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New York

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New York, like every state, has its own civil commitment laws that establish criteria for determining when court-ordered treatment is appropriate for individuals with severe mental illness who are too ill to seek care voluntarily. The state authorizes both inpatient (hospital) and outpatient (community) treatment, which is known in New York as "assisted outpatient treatment." It is one of the 27 states whose involuntary treatment standard is based on a person’s “need for treatment” rather than only the person’s likelihood of being dangerous to self or others.

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 For inpatient treatment, a person must be meet the following criteria:


 

  • be a danger to self/others;
  • have treatment in a hospital deemed essential, and 
  • be unable to understand need for care and treatment.

For outpatient patient treatment, a person must meet the following criteria:

  • be unlikely to survive safely in community without supervision;
  • have a history of noncompliance that includes two hospitalizations in past 36 months, or
  • act/threaten/attempt violence to self/others in 48 months immediately preceding petition filing;
  • be unlikely to voluntarily participate, needs in order to prevent relapse or deterioration likely to result in serious harm to self/others, and
  • be likely to benefit from assisted treatment.

State standards for emergency hospitalization for evaluation and state-by-state information on initiating emergency hospitalization and assisted inpatient or outpatient treatment can be found from our Civil Commitment Laws and Standards page. 

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Kendra’s Law (New York Mental Hygiene Law § 9.60) allows courts to order certain individuals with brain disorders to comply with treatment while living in the community.

New York’s assisted outpatient treatment Law (commonly known as “Kendra’s Law”) has been the subject of two empirical investigations: a 2005 study conducted by the New York State Office of Mental Health (“the OMH study”) and a 2009 evaluation performed under contract with New York State, by an independent research team (“the independent evaluation”). Taken together, the two reports establish that assisted outpatient treatment (AOT) drastically reduces hospitalization, homelessness, arrest, and incarceration among people with severe psychiatric disorders, while increasing adherence to treatment and overall quality of life. The independent evaluation further indicates that the effectiveness of Kendra’s Law is not simply a product of systemic service enhancements but is in part attributable to the value of AOT court orders in motivating treatment compliance. Click here to view the Treatment Advocacy Center's briefing paper on New York's AOT law>>>">Receive your free Guide to Kendra's Law>>


Visit Get Help for tools and information about preparing for and handling a psychiatric crisis.

Visit Get Involved for information about how you can help bring down barriers to the timely and effective treatment of severe mental illness.


 
 

New York News

  • Is New York Really "Sweeping the Streets?"
    on 02/21/13 ( Blog / NY )

    (Feb. 21, 2013) A New York Post article this week with typically offensive headline, “Scoop the Nuts,” has brought distress to some mental health advocates and families ("Scoop the Nuts: Mentally ill roundup plan after train pushes,” Feb. 18).

    A quick glance at the story conveys an impression that the New York City Police Department has launched a campaign to “sweep the streets” of people with untreated mental illness. The story makes unsettling mention of a newly compiled “most wanted list” of 25 mentally ill individuals believed to be untreated and homeless.

    The alarm is unwarranted. Cutting through the breathless rhetoric, it turns out that the initiative reported here is simply an effort by the city to meet its court-ordered obligations to provide treatment to people in desperate need.

    Individuals on the city’s list reportedly all have documented histories of treatment non-compliance leading to violence and/or repeated hospitalization sufficient that they have qualified for assisted outpatient treatment (AOT)  under New York’s Kendra’s Law.  All are currently believed by their doctors to be in violation of their AOT court orders by not complying with their treatment plans and are possibly dangerous.

    In this new city campaign, the police have not been asked to arrest anyone. Instead, they are fulfilling the function set out for law enforcement officers in New York’s AOT law: to bring people who are in violation of their treatment orders and believed to possibly be dangerous to a health-care facility for evaluation. Those found by doctors to not currently meet New York’s hospital commitment standard will be immediately released (with, one hopes, a re-connection to their treatment team and continued monitoring.)

    Needless to say, this is exactly how AOT is supposed to work in New York. The only thing new about the “most wanted list” is that, according to the Post, in the past only non-adherent AOT patients with known addresses were pursued. Now, the NYPD is actively searching for those whose whereabouts are unknown.

    To which we can only say: it’s about time! Considering that the alternative is the abandonment of people with untreated mental illness to the perils of street life, we commend NYC for its heartening new policy.

    To comment, visit our Facebook page. 
    Visit our blog archive to read all our recent posts.

  • “I Was Irresponsible about My Medication”
    on 02/01/13 ( Blog / NY )

    (Feb. 1, 2013) "Do you feel you're responsible for Kendra's death?"

    Scott Brown of WGRZ 2 in New York this week put that question to Andrew Goldstein, who pleaded guilty of pushing Kendra Webdale to her death under a Manhattan subway train 14 years ago. He now is serving a 23-year sentence in the mental health unit of a prison north of New York City as a result.  

    “I know physically I was the pusher, I don't want to be manipulative. I was mentally ill and I was irresponsible about my medication,” Goldstein said in his first TV interview since he killed Kendra Webdale in New York City.

     “I was hearing voices, and I was living in paranoia. I would miss one or two clinic appointments, and I wouldn't take my meds for a week or two.”

    In the same segment, Kendra’s father Ralph Webdale told Brown, "I think we've always thought there's more than one victim here. The victim here is Kendra certainly in our case, but the family of Goldstein, but then of Goldstein himself. He was a victim of the mental health system in New York state- they did not take care of him adequately."

    Ralph and his wife Pat Webdale, who also was featured, were instrumental in getting New York’s assisted outpatient treatment (AOT) law – called Kendra’s Law – passed after their daughter died. The Webdales told their interviewer they found Goldstein’s description of his illness “sad, sad.”

    Several improvements to Kendra’s Law were passed by the legislature and signed into law in January as part of a gun control measure that followed the Newtown tragedies. Many additional states are looking at implementing or strengthening their own AOT laws or civil commitment standards.

    You can help implement assisted outpatient treatment in your state. You’ll also find tools and tips for advocacy on our Get Involved page.

    Watch the interview with Andrew Goldstein, who speaks for the first time on TV how his mental illness led to Kendra Webdale’s death.

    To comment, visit our Facebook page.
    Visit our blog archive to read all our recent posts.

  • The Next Battle for New York (and America)
    on 01/25/13 ( Blog / NY )

    (Jan. 25, 2013) Last week, Governor Andrew Cuomo signed legislation to close gaps in Kendra’s Law. The improvements - developed and first recommended by the Treatment Advocacy Center in 2010 - should lead to wider use, fewer premature lapses in court orders and more consistent enforcement of New York's “assisted outpatient treatment” (AOT) law.

    With that victory behind us, we are now addressing an even bigger failure of New York’s mental health system: the unavailability of court-ordered inpatient treatment for people in desperate need of hospital care. That is the focus of an op-ed piece by Treatment Advocacy Center Policy Director Brian Stettin in this week's Daily News. We also hope to make reforming the state's inpatient commitment law a priority of its legislature this session.  

    The improvement in Kendra's Law is only one of many mental illness treatment law reforms we are working on as legislatures around the country convene for their 2013 sessions. In the wake of the Newtown tragedy, numerous states are taking a new look at their treatment laws and finding room for improvement.

    YOU can help us achieve reforms!

    • DONATE – We do not accept funding from companies or entities involved in the sale, marketing or distribution of pharmaceutical products. That makes individual donations essential to our success. 
    • LEARN more about the issues – Follow us on Facebook and Twitter, read our daily blogs and/or the weekly news roundups, use our website to familiarize yourself with topics like the dire shortage of public hospital beds and the criminalization of mental illness.
    • BECOME an advocate – Help us shape and inform others by writing letters to the editor when mental illness issues are in your local news, sharing our Facebook posts, forwarding our news. You’ll find tools and tips for advocacy on our Get Involved page.

    Meanwhile, New Yorkers, please forward a link to the Daily News article to your state senator, assemblymember and Governor Cuomo. Be sure to identify yourself as a constituent and include your own personal story that illustrates why this reform is so important to you.

    Please forward any replies you receive to us. It will help us identify potential allies in the New York legislature.

    To comment, visit our Facebook page. 
    Visit our blog archive to read all our recent posts.

  • Roasted by the Post for Shocking Boast
    on 01/07/10 ( Blog / NY )

    Last month we blogged about Steve Miccio, the mental health peer counselor from Poughkeepsie, NY who spoke proudly at an academic conference about enabling a severely mentally ill client under court-ordered outpatient treatment to “choose” homelessness and substance abuse over safety and stability.  Today , Miccio is in the crosshairs of Andrea Peyser, the New York Post columnist never known to suffer fools gladly.

Visit Your State

NY AOT Program Evaluation

A research team led by Duke Medical School faculty finds striking evidence to confirm the utility of assisted outpatient treatment (AOT). 

Click here to see the results of the New York State Assisted Outpatient Treatment Program Evaluation