The Empire Page

As a family member of someone with serious mental illness I am saddened by the refusal of NYS Office of Mental Health (OMH) to support bills that would make Kendra's Law permanent and improve it. 

But I am not surprised.

Under the rubric of “transformation” OMH has cut back on medication, hospitalization, and other symptom amelioration services for the serious mentally ill in favor of “rehabilitation” programs for those much less symptomatic. Getting treatment from OMH is largely inversely related to need.  

 

Fortunately, the decision on whether to make Kendra’s Law permanent before it sunsets in June, is not in the hands of OMH, it’s in the hands of the legislature. At the risk of sounding naïve and Pollyannish, that’s a good thing.

Kendra’s Law allows courts to order historically violent or recidivist mentally ill individuals who continually go off treatment and decompensate, to accept treatment as a condition for living in the community. It also commits the mental health system to providing the treatment. For the seriously ill, that’s a Godsend. For the public, fearful of random violence by the untreated seriously mentally ill, it could be a matter of life or death.

Kendra's Law is a kinder, gentler, less expensive, less restrictive, than its alternative: involuntary inpatient commitment. It allows patients to exercise their free will and civil rights by freeing them of the “Bastille of their psychosis”. Kendra’s Law is not an alternative to voluntary programs. It serves a different population: those who need a court order to accept care because they are too sick to recognize their need for it.  Does it solve every problem with OMH? No. Does it solve some? Yes.

In 1999, politics were put aside and Pataki, Bruno, Spitzer and Silver came together and passed Kendra’s Law over OMH objections by an bipartisan vote (191-6) of the Senate and Assembly. Prior to passage, Speaker Silver wrote in the Albany Times Union:

 

For too long, many families have been forced to stand helplessly by as mentally ill loved ones, refusing to adhere to physician-prescribed treatment plans, spun through a revolving door of care. While these families witness firsthand the personal destruction of mental illness, they frequently have no power to stop or control it. …(W)e cannot overlook or minimize the importance of this bill for those struggling every day with mental illness.

Amen.

The 1999 law was studied for five years and found to reduce 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%).

From a budget perspective, Kendra’s Law saves money by reducing hospitalization (77%); arrests (83%); and incarceration (87%).

What 191 legislators hypothesized in 1999 was proven true in 2005. Predictions that “tens of thousands of individuals’” would be “chased by police with needles” proved false. Of the 650,000 individuals ‘served’ by OMH, only 1800 individuals are in Kendra’s Law.

In 2005, based on that research, the law should have been made permanent. But those who previously said it wouldn’t work raised new concerns to prevent that…and were again proven wrong.

 

In 2005, they claimed the law was racist, increases stigma, and it is services not court orders that improve outcomes. So the legislature ordered up another five year extender and another study.

 

The Duke University Study, put to rest the charge of “increased stigma” (it found none), court orders don’t work better than enhanced services (they do) and of racism:

We find no evidence that the AOT Program is disproportionately selecting African Americans for court orders, nor is there evidence of a disproportionate effect on other minority populations. Our interviews with key stakeholders across the state corroborate these findings.

 

A study by Columbia University showed Kendra’s Law decreased stigma, and those in it were 4X less likely to be involved in violence.

 

In a meeting with Assembly Mental Health Chair Ortiz earlier this month, an in interviews with reporters opponents ignored the research and raised the same disproven claims.

 

OMH introduced a bill memo that lists many of the reasons to make the law permanent. But the bill itself brings the program to an end in five years. No new studies are requested. No new objections raised. Money is not the issue. Over the next five years, a five year extender costs the same as making it permanent.   

 

But again. The decision isn’t OMH’s to make.

 

Assemblywoman Aileen Gunther (D) and Senator Catharine Young (R), introduced a bipartisan bill S7596/A10421 that is better than the OMH bill because it makes it permanent and incorporates the findings of the studies. Among other improvements, their bill:

 

·      eliminates the loophole whereby enforcement of a court order can be avoided by stepping across a county line. 

·      requires the state to consider mandatory community treatment whenever someone who was admitted to a hospital because they were proven to be 'danger to self or others' is being released.

·      requires the state to consider mandatory community treatment whenever a prisoner who used mental health services while in prison is being released to the community.

 

OMH could still throw these individuals—who have been proven to be dangerous-- unsupported into the community, if they want. But the Gunther/Young bill would require them to consider what they are doing first.  That’s all. OMH opposes.

 

Their bills also include numerous non-controversial provisions to streamline the program and save counties money. 

 

Making Kendra’s Law Permanent is supported by the Alliance on Mental Illness of New York State, Harlem Alliance on Mental Illness, Public Employees Federation (PEF), and numerous other groups who care about the seriously mentally ill.

 

It is also supported by those responsible for public safety including the NYS Chiefs of Police (NYSACOP), NYS Sheriff’s Association, District Attorney’s Association of the State of NY (DAASNY), Citizens Crime Commission of NYC and others.

 

Editorial boards are also chiming in: The Oneanta Daily Star said “Kendra’s Law is worth keeping”. Gannett Papers wrote “Kendra’s Law for Good”. Newsday, which supported it in 2000, wanted racism charges of 2005 investigated, read the results and recently declared, “Make Kendra’s Law Permanent”. The Buffalo News said the same thing and Daily News wrote several favorable editorials.

 

OMH can choose to ignore the seriously ill. But that is harmful to patients, dangerous to the public, and too expensive for taxpayers. The legislature should pass Gunther/Young bills A1042/S75961 to make Kendra’s Law Permanent and Enhance it. Anything less would be insane.

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DJ Jaffe is a long-time advocate for the seriously mentally ill who writes a column on serious mental illness for Huffington Post. djjaffe@gmail.com