Still mentally ill, and still dangerous: Court-ordered treatment for the disturbed needs to be fixed

By D.J. Jaffe

Thursday, May 19th 2011, NY Daily News

Kendra’s law lets courts order certain people with serious mental illness to stay on medications and continue other treatments that prevent them from becoming psychotic.
It’s virtually impossible to get the public to focus on the chronic problem of serious mental illness absent an act of violence by someone who suffers from it. That’s unfortunate, because everyone in the city is aware of people – like the apparently mentally ill man who recently ran through the subway nude – who didn’t get the treatment they needed, who should have received medicine, but got handcuffed instead.

A bill pending in Albany to improve Kendra’s Law could help people with serious mental illness – and, in the process, prevent the next “psychotic killer goes on rampage” headline. But there’s been precious little movement on the bill in Albany.

Those content with the current law are playing with fire.

Kendra’s Law, which is what’s on the books right now, took effect in 1999 after a young man with schizophrenia and a history of violence who was not taking his medications pushed Kendra Webdale to her death in front of an oncoming subway train. The law lets courts order certain people with serious mental illness (those with a past history of violence) to stay on medications and continue other treatments that prevent them from becoming psychotic, delusional or even violent again. Equally important, courts can order the community-based mental health programs to start accepting these individuals into their programs. They can no longer shun the most seriously ill.

The results have been outstanding. Multiple studies show people who are treated under Kendra’s Law – who were more violent to begin with – experience dramatic drops in homelessness, incarceration, suicide, violence and hospitalization. A study by Bruce Link and others published in the journal Psychiatric Services in May 2011 found that the odds of arrest for a violent offense for mentally ill individuals were reduced more than eightfold after they were put under court orders to accept treatment. That saved massive amounts of money for police, courts, prisons and jails and improves the quality of life for everyone. As the authors noted, “Both the general public and people assigned to [Kendra’s Law] benefit – the former through a reduction in crime and violence and the latter through a reduction in experienced coercion and all of its untoward consequences.”

Unfortunately, Kendra’s Law has serious loopholes that prevent people who could benefit from it from being included. A bill sponsored by Assemblywoman Aileen Gunther (D-Sullivan County) and state Sen. Catharine Young, a western New York Republican, would close them. It would:

* Fix a crack in the system that allows mentally ill people to be released from prisons and jails without first determining if they should be court-ordered to stay in treatment and on the medications that can prevent them from becoming violent again.

* Fix a crack in the system that allows people who were involuntarily hospitalized because they were a “danger to themselves or others” to be released without determining whether they need court-ordered treatment in the community to prevent them from deteriorating.

* Fix a crack in the system that allows court orders to expire without a review of whether they should be renewed. Of the 9,393 individuals courts have ordered to accept treatment so far, only 1,928 currently have active orders. That means 7,465 people are no longer required to stay in treatment. Talk about playing with fire.

Albany ought not wait until there is another horrific headline-grabbing violence victim who winds up giving his or her name to yet another law. Acting now would be far more humane for people with mental illness and far safer for the public at large.

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.