Assist


			OVERVIEW OF ASSISTED TREATMENT LAWS AND ISSUES IN NYS

			What is Assisted Treatment? Assisted Treatment ensures that individuals with neurobiological disorders so severe that they lack the awareness of their illness necessary to make treatment decisions get the medical help they would have obtained if they were free of cognitive impairment. Neurobiological disorders (NBD) is a term used to encompass the most severe illnesses of the brain such as schizophrenia, bipolar disorder, schizo-affective disorder, obsessive-compulsive disorders and others that are now known to have biological origins. Assisted Treatment is commonly and inappropriately referred to as "involuntary treatment." This term is a misnomer because someone incapable of expressing his or her true will cannot be treated against it. Individuals with this level of impairment often go off the medicines that keep them from becoming psychotic, wreaking havoc on their lives as well as on the lives of those who love them. The term “Assisted Treatment” is designed to convey the thought that treatment should be given that helps, not hurts the individual. Assisted Treatment is designed to end the "revolving door syndrome" whereby individuals who are helped by medications and treatment go off them, become psychotic, get re- hospitalized, and then stabilized, only to be released and go off treatment again. Most often implemented by states via programs entitled "outpatient commitment" or "conditional release," Assisted Treatment for individuals with a history of deterioration because of medication non-compliance can take many forms: participation in consumer support groups, taking medications, attending drug counseling programs, or whatever else a particular consumer needs to stay healthy can all be required by an order of the court. Violation of the order would result in interventions designed to encourage compliance and avoid danger. Such interventions might include short-term inpatient hospitalization for treatment, visits from a community monitoring team, or "a stern talking to" from a judge. An Assisted Treatment Program provides stringent due process mechanisms, yet allows intervention before individuals become a "danger to themselves or others. Assisted Treatment is not an alternative to other forms of treatment; it is simply a way to ensure these treatments are utilized. Many individuals with neurobiological disorders resist the very medicines and treatments that allow them to function in the community and prevent their deterioration. Assisted Treatment can substantially cut the number of people suffering from disorders who are involuntarily hospitalized. Moreover to a consumer, living in the community while receiving treatment is a far preferable alternative to hospitalization. By ensuring that those most in need receive treatment, it can dramatically reduce the number of people with neurobiological disorders who are homeless, jailed, suicidal, violent and victims of violence. Its success has been proven in state after state. Assisted Treatment in New York Unlike other states, New York makes very limited use of Assisted Treatment. Involuntary intervention in New York is exceedingly difficult. Rather than assessing whether an individual is capable of understanding and acting on his or her need for treatment, current laws normally require an individual to become a "danger to self or others" before society is allowed to help. Dangerousness is too late. Moreover, even once intervention is allowed, New York laws requires a second hearing before someone who objects to care because he or she lacks insight into their illness can be treated. This second hearing (“Rivers”) is still necessary despite the obvious fact that the objecting patient has already been committed to the hospital's care. And perhaps most absurd, the only form of Assisted Treatment currently utilized in New York is Assisted Inpatient Treatment: the placing of someone in a hospital. This is the most expensive and restrictive form of treatment; it is also sometimes a less beneficial form of treatment. New York needs to make greater use of Assisted Outpatient Treatment. Assisted Outpatient Treatment gives individuals with a history of dangerous decompensation caused by medication non-compliance, the opportunity to live in the community if they agree to the treatment that prevents their deterioration. Assisted Outpatient Treatment is a much kinder, gentler, and less intrusive form of treatment than involuntary inpatient hospitalization. OUR GOAL The National Alliance for the Mentally Ill, NAMI/NYC, and NAMI/NYS all have policies calling for the availability of Assisted Treatment combined with procedural safeguards. A pilot Outpatient Assisted Treatment program is currently taking place at Bellevue Hospital and is directed by former NAMI/NYC board member, Dr. Howard Telson. Preliminary reports are that the program has been very successful. Legislation is currently being developed to expand this program statewide. It should be introduced in the first quarter of 1999. NYS Attorney General wrote legislation in January 1999 designed to improve the Bellevue Pilot program and expand it statewide. Educating the public about these issues will be the initial primary focus of the New York Treatment Advocacy Coalition. [ To Top of Page ] [ To NY-TAC Index ] Help make Assisted Treatment more readily Available A coalition of organizations and individuals in New York interested in improving assisted treatment laws in New York is being formed. If you or your organization is interested in joining, please contact the Treatment Advocacy Center by e-mail or join on-line or by regular mail: DJ Jaffe CO-coordinator NYS Treatment Advocacy Coalition 250 West 27th St., Suite 4B New York, NY 10001-5923 212 366-0527 stanleyj@psychlaws.org You must give your name, address, telephone number, and affiliation. You also must include the statement: "I (We) support reform of New York State laws to make assisted treatment, particularly outpatient treatment orders, more available to those with neurobiological disorders.” Following are some of the organizations which have called for reform of Assisted Treatment Laws in New York Greater NY Hospital Association Alliance for the Mentally Ill of NY State Citizens Crime Commission American Psychiatric Assoc. Task Force on Involuntary Commitment to Outpatient Treatment Center for the Community Interest Victims Services Agency Visiting Nurses Service Buffalo News NY Post Office of the New York State Attorney General Kenmore Residence St. Francis Residence Project for Psychiatric Outreach to the Homeless The Bridge, Inc. National Alliance for the Mentally Ill NY Society for the Deaf Concerned Citizens of Creedmoore NAMI/Metro-NYC AMI/PATH (Queens/Nassau) NAMI/Buffalo and Erie County NAMI/Familya (Rockland County) Public Employees Federation [ To Top of Page ] (Posted 2/1999)

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	The information on /newyork is provided as a public service by the NY Treatment Advocacy Coalition. For more information, to join, or to make a donation, write to NY Treatment Advocacy Coalition, Suite 4B, 250 West 27th St., New York, NY 10001 or call (212) 366-0527. To support our efforts, make checks payable to Treatment Advocacy Center. To become a free member and receive updates, please send your name, (organization's name, if any) address, phone, fax, and e-mail address to the above address, along with the following signed statement: "I HAVE RECEIVED INFORMATION ABOUT THE NY TREATMENT ADVOCACY COALITION, SUPPORT IT'S MISSION, WANT TO RECEIVE UPDATES AND BE LISTED AS A MEMBER AND SUPPORTER." Unfortunately, requests for free memberships without this information and statement can not be honored. Contents of all material on the Coalition's web site is copyrighted and rights are reserved by the NY Treatment Advocacy Coalition unless otherwise indicated. However content may be reproduced, downloaded, disseminated, or transferred by nonprofit organizations that support our mission for educational purposes if correct attribution is made to the NY Treatment Advocacy Coalition. Please feel free to call with questions on neurobiological disorders, treatment laws or the benefits of medication compliance at 703.294.6001 or 212.366.0527. Send questions via e-mail to stanleyj@psychlaws.org. Media inquiries to press@treatmentadvocacycenter.org. Technical comments on the web site (www.psychlaws.org) can be sent to Webmaster@psychlaws.org.