Kendra’s law

Last January, Kendra Webdale, a 32-year-old aspiring screenwriter, was killed after being pushed into the path of a New York City subway train. Her assailant was Andrew Goldstein, a schizophrenic who had a long history of non-compliance with his treatment programs. In April, Edgar Rivera, father of three, lost both his legs after he was pushed in front of another NYC subway train, once again by a mentally ill person not taking medication.

As tragic as these events are, however, they should not have led New York to impose a law that presumes danger from mentally ill people, and perpetuates a stereotype that advocacy groups have spent years trying to erase.

The New York City crimes led the New York State legislature to pass “Kendra’s Law,” which gives the courts the power to require mentally ill persons who are unlikely to function safely in the community without supervision to accept medications and other needed mental health services.

The key component in the law is a provision known as involuntary outpatient commitment. A court hearing can be ordered for a mentally ill people who are believed by a family member or health-care provider to be unable to care for themselves or have histories of being dangerous and have been noncompliant with treatment in the last three years. If the court finds against these patients, they are taken to a hospital for evaluation. A treatment plan is constructed, and the patient is required to follow the plan.

Treatment can consist of a combination of services such as individual and group therapy, educational and vocational services, medication and testing for medication compliance. If the patients do not follow the court-ordered treatment regimen, they are returned to a psychiatric hospital, where they are given the “opportunity” to receive treatment. The mandated treatment plan remains in effect for six months, and can be renewed every 12 months.

Thirty-nine states now have some form of Kendra’s Law. Maine does not, nor should it. As Kim Moody of the Disability Rights Center in Augusta said recently, “It shouldn’t be illegal to have a mental illness.”

Forcing the mentally ill to receive whatever type of treatment a court prescribes makes a mockery of individual liberty. Psychiatric patients are less likely to commit crimes than the rest of us. Being psychotic is not a dangerous condition. People with non-psychotic chronic illnesses are more likely to commit crimes, yet no one is advocating forced treatment for those patients.

Proponents of the bill argue that a delusionally psychotic patient cannot make a well-reasoned decision about his condition, and public safety requires forced treatment. They cite the numerous protections of the patient’s rights within the bill, such as providing a lawyer free of charge, and the right to call witnesses in support of the patient. However, once a patient has been placed into the involuntary outpatient commitment system and is no longer a danger to self or others, the standard becomes adherence to treatment.

Should a person’s freedom depend on whether he takes his medication?

The deinstitutionalization movement of the late ’70s and early ’80s was intended to move the mentally ill out of the back wards of asylums and into the community, where they could receive outpatient treatment, find jobs in sheltered workshops, and have a significantly improved quality of life.

Instead, one-third to one-half of the homeless in the country today are mentally ill, three times as many severely mentally ill are in jails or prisons as are in hospitals, and less than 50 percent of people with schizophrenia receive the appropriate treatment for their condition. Community mental health centers are chronically underfunded, and the waiting lists for supervised housing for the mentally-ill are years long in some cases.

Before any government thinks about forcing treatment on the mentally ill, it should make sure the best and least restrictive treatment is available to them. In Maine, that is not the case.