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Start of Modern Involuntary Outpatient Treatment

In 1999, New York State Enacted Legislation that provides for involuntary assisted outpatient treatment for certain people with mental illness, against their will, who, in view of their treatment history and present circumstances, are unlikely to survive safely in the community without supervision.  This law is commonly referred to as “Kendra’s Law” and is named after Kendra Webdale, a young woman who died in January 1999 after being pushed in front of a New York City subway train by a person who was living in the community at the time, but was not receiving treatment for his mental illness.  This article explains the law.

Brief Description of Kendra’s Law

The law, gives certain people the authority to make people with mental illness receive outpatient treatment against their will in order to protect themselves and others.  In 2005, the law was renewed with several changes, which are noted in this article.  Versions of this law have been passed in other states, and sort of in Florida under Mental Health Courts, where people get a choice between outpatient treatment or jail when they have broken the law.  The idea has been discussed in Florida, NAMI national advocates for it in their public policy statement of 2007, several large providers are for it, and some consumer groups are for it.  Some consumer groups, and providers are against it.  The Brevard Drop-in Center doesn’t have an official position on this issue, we think each person should make up their own mind.

Overview of Assisted Outpatient Treatment (Kendra’s Law)

Kendra’s Law 2005 in New York State established a procedure for obtaining court orders for certain individuals with mental illness to receive and accept outpatient treatment.  The prescribed treatment is set forth in a written treatment plan prepared by a physician who has examined the individual.  The procedure involves a hearing in which all the evidence, including testimony from the physician, and, if desired, from the person alleged to need treatment, is presented to the court.  If the court determines that the individual meets the criteria for assisted outpatient treatment (“AOT”), an order is issued to the director of community services (DCS) who oversees the mental health program of a locality (i.e., the county or the City of New York mental health director).  The court orders will require the director to provide or arrange for those services described in the written treatment plan that the court finds necessary.  The initial order is effective for up to 6 months and can be extended for successive periods of up to one year.  The legislation also establishes a procedure for evaluation in cases where the individual fails to comply with the ordered treatment and may pose a risk of harm.

This legislation also requires the Office of Mental Health to designate “program coordinators” who are responsible for monitoring and overseeing AOT programs.  County directors of community services are required to operate AOT programs, either separately or jointly with other counties.  The directors of local assisted outpatient treatment programs report to the program coordinators regarding the operation of their AOT programs and also supply the program coordinators with information on every assisted outpatient treatment order.  The Commissioner of Mental Health must approve all AOT programs.


The process for issuance of assisted outpatient treatment orders begins with the filing of a petition in the supreme or county court where the person alleged to be mentally ill and in need of AOT is present (or is believed to be present).  The following may act as petitioners:

        An adult (18 years or older) roommate of the person;

        A parent, spouse, adult child or adult sibling of the person;

        The director of a hospital where the person is hospitalized;

        The director of a public or charitable organization, agency or home that provides mental health services to the person or in whose institution the person resides;

        A qualified psychiatrist who is either treating the person or supervising the treatment of the person for mental illness;

        A licensed psychologist or licensed social worker who is treating the person for mental illness;

        The director of community services, or social services official of the city or county where the person is present or is reasonably believed to be present; or

A parole officer or probation officer assigned to supervise the person.