New Study Torpedoes Mental Health Treatment Mandate

NEW YORK — A new evaluation of court-mandated treatment for mentally ill New Yorkers found the system’s harms outweigh its benefits.

Researchers compared the outcomes of people who were forced into outpatient mental health treatment under state law and individuals who received similar services voluntarily. In both cases, they found positive outcomes, including significant improvements in people’s ability to function, shorter hospital stays and a reduced risk of harm to others.

The people who voluntarily sought treatment were less likely to be arrested and had fewer hospitalizations for mental health issues, according to the study of Kendra’s Law, which authorizes treatment orders for seriously mentally ill people who are unlikely to voluntarily undergo care and are a danger to themselves or others.

The researchers uncovered “quite disturbing” results among people who went through assisted outpatient treatment under Kendra’s Law, according to study co-author Nev Jones, a University of Pittsburgh social worker. Dozens of participants said they were desperate for assistance and unaware of alternatives — contradicting the state’s portrayal of Kendra’s Law as a solution for people who refuse to follow treatment plans or accept services.

The findings are politically inconvenient for Gov. Kathy Hochul, who pushed the Legislature last year to expand the state’s civil commitment laws and make it easier to obtain a court order under Kendra’s Law as part of her public safety agenda.

Justin Mason, a spokesperson for the Office of Mental Health, said the report shows assisted outpatient treatment is accomplishing what it is designed to address by reducing hospitalizations and improving community safety.

“Assisted Outpatient Treatment is a small but critical component of our state’s outpatient community-based care system which helps some New Yorkers live safely and successfully within their communities,” Mason said in a statement. “We will continue to review the findings and recommendations to ensure this program continues fulfilling the key role it plays in our continuum of care.”

The study was commissioned by the state Office of Mental Health at the direction of state lawmakers, who made it a condition of reauthorizing Kendra’s Law in 2022 for another five years. The law will sunset on June 30, 2027 if the Legislature doesn’t pass another extension.

The Office of Mental Health tapped the University of Pittsburgh’s School of Social Work and the Human Services Research Institute to conduct the study. The agency buried the researchers’ 400-page report on its website this week, where it has largely escaped public notice.

The report concludes that expanding voluntary services — and providing more information about them — “could produce similar outcomes without the attendant harms” of court-ordered treatment. The researchers also recommended that the state publicly report detailed data on the court process, track outpatient capacity and establish an independent oversight body to investigate complaints about assisted outpatient treatment.

Harvey Rosenthal, CEO of the Alliance for Rights and Recovery, a behavioral health advocacy group that opposes coercive measures, said the findings indicate assisted outpatient treatment is being overused.

“AOT’s supposed to be a last resort,” he said in an interview. “This is a force-first system too often.”

The organization supports Hochul’s recent effort to standardize and expand the use of voluntary treatment agreements, enabling more people to access outpatient services without a court order. The Office of Mental Health touted the alternative in an announcement earlier this month about improvements to the program — not long before the AOT evaluation’s quiet release.