Should The Severely Mentally Ill Be Forced to Receive Treatment?

Friday, August 02, 2013

A New York State law requires people suffering from severe mental illness to receive treatment when they are not hospitalized.

Kendra’s Law was passed by the state as a response to the death of Kendra Webdale in 1999. She was pushed to her death on a New York subway platform by a diagnosed schizophrenic man.

At least 44 other states have issued similar laws.

In the case of the New York law, a patient must have been committed to a hospital at least twice within the past three years, and must have displayed violent behaviors toward him or her self or others within the past four years in order to qualify for what’s called assisted outpatient treatment, or AOT.

AOT provides patients with a caseworker who ensures that they are attending therapy and taking their medications.

The law has caused a fair share of controversy, given that the person is forced to undergo treatment. But a new study shows that the law is not only beneficial to those who are forced into therapy, but ends up saving states money in the long-term.

Dr. Paul Appelbaum, director of the Division of Law, Ethics and Psychiatry at Columbia University’s medical school explains the law.

Margaret, whose son has been forced into assisted outpatient treatment under the law, shares her story.



Dr. Paul Appelbaum and Margaret

Produced by:

Tyler Adams


T.J. Raphael

Comments [8]


Yes, its true that kendra's attacker seeked treatment, and pataki's government cut funding and support for hosptials, ironically, so one bad apple produces laws, while I agree that drugs can be of use, doctors sometimes prescribe off-label uses of a drug, especially in children which can cause a lifetime of issues.

The problem is that one never hears the side of the "patient", the person who are supposed to hear pay lip-service. Even lawyers for the mentally ill don't do much. A patient is viewed as non-compliant if they don't medication even if they aren't really a threat or have severe disorders, the door is shut, because most doctors its there job to medicate, not deal with possible underlying issues such as family structure, counseling, etc

Does the state save money, well they have to pay for medication and court costs, folks who are on medications are zombies do they are unproductive costing folks money and society.

Jan. 09 2014 01:51 AM
Paige Eastman Dickinson from massachusetts

I wanted to share this with you all, especially Margaret...really anyone who has voices or a loved one who hears voices. I read this on the Guardian today and immediately thought of what I had heard on this program. Margaret's story of her son's and families struggles, like many others, was very moving. I wanted to come back here and share this link about Eleanor Longden's journey...please share widely and especially with Margaret. Thank you for having this story...I hope the changes in healthcare will be executed with the greatest of respect for all.

Aug. 08 2013 09:19 PM

Kendra’s Law was passed by the state as a response to the death of Kendra Webdale in 1999. She was pushed to her death on a New York subway platform by a diagnosed schizophrenic man.
Andrew Goldstein repeatedly sought treatment so it is more than ironic that he is regularly referenced as a reason for Kendra’s Law. It is one of the failures of journalism, he the easy target, the hospitals that denied him treatment passed by almost every journalist.

It did not pass by Kendra’s parents, who sued each of them...and won. Andrew’s parents did not sue. though it was they who failed him. Had he not been victimized, she would have been.

AOT: Who is selected for the program, among the many needing help, has not been discussed. One result of the program, a judge forces people to provide treatment.

“Diagnosed schizophrenic” is offensive, unworthy of PBS. “Diagnosed wish schizophrenia

Aug. 02 2013 04:25 PM

I know this topic well. There are endless facets to this topic, but what is missing is the amount of money that psychiatrist and the pharmaceutical companies make from medications for the mentally ill. Once a person is caught in the web of a court order/psychiatrist ruling he or she is forced to take a medication that may and does cause a lifetime of health problems that are worse than the degree of mental illness one may or may not have, yet, said person has no legal recourse unless he or she is wealthy. Eli Lilly has been sued many times for their drug Zyprexa which causes a plethora of lifetime health problems such a pharmaceuticals, kidney failure, heart problems and death, yet the FDA along with Congress does little or nothing to stop the manufacture os Zyprexa. Why, most likely because Congress is more interested in the investors dividends return from Eli Lilly and has a modicum concern for the mental health of a person. It is not surprising that George Bush Senior sat on the board for Eli Lilly. These people, the investors, have made billions from a drug that is worse than cocaine but unlike cocaine or heroin is legal!
A friend of mind is caught in the Zyprexa spin web. His son is court ordered to take the drug by injection. His son must be monitored for three hours after the injection in case he has trauma such as death from the injection. His son has gone from 135 pounds to over 160 pounds weight gain and may be on his way to becoming a diabetic.
His son lives in a special home. He comes and goes as he pleases. He is fully capable of any type of physical activity such biking or skiing and is fully independent, yet because of the Zeprexa he forced to take by law he is unable to motivate himself for a simple job in the work place because he unable (due to the drug) to get up past the hour of ten in the morning. The Irony of his dilemma, the father is forced to pay child support because his son who is now 24 years of age has a disability! - A disability caused by Zeprexa. In the past he has sought recourse, to wean himself off the drug in increments of three or four months with the idea that he may not have to take the drug. At present he pays a modicum of rent for his home, he receives on top of his child support which really is adult support, funds from SSI and food stamps. With this arrangement, there is no incentive for my friend's son to work, yet he wants all the good things in life paid for by his father who is now 70 years of age and retired, without out performing any type of work whatsoever. Clearly this mental health scenario is a win win for the son, psychiatrist, and the pharmaceutical companies whom are laughing all the way to the bank.

Aug. 02 2013 01:45 PM
Emily from Hollywood, Florida

My mother has suffered schizophrenia my entire life. Getting your loved on committed, even when it's life and death, is traumatic. Often they take sick patients with sheriff's department or in squad cars. At least, that's how they did it in Texas. It almost guarantees that the experience is more traumatic than it needs to be and discourages even the most desperate to seek this method again. There is no help for caregivers, and no rights, either. Until we treat severe mental illness as a potentially life-threatening disease, and stop waffling on "rights" for people who are out of their mind, we will never move forward.

Aug. 02 2013 10:41 AM
Margarette Adam from Miami, Florida

Do you know if this law also exist in Florida?

Aug. 02 2013 10:23 AM

Hi Joe, this is T. J. Raphael, The Takeaway's Digital Content Editor. Thanks for commenting! We did try to get a guest that's in AOT, but were unable to. Fortunately Margaret was able to join us—her son is in the program. Thanks for listening, have a great weekend!

Aug. 02 2013 10:15 AM
Joe from NY

One can only wonder why an inidividual under AOT was not included as a scheduled guests. Could it be as mental health consumers say, "About us, without us."

Aug. 02 2013 10:07 AM

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