Assisted outpatient treatment was first proposed in New York in 1989 as a way to help individuals with brain disorders who suffer because their illness prevents them from accepting treatment. In 1994 the New York City chapter of NAMI convinced the New York legislature of the need for assisted outpatient treatment. The legislature established a watered-down, three-year pilot program, recognizing that "some mentally ill persons frequently reject the care and treatment offered them on a voluntary basis and decompensate to the point of requiring repeated psychiatric hospitalizations."

The statutory authorization for the Bellevue pilot program was scheduled to expire June 30, 1999. The New York Treatment Advocacy Coalition (NYTAC) was formed in late 1998 to mobilize support for both extending the pilot program and to make assisted outpatient treatment available statewide. DJ Jaffe, Treatment Advocacy Center Board member and long-time advocate for individuals with neurobiological disorders, is NYTAC's coordinator. Jonathan Stanley, Treatment Advocacy Center Assistant Director, serves as the NYTAC liaison. DJ, Jon, and NYTAC members were tireless in their efforts.

As the new year approached, it was not clear that New York legislators had the political will to extend assisted outpatient treatment. All of that changed on January 3, 1999, when Kendra Webdale, a beautiful, vivacious, 32-year-old woman was pushed to her death in front of a New York subway train by a man with untreated schizophrenia. Her family explained that, "Kendra was the kind of person who would have tried to help the kind of person who pushed her."

Immediately following the incident, New York's newly elected Attorney General, Eliot Spitzer, contacted the Treatment Advocacy Center. He was seeking a means of helping both individuals with brain disorders and the communities where they live. The Treatment Advocacy Center recommended that the Attorney General pursue passage of a comprehensive assisted outpatient treatment law for New York. On January 28, 1999, the Attorney General announced his proposal for statewide assisted outpatient treatment and acknowledged the assistance provided by the Treatment Advocacy Center in crafting the bill.

The Treatment Advocacy Center also partnered with Kendra Webdale's family, who, as a tribute to Kendra, were seeking a way to improve the quality of life for individuals who suffer from severe mental illnesses and their communities. They enthusiastically supported the bill and allowed it to be named "Kendra's Law."

As if Kendra's death was not enough to demonstrate the need for assisted treatment, more tragedies soon followed.

On April 6, 1999, Charles Stevens, a 37-year-old man with untreated schizophrenia, wearing fatigues and wielding a sword, was shot eight times by police on a Long Island Railroad train. Remarkably, he lived.

On April 28, 1999, Edgar Rivera, a 36-year-old father of three young children, was pushed in front of a subway train by a man with untreated schizophrenia. Mr. Rivera lived, but lost part of his legs. Mr. Rivera, like the Webdales, showed compassion for his assailant. At the hospital he said "I have no legs, but at least I have my mind. This guy doesn't have that. I think I'm ahead."

The Treatment Advocacy Center approached the Rivera and Stevens families and found that they, too, enthusiastically supported Kendra's Law. Kendra Webdale's family, Charles Stevens' family, and Edgar Rivera and his family joined forces with NYTAC and the Treatment Advocacy Center to advocate for Kendra's Law. The Center for the Community Interest also played a vital role in the campaign.

From then on, momentum for passage started building.

The families set out on meetings with newspaper editorial boards, reporters and legislators. While support from the conservative media was expected, support from New York's more liberal media was not. Major breakthroughs occurred when the New York Times and Newsday, two liberal publications, joined conservative publications like the New York Post and Daily News in support of Kendra's Law. In fact, New York's six largest newspapers all enthusiastically supported Kendra's Law. The numerous letters written by NYTAC members no doubt contributed to this success.

The Webdale family arranged meetings with Republican Governor George Pataki's counsel and invited the Treatment Advocacy Center to attend. Following the meetings, Governor Pataki joined the effort to pass Kendra's Law. Democratic Assembly Speaker Sheldon Silver announced his support of Kendra's Law with Attorney General Spitzer in a press conference on May 19, 1999, and invited the Stevens, the Webdales, and the Treatment Advocacy Center. The same day, Governor Pataki introduced a slightly different version of Kendra's Law.

The slight differences in the bills provided an opportunity for opponents to try to divide and conquer. A further complication was that the legislature became engaged in a protracted battle over the state budget. However, the Treatment Advocacy Center, NYTAC members, the Webdale, Stevens and Rivera families kept the pressure on and continued to build its coalition. In June the New York State Association of Chiefs of Police passed a Memorandum in Support of Kendra's Law.

The efforts culminated on August 3, 1999, when Treatment Advocacy Center staff, the Webdales, and Mr. Rivera traveled to Albany to hold a press conference to beseech the Governor and the legislature to enact Kendra's Law. Shortly before our press conference was scheduled to begin, the Governor announced that a political agreement to pass Kendra's law had been reached. One hour later, Governor Pataki and leaders of the State Senate and Assembly held their own press conference announcing that they reached an agreement to pass Kendra's Law. The bill subsequently passed the legislature by an overwhelming majority (Senate 49-2/Assembly 142-4) and was signed into law on August 9, 1999.

The efforts to pass Kendra's Law shed light on the failures of the mental illness treatment system in New York. As a result, Kendra's legacy is even more than bringing assisted outpatient treatment to New York.

On November 9, 1999, Governor Pataki announced that he is halting the decades-old failed deinstitutionalization policy in New York. The Governor proposed infusing an additional $125 million in the budget for community-based services, of which $52 million is earmarked for assertive community treatment, and $20 million will create 2,000 new supervised housing units. This brings the Governor's total commitment for increased budget allocations this year to $420 million for community treatment, supervised housing, and implementation of Kendra's Law. The Governor is also suspending the push to eliminate 2,300 of New York's existing 6,000 inpatient psychiatric hospital beds (down from 96,664 beds in 1955).

It is sad that years of efforts by relentless mental health advocates like DJ Jaffe to secure the benefits of assisted outpatient treatment for citizens with severe mental illness had previously yielded such meager results. It is also discouraging that tragedies and concerns about public safety became the catalysts to make Kendra's Law a reality. However, it is a lesson about the importance of advocating outside the traditional mental health arena and involving those with an interest in public safety and the victims of untreated mental illness. The bill clearly would not have passed had it not been for Attorney General Eliot Spitzer, the Webdales, the other families, the Center for the Community Interest, and the Treatment Advocacy Center.

In the end, Kendra's Law will benefit individuals with severe mental illnesses because treatment will finally be accessible to those who need it most. Achieving that goal is the only hope of ending the senseless tragedies that make headlines; the ones that are responsible for creating stigma against individuals with brain disorders. It is the first real prospect of a better quality of life for individuals who are most ill with these devastating diseases of the brain.

[Note: Visit the Treatment Advocacy Center's online press kit for copies of news articles, press releases, and resources including a copy of Kendra's Law and the Treatment Advocacy Center's summary A Guide to Kendra's Law.]