The Nightmare Fallout of Kendra's Law

The idea is not necessarily a bad one. There's no denying that some people should be under constant supervision, whether in or out of the hospital. Pundits always bring up the case of "The Wild Man of 96th St."?and more recently of Paris Drake, who smashed Nicole Barrett's skull with a paving stone. I remember a case in Philadelphia where a patient was released from an institution despite the protests of his family. Two hours after being released, he took off his clothes, jumped in a river and drowned. Granted, mental hospitals are overwhelmed these days, despite the efforts to empty them out?but some people simply need lifelong care. The problem with this new law, however, is that some of us don't.

Now, to be blunt, I've been institutionalized twice. The last time was 13 years ago, in 1987. These days, I'm a...well, okay, I wouldn't say "productive member of society," but I've got a job and an apartment. I pay my taxes. I get by. I haven't been bothered by the police in quite some time. Still, let's say something happens?a simple public drunkenness charge or the like. Do I then run the risk of being forced back into an institution, or into a lifelong AOT program or, worse, forced to ingest some sort of unnecessary psychotropic medication to keep me under control? Could I be forced onto lithium or thorazine, even though I'm right as rain?

It seems improbable, if not impossible. But it's not.

"It's an extremely dangerous law," says Constance Lesold, of the Brooklyn Mental Hygiene Court Monitors Project. The project, as the name implies, monitors the hearings at Brooklyn's Mental Health Court, just to make sure that cases are being handled fairly on behalf of those patients trying to earn their freedom from psych wards. "In my opinion, the decisions in [the court] have changed rather dramatically since Kendra's Law passed. They don't even have to implement the law for it to have a tremendous effect. So far, the law has not been implemented very much?but I understand that that's because people are still hiring staff in the various boroughs."

Lesold says she's seen several instances of people?people with no history of psychiatric trouble?who've found themselves locked away in state hospitals after the slightest brushes with the law.

"A woman in my own neighborhood had been in an argument with a businessperson," Lesold told me. "It was near closing time. There was no physical interaction?it was just a verbal argument. The police were called. The woman is small and usually very well dressed, but that day she had gone downtown not all that dressed up. The police arrested her and, from my understanding, onlookers did try to intervene to no avail. They...took her directly to a precinct, not a hospital... They later took her to a hospital, where they knocked her out. This business of taking people to emergency rooms and [knocking them out], I do not like. They did a lot of testing on her without her consent... She was taken to Rikers Island, charged with resisting arrest. She...got sent from Rikers to Kingsboro [Psychiatric Center] in Brooklyn for long-term care for arguing with her drycleaner. You don't have to have Kendra's Law to have what I consider very questionable uses of psychiatry. This is pretty scary."

One of the first problems here is that the NYPD, according to Lesold, teaches its cadets that the definition of "mental health" is "the ability to integrate into your community." So where does that leave the rest of us? Another problem she cites?especially for those cases she was telling me about?lies with the hospitals themselves."Hospitals are very dangerous places," she said, "particularly after you have stood up in court and told them that you're going to sue them for all they're worth. They're going to be looking for any infractions."

Lesold spent much of last summer in Albany, campaigning against the passage of the law. She was shocked when it was passed almost unanimously.

"When it passed," she said, "it was a real blow to all the efforts that have gone on for years to build up peer programs and all kinds of other programs. You don't have to pass Kendra's Law to pass laws to provide more housing."

One of the more frightening aspects of the law's passage, as Lesold sees it, was its political nature. Attorney General Eliot Spitzer "comes from the Upper East Side of Manhattan, where most of the support for this bill comes from," she explained. "In my opinion, ordinary citizens from around the city still don't know anything about Kendra's Law and could care less. For the most part they're not feeling threatened by people who are mentally ill. But that is not true of people on the Upper East Side. They seem to feel threatened by most everything. That was the only geographic region of the city that showed up for the hearings on the Bellevue Project, to testify about how important it was to have forced outpatient psychiatric treatment. I think he [the Attorney General] saw this as a golden opportunity for future political advancement and a chance to make contacts upstate."

While all that was going on, she told me, the experts?the psychiatrists themselves?were swallowed up by the system.

"I think that what happened in New York is a tragedy, because the people who are the real leaders in this field, who have had the experience of being in a psychiatric facility, and who really wanted to try and create better ways of helping people, a lot of them went to work for the state and the city. And this law caught them by surprise. In a way, the leadership had been taken out. It's really sad. They seem to be staying on the job?they don't seem to be running away from their state and city jobs. I myself considered leaving the state entirely, because I was so horrified and disgusted."

There is still debate and dissension within the psychiatric community over Kendra's Law, Lesold says. A majority?especially those in administrative positions?are opposed to it.

What's more, she argues, if these psychiatrists don't want to have their very livelihood yanked out from beneath them in the future, they may well want to think about fighting back. As Lesold puts it, "If you're just going to give somebody a pill, then you don't need a psychiatrist. You can cut out the middleman."

I eventually brought up my own situation?that is, my history of psychiatric hospitalization?and asked if she thought I had anything to worry about. She began to assure me that I didn't?that Kendra's Law only applies to people who've been institutionalized within the past three years, or within the past four years if there was a history of violent behavior. Then she thought a second. "I must say that if you've had two hospitalizations at any time in your life, you're very vulnerable to ordinary psychiatric hospitalization if anybody takes a disliking to you. Just be aware of that."