Kendra's Law

In 1999, New York State Enacted Legislation that provides for assisted outpatient treatment for certain people with mental illness who, in view of their treatment history and present circumstances, are unlikely to survive safely in the community without supervision. This law is commonly referred to as “Kendra’s Law” and is set forth in §9.60 of the Mental Hygiene Law (MHL). It was named after Kendra Webdale, a young woman who died in January 1999 after being pushed in front of a New York City subway train by a person who was living in the community at the time, but was not receiving treatment for his mental illness (AOT Summary).

Link to §9.60 of the Mental Hygiene Law:

http://codes.lp.findlaw.com/nycode/MHY/B/9/9.60

Kendra’s Law (New York Mental Hygiene Law § 9.60) allows courts to order certain individuals with brain disorders to comply with treatment while living in the community. This court-ordered treatment is called assisted outpatient treatment (AOT).

AOT was first proposed in New York in 1989, by families of people with serious mental illness who were concerned that current law required them to be “dangerous to self or others” before they could receive care. In 1994, NYS started a pilot outpatient commitment program at Bellevue Hospital in New York City. The three-year pilot program, recognized 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. In August 1999, New York State enacted five-year statewide legislation based on the Bellevue Pilot called “Kendra’s Law”. It provides assisted outpatient treatment (AOT) for certain mentally ill persons living in the community. The law was renewed in 2005, and again in 2010. It sunsets in 2015 (Kendra’s Law Overview).

Works Cited:

AOT Summary. (n.d.). New York State Office of Mental Health. Retrieved December 18, 2011, from http://www.omh.ny.gov/omhweb/Kendra_web/Ksummary.htm

Kendra's Law overview. (n.d.). MENTAL ILLNESS POLICY ORG.. Retrieved December 18, 2011, from http://mentalillnesspolicy.org/kendras-law/kendras-law-overview.html

The Community Mental Health Act of 1963

The Community Mental Health Act of 1963 (CMHA of 1963), also known as the Community Mental Health Centers Construction Act, was an act that was passed as part of John F. Kennedy’s New Frontier plan.  The community mental health act of ’63 helped provide federal mental health funding for community mental health centers in the United States.   

These centers were a new idea as persons with mental illness were most often placed in some form of hospital or other institution not necessarily considered to be interactive with or a part of the community or neighboring communities.

The emphasis with the CMHA of 1963 was on shifting from hospitalizations and institutions to community based housing and treatment centers aimed to help treat persons with mental illness in the community, using the community as a part of this process, rather than keeping these individuals out of the community.

While this act received “mixed reviews” and results because people were uneasy about the idea persons with mental illness in the community, it helped pave the way for providing more equal human rights for individuals with mental illness.  CMHA of 1963 helped to provided more balanced access to a sense of community and normalcy for individuals.  It helped them to feel more like people and less like patients. 

While persons with mental illness will usually require additional services such as counseling and supplemental income, moving away from institutionalization was a positive step toward helping these people rather than simply detaining them in a hospital or possibly even imprisonment. 

More information on CMHA from Duke's journal of health politics, policy and law: http://jhppl.dukejournals.org/content/9/1/1.abstract

The following video displays some treatments used for mental disorders in mental institutions during the early 20th century.

Psychiatric Care for the Mentally Ill during The Great Depression

Mental Institutions were a popular and common habitat for persons with mental illness during The Great Depression.  However, conditions in state mental institutions deteriorated as a result of Depression-era financial hardships and the resource and personnel demands of the war. Decaying physical plants and extreme overcrowding were common. (Overview of Mental Health)

Although it had come a long way from the days of simply restraining and locking away the mentally ill, psychiatric care in the 1930s was still very limited. There was essentially no treatment for schizophrenic patients, for example. Psychiatrists attempted to treat their symptoms by prescribing drugs like sedatives, which suppressed the patient's nervous system, and trying a number of different mind-body therapies. (Freeman)

There were also some new methods of treatment for the mentally ill introduced during this era.

Insulin shock and metrazol shock therapies and surgical technique of prefrontal lobotomy were developed.  Soon after, Electroconvulsive therapy replaced some of these procedures.

The original lobotomy was a medical procedure where the neural passages from the front of the brain are surgically separated from those in the back of the brain. The common result of this procedure was the patient forgetting their depressing or discouraging feelings or tendencies. This was a very delicate, time-consuming procedure that required great skill and training from the practicing surgeons. Because the lobotomy appeared to effectively alter the mental health of patients, great effort was invested into developing a more practical procedure with similar desired results. (The History of Mental Illness)

Works Cited:

Freeman, S. (n.d.). HowStuffWorks "Psychiatric Care in the 1930s". HowStuffWorks "Science". Retrieved December 2, 2011, from http://science.howstuffworks.com/environmental/life/human-biology/lobotomy3.htm

Overview of Mental Health in New York and the Nation. (n.d.). New York State Archives. Retrieved December 1, 2011, from http://www.archives.nysed.gov/a/research/res_topics_health_mh_timeline.shtml

The History of Mental Illness. (n.d.). Kathi's Mental Health Review - The Book 5150, Infantilism, BPD, Advocacy and more. Retrieved December 4, 2011, from http://www.toddlertime.com/advocacy/hospitals/Asylum/history-asylum.htm