The Senate overwhelmingly passed a bill that would expand a law that forces treatment for those with severe mental illness while making it permanent.
Supporters of the bill to make Kendra’s Law permanent (S.516-b) say it would improve the quality of care for the mentally ill and strengthen existing state laws regarding mental health.
Opposition to the law favors a more holistic approach to treating mental illness in New York.
On March 26, the Senate voted 58-2, with three excused, to make Kendra’s Law permanent and more stringent. The bill has not been introduced in the Assembly yet. The law is scheduled to sunset on June 30, 2022.
Kendra’s Law, first passed in 1999, allows a court to order treatment for people with serious mental illnesses who might be a danger to the community. Now, some lawmakers are hoping to make it permanent.
The bill, sponsored by Sen. Catharine Young, R-Olean, received strong bipartisan support in the Senate, but could face a tough road in the Assembly, where the bill has faced an uphill battle in the past.
“Since its enactment in 1999, Kendra’s Law has been a lifeline for thousands of New Yorkers, ensuring they receive the treatment they need to build stronger lives and protecting the public by getting people help before they become a danger to themselves or others,” Young said. “It is past time to take this landmark law and improve it further by making it permanent and closing loopholes that are still allowing too many people to fall through the cracks.”
Not only would Young’s legislation make Kendra’s Law permanent, it would also incorporate several new requirements.
For example, Young’s bill would require follow-ups for individuals who move during the assisted outpatient treatment period to ensure they continue to receive treatment.
Additionally, mandated assessments would be necessary after patients are released from inpatient treatment or incarceration in order for individuals.
Counties would be required to notify the state Office of Mental Health when an individual in the program is missing or unavailable for an evaluation to consider whether they still meet the program’s criteria.
The commissioner of the Office of Mental Health would also be required to develop educational pamphlets to help understand the assisted outpatient treatment process.
Kendra’s Law is named in memory of Buffalo journalist Kendra Webdale who — on January 3, 1999 — was shoved in front of a moving subway train in New York City by Andrew Goldstein, a schizophrenic, who was not in treatment and had no housing.
Four months later, Edgar Rivera was pushed in front of a train by Julio Perez resulting in the loss of his legs.
Both Perez and Goldstein were discharged from psychiatric facilities with little to no medication. Webdale’s family and Rivera advocated strongly for the bill, which was passed in November 1999. Supporters of the law argue Webdale would be alive today if court-ordered treatment was legal at the time.
The law had national, statewide, regional and local and media support along with Rivera and Webdale’s family advocating for stronger mental health laws. Then-governor George Pataki created the law in response to the public outcry surrounding the events.
Kendra’s Law originally passed with a sunset clause, but it has always been renewed by the state legislature. The clause requires the law to be reviewed every five years, which leaves the possibility of the law phasing out.
While Kendra’s Law addresses immediate public safety concerns, mental health advocates are critical of Kendra’s Law and push for a more holistic model of treatment. Opponents argue effective relationships and care between doctors and patients should be valued over medication and the courts.
“We are not giving people the quality of care that they deserve,” said Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services, which has fought Kendra’s Law, saying it is more a violence reduction strategy rather than a way to give a patient proper care.
The organization is a coalition of people suffering from mental illnesses as well as recovery-focused providers who help them. The treatment model they have been advocating for in Albany stresses what’s important is not court-mandated care, but rather the quality of care. They are advocating for care that “looks beyond assessing an individual’s symptoms and looks to what the person truly desires as a human being, not restricting them to what the program or service can offer.”
The organization advocates for “Project INSET”, standing for Intensive and Sustained Engagement and Treatment, to get passed in the legislature as an answer to Kendra’s Law.
With this new model the organization would consist of teams of 4 peer specialists, a care coordinator and a nurse practitioner. Each of these teams would work with 100 individuals to develop individualized service plans and work with providers to arrange these individuals into desired or needed ongoing care management services. Through this program, the organization would work with county governments to get supportive housing for these individuals. Teams would also have to adhere to systematic guidelines to help them monitor whether or not a patient’s treatment is appropriate.
The organization argues that Goldstein, Webdale’s killer, was not denying treatment, but was denied access to housing and support services. They argue that there is a major lack of accountability in state mental health services and a severe lack of sufficient and persistent patient outreach and engagement.
This program would differ from others because the treatment would be at the “discretion and comfort”of the patient. The Project INSET literature states that people who might deny care initially become more motivated to accept it when allowed more control over their treatment plan.
A major goal of this program is decreased involvement with the criminal justice system, which Rosenthal believes stigmatizes mental illness by associating it with violence.
“It’s the services that matter, not coercion,” Rosenthal said.
With Project INSET, mental health advocates hope for a reduced number of hospital visits, decreased involvement with the criminal justice system, decreased drug and alcohol use, reduced costs in care services, improved family relations, an increase in schooling, volunteering and employment and decreased psychiatric symptoms.
“My role is to reduce the number of court orders,” Rosenthal said. “My job is to work with communities for better care.” Rosenthal said.
