By Jonathan Stanley, JD, Treatment Advocacy Center
(January 2000)

On August 9, 1999, Governor George Pataki signed New York's new act for assisted outpatient treatment, popularly known as Kendra's Law. The act authorizes courts to issue orders to maintain treatment while in the community to certain individuals with mental illness. More specifically, those who are in a deteriorating condition, unlikely to comply with treatment, and have a history of either multiple hospitalizations or violence due to noncompliance with the medications they need to control their illness.

Kendra's Law seemed to fly through a New York legislature that was hopelessly stalled by partisan conflict in most other matters. The measure was originally proposed the previous January by Attorney General Eliot Spitzer; he named it in honor of Kendra Webdale, a vibrant young woman who was pushed to her death last January by a man with schizophrenia and a history of both repeated hospitalizations and violent acts caused by his untreated mental illness. In April the proposal was endorsed almost simultaneously by the leaders of both the Democratic and Republican parties in New York-a rarity-and in early August it passed both houses of the legislature by staggering margins (49-2 in the Senate and 142-4 in the Assembly). Regardless of its identification with such tragedy, what endowed this legislation with such potency? It addressed a dire and obvious need.

The shortfallings of deinstitutionalization are varied and many. Chief among them is that the laws of many states forbid the treatment of those who are incapable of rationally deciding whether or not to accept treatment for their illness. Unless there is an immediate danger, the law of many jurisdictions would hold as sacrosanct a person's psychotic refusal of treatment based on the belief that his or her psychiatrist is Jack the Ripper. Quite simply, our laws have been stopping us from caring for those who are the most sick.

This was compounded in New York by the lack of any provision, based on any standard, for court-ordered assisted outpatient treatment (a.k.a. assisted outpatient treatment or outpatient commitment). When it was decided that someone was so sick as to require court-ordered treatment, care could only be given in the most restrictive setting.

Kendra's Law improves New York's treatment system in two fundamental ways. First, it allows individuals who are ordered to comply with treatment to remain outpatients. Thus some committed to inpatient facilities may be released earlier and transferred to supervised outpatient treatment while others who previously would have been placed in a hospital can now instead remain in the community under assisted outpatient treatment orders.

Second, Kendra's Law can be applied to a wider range of people than statutes that rely on the constricting "dangerous to self or others" standard. Specifically, it can be applied, if certain other criteria are met, to anyone who has been hospitalized twice due to noncompliance in the previous 36 months or anyone who has been or threatened to be violent in the last 48 months for the same reason. Kendra's Law substantially increases New York's ability to care for those who refuse treatment only because of their mental illness and often allows that care to be given in a far less restrictive setting.