Problems with timely treatment according to Kendra's law

The New York State Office of Mental Health must better oversee timely treatment for individuals under a state law that requires people in a mental health crisis to receive treatment, according to an audit released Thursday by State Comptroller Tom DiNapoli's office.

Known as Kendra's Law, the state allows court-ordered assisted outpatient treatment (AOT) for people with serious mental illness who pose risks to themselves or others and whose treatment history meets a set of criteria.

According to the audit, local authorities have conducted nearly 47,000 investigations under the Kendra Law through August 2023. Of the 33,847 processing requests submitted, 96% were granted. Local mental health authorities are expected to investigate the referrals in a timely manner, the comptroller said, but a timetable for this review has not been defined. Using a six-month benchmark, the auditors found that almost half of investigations (19 out of 41 in the sample) lasted longer, including five that lasted more than two years.

Auditors said they found that when significant events involving these individuals occurred, such as becoming homeless or being arrested, the information was often incomplete and not properly communicated. Providers are expected to report such events to local authorities within 24 hours to avoid any negative consequences for treatment, DiNapoli said.

“Kendra's Law was enacted to ensure that people with serious mental illness receive treatment to prevent them from harming themselves or others,” DiNapoli said in a statement. “In many cases the program works, but when errors occur the consequences can be fatal, as our audit shows. [Office of Mental Health] must implement our recommendations to improve the implementation of Kendra's Law at a time when we are facing a serious mental health crisis.”

Those recommendations are:

  • Establishing time-frame guidelines so that local authorities and field offices have a benchmark for completing investigations
  • Research into collecting data on the time it takes to connect individuals with their legal services
  • Improve reporting on key events to better capture and share information
  • Improving assurance that local authorities take appropriate action to renew services when necessary before they expire, to avoid errors in treatment and monitoring

In its response to the audit, the Office of Mental Health said it generally agreed with the recommendations and would develop guidelines to define the “timely” completion of AOT examinations.

Kendra's Law is named after Kendra Webdale, a Fredonia resident who died in 1999 after a man who said he had had a psychotic episode pushed her in front of a subway train.

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