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Racial Disproportion Seen in Applying 'Kendra's Law'

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http://www.nytimes.com/2005/04/07/nyregion/07kendra.html?

By MICHAEL COOPER
Published: April 7, 2005

ALBANY, April 6 - After Kendra Webdale was killed in 1999 by a schizophrenic young man who pushed her into the path of an approaching subway train, the state passed a law giving judges the power to force the mentally ill to comply with treatment.

State officials say the statute, known as Kendra's Law, has been a great success, and Gov. George E. Pataki wants to make it permanent when it comes up for renewal in June. But an analysis of state data by a group that opposes its compulsory-treatment provision found that the law has been disproportionately applied to black New Yorkers.

The group, New York Lawyers for the Public Interest, concluded that blacks were nearly five times as likely as whites to be the subject of court orders stemming from Kendra's Law. Examining court orders for treatment that have been issued since the law took effect, the group found that 42 percent of the 3,958 orders for treatment were invoked against blacks, who make up 16 percent of the state's population, while 34 percent of the orders applied to whites, who make up 62 percent.

"It's important to know if our mental health policy is disproportionately taking away the freedom of groups of people who have historically been oppressed," said John A. Gresham, the senior litigation counsel for the group, a research and advocacy organization.

Jill Daniels, a spokeswoman for the state's Office of Mental Health, said that it was misleading to compare the race and ethnicity of those being treated under Kendra's Law with the race and ethnicity of those in the general population, and that the proportions were similar to those for adults receiving intensive care in urban areas.

Mr. Gresham's group is releasing the report this week because the State Assembly is planning to hold its first hearing on the law on Friday.

Under Kendra's Law, the courts can order mentally ill adults to receive outpatient treatment if nonadherence to past treatments resulted in hospitalizations or in violence toward themselves or others. If the court-ordered course of treatment is not followed, the patient can be involuntarily hospitalized.

A report issued last month by the Office of Mental Health cited reports by case managers that patients ordered into outpatient treatment under Kendra's Law were less likely to try to harm themselves or others, destroy property or create disturbances at the end of their treatments.

The concept of compulsory treatment has long been controversial. Last year the state's highest court, the Court of Appeals, upheld the law in a 6-to-0 vote. "The state's interest in immediately removing from the streets noncompliant patients previously found to be, as a result of their noncompliance, at risk of a relapse or deterioration likely to result in serious harm to themselves or others is quite strong," Chief Judge Judith S. Kaye wrote.

Mr. Gresham said that given the inequalities shown in his data, the parts of the law allowing the courts to compel treatment should be eliminated, while those providing greater access to mental health services should be kept. But other advocates warned against eliminating the forced treatment.

"That would gut the law," said J. David Seay, the executive director of the National Alliance for the Mentally Ill of New York State, an advocacy group that wants Kendra's Law to be extended permanently, and strengthened to make it easier for families to petition the courts to issue orders.

Mr. Seay added that his group would like to see the law applied more evenly throughout the state.

The question of what the numbers meant was the subject of debate on Wednesday.

Mr. Gresham pointed to state data showing that, even compared with demographics of who is served by the public mental health system, blacks are disproportionately subjected to court orders under Kendra's Law. But state mental health officials noted that those figures included children, who are not covered by Kendra's Law, and that the figures were comparable to recent studies of adults served by the system.

Mental health advocates and city and state officials cited possible explanations for the disparity. Some noted that more than three-quarters of the court orders had been issued in New York City, which has a large black population. But Mr. Gresham said that even within New York City, blacks were the subject of a disproportionate number of court orders.

Others suggested that blacks and Latinos with mental illness might not have access to needed mental health care early on, making them more likely to find themselves in the kinds of crises that lead to interventions.

Whatever the reason, officials said it merited study. "It's very troubling," said Councilwoman Margarita López, chairwoman of the Council's Committee on Mental Health.

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