Mandatory treatment Number of court orders for outpatient treatment since 1999 Central New York:*207 Hudson River:852 Long Island:966 New York City:6,031 Western New York:441 Statewide:8,497 State considers the Southern Tier and North Country to be part of Central New York region -Source: State Office of Mental HealthTaking mentally ill people to court to force them into outpatient treatment happens much...
Mandatory treatment
Number of court orders for outpatient treatment since 1999
Central New York:*207
Hudson River:852
Long Island:966
New York City:6,031
Western New York:441
Statewide:8,497
State considers the Southern Tier and North Country to be part of Central New York region
-Source: State Office of Mental HealthTaking mentally ill people to court to force them into outpatient treatment happens much less frequently in Onondaga and many other upstate counties than it does downstate.
That disparity emerged in the debate over extending Kendra’s law, which authorizes court-ordered outpatient care for individuals who refuse treatment. The law, passed in 1999, was named for Buffalo-native Kendra Webdale, who was pushed to her death in front of a Manhattan subway train by a man with untreated schizophrenia.
Kendra’s Law is set to expire June 30. On Tuesday, the Assembly voted to extend it through 2015; the Senate is set to consider the extension Monday.
» Letter by Kendra's sister: Make law permanent
Statistics from the state Office of Mental Health show that since 1999 the number of people Onondaga County has been able to get into voluntary treatment is more than double the number it has asked the courts to force into outpatient treatment. That ratio holds true throughout an 18-county region that includes Central New York, the North Country and the Southern Tier.
Voluntary treatment
Number of voluntary treatment agreements since 1999
Central New York:*467
Hudson River:954
Long Island:629
New York City:2,279
Western New York:2,560
Statewide:6,889
State considers the Southern Tier and North Country to be part of Central New York region
-Source: State Office of Mental Health“We don’t do this lightly,” said Sue Wiegand, of the Onondaga County Mental Health Department, who coordinates court-ordered treatment for the mentally ill here. . “I always try to do a voluntary agreement first.”
Onondaga County has obtained court orders to force 41 people into outpatient treatment since 1999. During that time it has helped arrange voluntary treatment agreements for 91 people. Requests for court-ordered treatment come from families, hospitals and other community providers.
In New York City, court orders for treatment exceed voluntary agreements nearly 3 to 1.Harvey Rosenthal, executive director of the New York Association of Psychiatric Rehabilitation Services, said court-ordered treatment should be used only as a last resort.
“We have so many more, and better, things we can do before we haul people into court,” said Rosenthal, whose group represents people who use and provide outpatient mental services
He called Onondaga County a leader in helping mentally ill individuals in a voluntary way “with persistence and patience.”
“They (Onondaga County mental health officials) have beefed up their responsiveness to people at risk and provide packages of voluntary services that have been equally effective as any court-ordered care,” he said.
Involuntary outpatient treatment is one of the most controversial issues in mental health.
The Treatment Advocacy Center is a national nonprofit that supports the use of court-ordered treatment, known as assisted outpatient treatment. It says it’s necessary in cases where individuals with conditions like schizophrenia and bipolar disorder are so severely ill they don’t recognize they need treatment, and they become risks to themselves and others. It says court-ordered treatment can make a dramatic difference in the quality of life and vastly improve treatment compliance.
On the other side of the debate are groups such as the Bazelon Center for Mental Health Law, a Washington, D.C., nonprofit working to improve the lives of the mentally ill through changes in policy and law.
“Court orders are not treatment,” the center said in a recent position paper. “New York should focus on expanding access to the numerous treatments and services with demonstrated effectiveness for individuals with serious impairments. Court orders are inappropriate when used simply to move individuals to the front of a waiting list that shouldn’t exist.”
When it was first passed, Kendra’s law was supposed to expire after five years. It was extended for another five years in 2005.
Wiegand, who has been coordinating the county’s court-ordered treatment for 10 years, would like to see Kendra’s Law made permanent.
“I have seen lives saved,” she said.
She talked of a case involving a young man who was in and out of hospitals and not getting outpatient treatment. He almost put his mother in a scalding shower before he was forced into court-ordered treatment, Wiegand said, adding that one year later, that young man is doing well and attending college, she said.
“We go to court with people who are not doing well and are really in danger if they don’t continue with treatment,” Wiegand said.
Most of the mentally ill individuals referred for court orders are well known to her, she said. Wiegand credits the area’s mental health providers, in part, for Onondaga’s high rate of voluntary treatment agreements. Wiegand said they are very cooperative in coming up with packages of services to present to the individuals.
“This law doesn’t work for everybody,” she said. “But it’s helped some people resume their lives.”
Contact James T. Mulder at 470-2245 or jmulder@syracuse.com.