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Kendra's Law: Fear, politics and mental illness

By LISA TARRICONE (Original Publication: Journal News June 12, 2005)

We have a propensity to create feel-good acts of justice when things go wrong. In order to appease public unease during times of random violence, laws spring up to pay homage to certain victims while professing to better serve the public.

Kendra's Law is one such example a seemingly well-meaning response to the sensationalized death of Kendra Webdale, who was pushed under a New York City subway train in January 1999 by Andrew Goldstein, an individual with a lengthy history of mental illness and hospitalizations. The legislation is due to expire on June 30 of this year and, in its five-year run, has created an unconscionable standard of court-ordered treatment for certain individuals with psychiatric disabilities.

Although Kendra's Law is strongly supported by Albany lawmakers and the National Alliance for the Mentally Ill, advocates for persons with mental illness feel differently, citing that it violates the civil rights of individuals with psychiatric symptoms through court-sanctioned treatment and forced institutionalization.

Public reaction to anything that is more feared than understood takes its most tangible form in legal sanctions. Kendra's Law took only eight months to pass the state Legislature. The August 1999 legislation provides for court-ordered assisted outpatient treatment (AOT) for people with mental illness who have a history of medication noncompliance that has led to hospitalizations or that has resulted in at least one act of violent behavior.

A parent, spouse, adult roommate, psychiatrist or social services official can file a petition with the court for an individual they feel meets the stated criteria for AOT. The court will then set a hearing date for that individual and, if the criteria for AOT are met, the individual will be required to accept a written treatment plan. Some persons who are considered to be a danger to themselves or to others can be involuntarily committed to a psychiatric hospital.

Since the law was adopted, more than 10,000 cases have gone to courts, and approximately 4,200 court-ordered AOT plans have been issued. The average court order lasts about 16 months.

Mental-health advocates charge that the law is a quick-fix solution that fails to address the fragmented community-service system. Andrew Goldstein sought help at least 20 times before he pushed Kendra Webdale. He repeatedly checked himself into psychiatric facilities only to be discharged a few days later. He asked for, and was denied, long term-placement and was not taking his medication at the time of the killing.

The advent of antidepressant medications and new treatment options for individuals with psychiatric symptoms led to the closings of large state-run institutions in the 1970s and 1980s, ushering in a new era of outpatient care. Moreover, enormous amounts of funding have been pulled out of the community-service system over the last decade, increasing waiting lists and making it far more difficult to provide services to people who need them.

This consequential shortfall of crises beds for the mentally ill combined with dwindling hospital insurance coverage have made criminal incarceration the only 24-hour per day answer for individuals with emotional problems. In essence, jail has become the poor person's mental hospital, housing a current inmate population of which more than 16 percent are persons with mental illness.

Public attitudes about mental illness due to a lack of education and awareness, and media stereotyping that links medication noncompliance with acts of violence have fostered the stigmatization of individuals with psychiatric disabilities. According to the first Surgeon General's Report on Mental Health, it is the "fear of violence of people with mental illness" that keeps the stigma vibrant and stereotypes rampant. However, the FBI's Behavioral Science Unit reports that crimes in America "are committed by people with all levels of functioning and personality types" and that only "3 percent of violence in American society can be attributed to mental illness."

State data conclude that only 15 percent of the people who have been required to accept AOT plans under the legislation had demonstrated any kind of physical harm to others in the period prior to the order.

Forced treatment unfairly singles out individuals with psychiatric disabilities and continues to deepen the cultural stigma that connects mental illness with dangerous behavior. Kendra's Law should not be made permanent nor should it be re-authorized for another three to five years, as it is now being considered by legislators.

We should not let court-ordered treatment impose force and steal personal civil rights as a substitute for adequate, well-coordinated, flexible, responsive and accessible community-based services.

Lisa Tarricone
Director, Systems Advocacy
Westchester Independent Living Center
White Plains, NY 10601
914.523.8922 (mobile)
914.682.3926 ext 2112(office)

Westchester Independent Living Center, Inc.
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