Kendra's Law for Albuquerque and N.M.?

By Mary Zdanowicz

 

In a nine-hour session last week, the New Mexico Behavioral Health Collaborative continued what the New Mexico secretary of health called an "18-month debate" over whether New Mexico's most severely mentally ill citizens would benefit from assisted outpatient treatment.

Assisted outpatient treatment, or "Kendra's Law," allows a court to order someone who meets a strict set of criteria to receive outpatient treatment. Those criteria include the inability to live safely in the community without strict supervision.

People under assisted outpatient orders in other states have experienced dramatic reductions in everything from repeated psychiatric hospitalizations to arrests, and increases in medication compliance and quality of life.

Despite other states' successes with assisted outpatient treatment, some in New Mexico's mental health community are working to defeat a proposed Kendra's Law not with logic, but with delay.

At the end of the marathon session, the problem became poignantly clear, when an audience member rose to testify that assisted outpatient treatment is unnecessary, because the problem it seeks to address is caused not by illnesses such as schizophrenia, but by a concerted government conspiracy to implant electrodes to control the behavior of tens of thousands of Americans. She was clearly distressed about the people she knew who she said had been involuntarily subjected to these implantations and other unspeakable tortures. She said she hadn't yet successfully gotten to Congress to complain.

The room was filled with state officials and mental health professionals. I expected someone to try to help her. Instead, they applauded and congratulated her on her testimony.

I looked at the national experts to gauge their reaction. After all, some of them had recently published a study finding patients with paranoid delusions, which this woman apparently had, were nine times more likely to be violent than people who have mostly negative symptoms, such as social withdrawal. They did nothing.

I am not a clinician. But many in the room had that level of expertise, and not an eyebrow was raised as she walked out of the building, alone and afraid.

At the end of hours of testimony and debate from local and national experts, legislators, researchers, practitioners, the general public and advocates of every stripe, it appeared the disappointing conclusion was that the issue needed more review.

Yet we already know assisted outpatient treatment works. Consumers - the group opponents of Kendra's Law say they want to "protect" - report an improved quality of life when asked retrospectively about assisted outpatient treatment. One of the national experts at the hearing, Marvin Swartz, testified assisted outpatient treatment can reduce expensive psychiatric "hospitalization, violence, victimization, family strain, arrests, and improve medication adherence and quality of life" for the most severely mentally ill.

So, lacking a basis for questioning assisted outpatient treatment's value, the discussion turned to whether New Mexico has resources to make it work.

This is a favorite red herring. Assisted outpatient treatment serves those who cannot ask for help. Most of this small group of people, an estimated 75 per year statewide, are already using resources - often far more than their share - in short-term hospitalizations, emergency room visits and law enforcement responses. Assisted outpatient treatment is designed to help exactly this population, make services more effective and free up resources for others.

The real question should be: Can New Mexico afford to continue without a tool such as assisted outpatient treatment? As one expert testified, without a court order, intensive services alone won't help the most severely ill patients that Kendra's Law seeks to help. There will be no significant reductions in expensive hospitalizations. Without assisted outpatient treatment, putting more money in the system for these individuals is just throwing good money after bad.

The adoption of this proven treatment mechanism - available in 42 other states - must overcome a New Mexico mental health community that refuses to take true responsibility for people who are paranoid and delusional and refuse treatment.

That task now falls to family members and, ultimately, law enforcement. Police get daily calls from families afraid of loved ones whose psychotic symptoms are worsening. Nobody is responsible for them until they become dangerous.

Instead, officers such as Albuquerque Police Department Sgt. Carol Oleksak end up on the front line. Three years ago, she was shot and severely wounded in an encounter with Duc Minh Pham. In the 10 years before Pham was killed by police after his attack on Oleksak, he was arrested at least 50 times, for everything from larceny to shoplifting. New Mexico law - still the law today - prevented him from getting proper treatment.

New Mexico's mental health community needs to finally stop talking and start acting. When New Mexico passes Kendra's Law, perhaps obsessive accusations of governmental mind-control will trigger treatment rather than applause.

More from New Mexico