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Treatment Advocacy Center

STATEMENT

By Executive Director, Mary T. Zdanowicz, Esq.


FOR IMMEDIATE RELEASE
April 5, 1999

CONTACT:

703 294 6008 or [email protected]

New York Must Pass "Kendra’s Law" to Prevent Future Episodes of Violence by Individuals With Untreated Severe Mental Illnesses

Arlington, VA – Kendra Webdale should not have lost her life under a New York City subway train, and Andrew Goldstein, her attacker, should not have been allowed to remain in the community without proper treatment and monitoring of his brain disease. The horrific incident that occurred in January at the 23rd Street and Broadway subway station tragically reflects the deadly pattern of what happens when schizophrenia and manic-depressive illness – the two severest forms of mental illness – are allowed to progress untreated.

Mr. Goldstein was hospitalized on six separate occasions in 1998 for his schizophrenia, and was released from his last hospital stay only three weeks before his deadly encounter with Ms. Webdale. Upon each hospital release there was no means of guaranteeing he would continue taking his medications, which would have ensured that his mental stability did not deteriorate following his discharge to the community.

New York must swiftly pass "Kendra’s Law," announced in February by Attorney General Eliot Spitzer, to reverse this deadly trend and improve the quality of life for all New Yorkers. "Kendra’s Law" would prevent individuals like Mr. Goldstein from spinning endlessly through the revolving door of hospital admissions and readmissions, only to be abandoned to the streets with no follow-up care.

One of the most effective means of ensuring that those who have serious brain disorders remain in treatment is the use of outpatient commitment (OPC). At least 39 states now use some form of assisted treatment to substantially improve the lives of those suffering from severe mental illness and enhance the communities in which they live. "Kendra’s Law," would make OPC available statewide for those individuals with severe psychiatric disorders.

Long-term OPC has shown repeatedly to be more effective in improving outcomes for severely mentally ill individuals than routine outpatient care. For example, among patients who had been outpatient committed in Arizona, 71 percent voluntarily maintained treatment contacts six months after their court orders expired compared to almost none of the patients who had not been put on outpatient commitment. A study in Iowa showed that 80 percent of patients in outpatient commitment complied with their treatment programs. After their outpatient commitment term expired, some three-quarters of that group remained in treatment on a voluntary basis.

A recent study of New York’s Bellevue Hospital OPC pilot program revealed that individuals who received court ordered treatment in addition to enhanced community services spent 57 percent less time in psychiatric hospitals than individuals who received only enhanced services. During the 11 months of the study, individuals who had both court ordered treatment and enhanced services spent only six weeks in the hospital, compared to 14 weeks for those who did not receive court orders.

Nearly half of those individuals who have schizophrenia or manic-depressive illness, the two severest forms of psychiatric illness, have no awareness of their disease. They do not recognize that the symptoms of their illness – hallucinations, delusions, paranoia and withdrawal – are, in fact, symptoms. These individuals consistently refuse to take medication because they do not believe they are sick, and commonly will only take it under some form of assisted treatment.

Mandatory treatment for those too ill to recognize their need for treatment is a much more humane intervention than what we have now: mandatory non-treatment. The legal standard for assisted treatment should be the need for medical care, not dangerousness. Society has an obligation to save people from degradation, not just death.

This does not mean that we will have to reopen all the psychiatric hospitals that have closed as a result of deinstitutionalization. Most individuals with severe mental illnesses who have experienced severe deterioration in rational thought can live in the community. But, their living in the community should be conditioned on continued medication compliance. OPC, conditional hospital releases, and conservatorships must be widely used to ensure that discharged patients continue to take their medication.

Mr. Goldstein should not be sitting in a jail cell today awaiting trial, and possibly facing a life behind bars. Ms. Webdale, a young woman with a promising future, should be fulfilling her dreams and ambitions. Both of these individuals should be living their lives to fullest in a system that protects and balances the rights of all its citizens. "Kendra’s Law" would help prevent such tragedies in the future and give every New Yorker the chance of living a safe and productive life.

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The Treatment Advocacy Center (www.treatmentadvocacycenter.org) is a national nonprofit organization dedicated to eliminating barriers to the timely and effective treatment of severe mental illnesses. TAC promotes laws, policies, and practices for the delivery of psychiatric care and supports the development of innovative treatments for and research into the causes of severe and persistent psychiatric illnesses, such as schizophrenia and bipolar disorder.

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