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Office of Mental Health

Kendra's Law: Final Report on the Status of Assisted Outpatient Treatment

The Preamble to Kendra’s Law states that the intent of the act is to “amend the mental hygiene law in relation to enhancing the supervision and coordination of care of persons with mental illness in community-based settings by providing assisted outpatient treatment.” This Final Report illustrates the degree to which the State of New York has successfully fulfilled the intent of the legislation. Since Kendra’s Law was enacted in August 1999, the State has responded in ways which suggest that the intent of the legislation is being realized. Since 1999, 10,078 individuals have been referred for a potential court order. As of December 31, 2004, 3,766 individuals have received services under an AOT order and an additional 2,863 have received service enhancements as a result of referral for a potential court order.

The local monitoring and oversight systems which are responsible for the administration of the AOT program operate under standards and guidelines set forth by OMH. Development and refinement of these standards and guidelines are part of the State’s commitment to continual review of program performance and quality improvement. Areas which have been the subject of standardized State policies include the dissemination of clinical risk information, specific policies on the coordination of care, review of residential placements for AOT recipients, and uniform procedures for the reporting of unexplained program and residential absences. Because State and local governments continually monitor the AOT program, management strategies to promote quality are ongoing.

Programmatic improvements are, however, only part of this AOT Final Report. It is the people who have used the program successfully who matter most when summarizing the results of this legislation. People in AOT have been able to improve their involvement in the service system as a result of their participation in the program, and by doing so, they have improved their lives. There has been an 89% increase in use of case management services among AOT recipients, and substantial increases in utilizing both substance abuse and housing support services. There have also been significant improvements reported in self care and community functioning and a 44% decline in the incidence of harmful behaviors (e.g., suicide threats, self harm, and harm to others).

For the people who have benefited from participation in services mandated under an AOT order, these positive outcomes are more than statistics; they are tangible evidence that the system of care has been responsive to their needs. These are individuals who, without Kendra’s Law, had limited experience of success in using mental health services. Over a three year period prior to their AOT order, almost all (97%) had been hospitalized (with an average of three hospitalizations per recipient), and many experienced homelessness, arrest, and incarceration. During participation in the AOT program, rates for hospitalizations, homelessness, arrests, and incarcerations have declined significantly, and program participants have experienced a lessening of the stress associated with these events.

This Final Report on the AOT Program demonstrates that program participants are able to make gains in their recovery process and maintain them over the duration of their AOT participation and beyond. All AOT recipients receive benefits from case management or ACT services, and from the local systems of monitoring and oversight which have been created in response to the legislation. OMH recommends that Kendra’s Law be extended permanently so these benefits can continue to be provided to those New Yorkers who require the support afforded to them through an AOT order.

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