NYAPRS Note: Calls to seek better alternatives to expanding Kendra’s Law emphasis on court mandated mental health treatment or to making it permanent are rising across the state from a broadening diversity of groups. Witness yesterday where 3 letters were published in newspapers in Staten Island, Albany and Schenectady and one in New York City and one in New York City recently from advocates representing a mix of provider, family and consumer advocates.
While they vary in emphasis, all 4 oppose either an expansion or permanence (or both) for Kendra’s Law and several object to unjust, stigmatizing connections with violence and/or look to recent initiatives backed by the Governor and state lawmakers.
Family members deserve a far better response than they have historically received from our mental health service system. While most advocates don’t believe Kendra’s Law is the right remedy for this, key stakeholders from the family, consumer and provider communities should sit with local and state officials after session to work jointly to identify the best and most effective strategies to see that people get the help they want and need.
Consider Voluntary Alternatives to Kendra’s Law
By Jason Lippman Staten Island Advance Letter to the Editor May 29, 2012, 1:50 PM
The Staten Island Advance editorial “Strengthen Kendra’s Law,” published on May 24, points out the benefits of the court-ordered Assisted Outpatient Treatment (AOT) program authorized under Kendra’s Law, while overlooking other critical facts.
Before I get into them, it is important to note that the violent crime rate among people with mental illness is not significantly different than the general population. With proper voluntary community supports in place, the vast majority of people with mental illness live and work safely in the community. In addition, the horrific and tragic incidences reported in the newspapers that involve individuals with mental illness should not be minimized.
In 2009, as mandated by the Kendra statute, an evaluation of the AOT program was published by Duke University called “New York State Assisted Outpatient Treatment Program Evaluation.” While the Duke study found improved outcomes for consumers who receive AOT services, it was unable to provide evidence that court-ordered treatment was more effective than voluntary programs.
A systematic comparison of involuntary versus voluntary participation was required by the statute that had extended the sunset date of Kendra’s Law from 2005 to 2010. Although almost half of AOT recipients receive services voluntarily, the Duke study could not evaluate the efficacy of voluntary alternatives in comparison to involuntary models. The report noted that the limited data available made for inclusive results.
Therefore, in 2010, the New York State Legislature extended Kendra’s Law through June 30, 2015, instead of making it permanent. In doing so, the Legislature allowed for more time to scientifically examine the usefulness of court-ordered participation in relation to voluntary types of programs. In addition, the state provided an opportunity to investigate further the geographic discrepancies and overrepresentation of racial minorities that currently exist in the implementation of the AOT program.
In documenting the improvements of the AOT program, the Duke study also noted that new services dollars were infused into the mental health system when the AOT program was first introduced. These dollars were a significant factor in producing better results. Unfortunately, since the timeframe in which the study was conducted, state dollars have been removed from the mental health system, while the funding mechanisms that support it are being adversely affected.
When tragedies like the case of Eric Bellucci occur, we are often quick to call for seemingly simple solutions, when in actuality the problems are far more complex.
Before reacting to the recently reported incidences in the press by strengthening laws to involuntarily confine or medicate one group based on acts committed by a minority of individuals, let’s make sure that we have exhausted every possible alternative. Let’s examine the voluntary approaches, adequately support the community-based providers that work with the people who may be at-risk for violent episodes, and assist local police departments that keep our communities safe.
[The writer is senior associate for policy and advocacy at The Coalition of Behavioral Health Agencies, Inc.]
http://www.silive.com/opinion/letters/index.ssf/2012/05/consider_voluntary_alternative.html
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Better Alternatives Are Available for Kendra’s Law
Daily Gazette (Schenectady) May 29, 2012
Re the May 19 letter [“Legislature should approve plan to make Kendra’s Law better”], it is understandable that families are grasping at anything that will help loved ones who resist treatment.
Kendra’s Law relies on court-ordered care for people who are suffering from a mental disorder but refuse treatment. On its face, the law appears to be the “magic wand” that will create positive results. (In some cases, it is.)
Some people in favor of this bill use all sorts of statistics to back up their claims. However, statistics often conceal more than they reveal.
For instance, although Kendra’s Law is a good concept, communities may not have the resources to implement it. What often happens is that the police are sent to handle the situation, but without proper training, they, members of the community and the person in need of help are put in a precarious situation.
Kendra’s Law should not be implemented until crisis teams are in place. It is totally irresponsible to send police into an unknown and chaotic scene without being properly trained.
Tasers, most of the time, are not the answer.
Furthermore, all of the latest reports state that the newer psychotropic drugs cause diabetes, heart problems, enormous weight gain, circulation problems and an array of other debilitating problems for many.
Plus, many years are taken off their lives. That’s a tough pill to swallow. Hence, there are people who can’t deal with such devastating side effects. Can you blame them?
Also, there are many gaps in the mental health system, due, in part, to massive cuts in local, state and national budgets. Quite often, people seek help but are turned away due to lack of services. It would make more sense to keep an eye on and encourage Gov. Cuomo’s proposals to fill in the gaps, improve outreach and support his behavioral health new home health initiatives. These new programs will hopefully make the mental health services more effective.
Already approved by state legislators, they show positive results and can help many vulnerable people. One such program makes sure that hospitals come up with better discharge plans; while another ensures that teams of providers stay closely involved to help avoid relapse-related crises.
That, along with proper police training and more research for safer drugs, can be of the utmost importance for helping a person in crisis, and preventing a chaotic scene.
There is still time to contact Gov. Cuomo, Sen. Roy McDonald and Assemblyman Felix Ortiz stating that you support the governor’s initiatives for better mental health services and not to sign the Kendra’s Law until such services, police training and crisis teams are in place.
Flora L. Ramonowski Schenectady
The writer is a mental health advocate.
http://www.dailygazette.com/news/2012/may/29/529_pournt/
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Kendra’s Law a Valuable Tool (but shouldn’t be made permanent now)
Albany Times Union May 29, 2012
Harvey Rosenthal‘s commentary “High marks for Cuomo’s aid for disabled,” May 14, offers some well-deserved plaudits to our governor for initiatives that, I hope, will improve mental health services in our communities.
I must take serious issue with Mr. Rosenthal’s characterization of Kendra’s Law as “unproven” and overly dependent on the courts and the police. This law was originally enacted in 1999 and has been repeatedly extended at five-year intervals. It is the law until 2015. A 2009 Duke University evaluation of the program concluded that it “improves a range of important outcomes for its recipients, apparently without feared negative consequences to recipients.”
I agree with Mr. Rosenthal that a certain few horrific incidents and a media frenzy among the New York City tabloids should not drive the legislative agenda. Like Mr. Rosenthal, I resent those who seek to capitalize on sensationalistic news and who do irreparable harm to those with a mental illness who are able to manage their disorder and who are a threat to no one.
Frankly, making Kendra’s Law permanent now will not begin to solve all the problems that plague the complicated system, which still allows some seriously disordered folks to fall through the cracks.
But, as one who has been involved in forensic mental health advocacy for more than 12 years, I do not look at Kendra’s Law as a panacea for all that is wrong but as a valuable tool in engaging at-risk persons in treatment and, hopefully, helping them to achieve a more rewarding life. The law deserves to be made permanent on its own merits, at the right time, not under the present circumstances.
Robert K. Corliss
Co-chair Forensic Task Force, National Alliance on Mental Illness Schenectady
http://www.timesunion.com/opinion/article/Letter-Kendra-s-Law-a-valuable-tool-3593650.php#ixzz1wLpz80So
Redesigned Help Letters to the New York Post May 20, 2012
Kendra’s Law relies on court- ordered care, and extending it is opposed by over 15 statewide advocacy groups and will needlessly raise state and county taxes by at least $30 million (“Ignoring NY’s Most Ill,” PostOpinion, Catherine Young & Aileen Gunther, May 17).
A better approach is to back new programs designed by the governor’s Medicaid Redesign Team to make our mental-health services more effective. Already approved by state legislators, they show impressive results and can help up to a million vulnerable people.
One such program makes sure that hospitals come up with better discharge plans. Another ensures that teams of providers stay closely involved to help avoid relapse-related crises.
The Medicaid Design Team’s programs are making New York a national leader and are a much better alternative to expanding Kendra’s Law.
Harvey Rosenthal, Member, Medicaid Redesign Team, Albany
http://www.nypost.com/p/news/opinion/letters/letters_Giya5wOG6xVco4cAqZMSHN#ixzz1wLudy4XC