plattsburg Police Department
Niagara Police Department
Colonie Police Department
Skanateles Police Department
Webster Police Department
Cambridge-Greenwich Police Department
West Seneca, NY Police Department
Franklin County Probation Department
Broome County District Attorney
Sharon Carpinello, Past Commissioner, NYS OMH
Pat Webdale, mother of Kendra Webdale
Andrew Goldstein: Pushed Kendra
Edgar Rivera, lost legs in subway pushing
Analysis and Source Documents
Kendra’s Law Analysis
Kendra’s Law Loopholes that need closing
Constitutional challenges to Kendra’s Law
NAMI/NYS Kendra’s Law White Paper
NAMI/NYS Kendra’s Law White Paper (PDF)
Olmstead requires NYS to use Kendra’s Law
Kendra’s Law: National Law Journal
Source documents
Forms to Access AOT
Contacts to Get in Kendra’s Law (AOT)
2017 Renewal and Improvement Bill
Kendra’s Law Editorials and opeds
Editorials
Collected Kendra’s Law editorials (2010-2013)
Daily News Supports (2010)
Opeds
Kendra’s subway pusher on Kendra’s Law (2012)
Mental Illness Policy Org on Kendra’s Law (2012)
Albany Times Union (2012 Letter)
Op-ed by Kendra’s Law Sponsors (2012)
NY Daily News op-ed by DJ Jaffe (2012)
Schenectady Gazette Letter supports Kendra’s Law (2012)
Ithaca Journal op-ed supports Kendra’s Law (2012)
Bellucci Supports Kendra’s Law (2011 Journal News)
Manhattan Institute oped (2011)
NY Daily News Op-ed Supports Kendra’s Law (Jaffe, 2011)
Pat Webdale on daughter Kendra (2010, Buffalo News)
Michael Biasotti: Police Chief (2010)
Legislature makes Kendra’s Law mistake (2010)
Involuntary Treatment Saves Lives (Forbes/Jaffe 2010)
Gannett Oped (Jaffe, 2010)
Make Kendra’s Law Permanent (Buffalo News Jaffe 2010)
2010 studies on Kendra’s Law (Huffington Post)
Help Mentally Ill New Yorkers (Daily News, Jaffe, 2008)
Assisted Outpatient Treatment Works (Torrey&Post, 2008)
NY Post-Remembering Kendra Webdale (2005, Torrey)
Albany Times Union Mary Barber (2005)
Kendra’s Law Supports Inmates (Torrey/Zdanowicz, Buffalo News 2002)
Right to Mental Illness (Torrey/Zdanowicz/Post, 1999)
Sheldon Silver on Kendra’s Law (1999)
Myths about Kendra’s Law
Available in all formats at Amazon and Barnes and Noble
NY City Mental Illness Policy
Policy Papers, Interviews and Articles
Nicole Malliotakis Mental Illness Platform
Manhattan Inst. forum with Belkin/Jaffe/D’Emic(2017)
Why Thrive NYC is Failing (PDF)
Only $165mil of $850mil NYC MH budget goes to SMI
NYC Mental Health Data (PDF)
MIPO Suggestions to Reduce Incarcerations
InFocus with Cheryl Wills on Kendra’s Law & ThriveNYC (video)
Mental Health Dept to blame for police shootings (Post 4/2018)
Daily News op-ed : Thrive Failure (3/2019)
NY Post: Ask Chirlane about Failure (3/2019)
Brian Lehrer (radio) on NYC Violence by Mentally Ill (Radio-2016)
Daily News oped on Failure of NYC Mental Health Plan (2016)
NY Post Editorial on Failure of NYC Mental Health Plan (2016)
NY Post oped on problems with ThriveNYC Plan (2015)
Bill to evaluate mentally ill discharged from jail (TV 2014)
Deblasio Panel on Mentally Ill at Rikers fails
NYC Dept. of Mental Health Fails to serve seriously ill
NYC Source Documents
NYPD Inspector General on Serious Mental Illness (2017)
Preliminary Mayor’s Management Report (2017)
NYC First Lady defends NYC Mental Health System (radio-2016)
Psychiatric Hospitalizations in NYC (2016)
ThriveNYC 150 Day Progress Report (2016)
ThriveNYC Mental Health Roadmap (2015)
NYC Mental Illness White Paper (2015)
NYC SAFE – Plan to help Seriously Ill (2015 press release)
NYC-SAFE to reduce violence (2015 story)
NYC Statistics on seriously mentally ill (2015)
NYS Mental Illness Policy Issues
Analysis
NYS Mental Illness Prevalence Data
“Capital Pressroom” on NYS Mental Health Budget (start at 36:40)
300 Preventable Tragedies in NYS
4000 Psychiatric Hospital Bed Shortage
Gov. Cuomo Wrong to Close Psychiatric Hospitals
Police Chiefs warn against closing hospitals
NYS Should spend on seriously ill, not ‘worried-well’ (2013 Mipo oped)
Gun Control & Mental Illness Law NYS SAFE Act
NYS Chiefs of police on Guns & Kendra’s Law (2012)
Poor OMH Leadership (2012 Times Union)
Mission Creep (2010 NY Post)
NYS Mission Creep (2011 National Review)
Focus on serious mental illness (Huff Po)
Solutions
Facts: Gun Control & Mental Illness NYS SAFE Act
Merge OMH and DOH (Albany Times Union)
Eliminate OMH (1/11)
Eliminate OMH (5/10)
Mental Health Courts
Why Treating Seriously Mentally Ill Is Important
Uncivil Liberties: Most Important article on site
Consequences of untreated mental illness
1000 Homicides by mentally ill
175,000 Homeless mentally ill
Increased Violence by mentally ill
NEW: SHORT VIDEO OF PEOPLE WITH UNTREATED SCHIZOPHRENIA