Study Finds N.Y. Mental Health Program Successful, Cost Effective
A New York state program requiring certain individuals with severe mental illnesses to receive outpatient treatment has reduced mental health and Medicaid expenses by as much as 50% and has lowered hospital readmissions and arrests of such individuals, according to a study published in the American Journal of Psychiatry, the New York Times reports.
The program -- known as Kendra's Law -- was enacted after a man with untreated schizophrenia pushed Kendra Webdale to her death onto New York City's subway tracks in 1999. At least 44 other states have enacted laws resembling Kendra's Law, but New York's is "by far the most developed" as a result of significant state investments and resources, according to some experts.
The program -- which costs New York $32 million annually -- provides psychiatric treatment and monitoring services to as many as 2,500 people under court order per year. Under the program, case workers monitor the individuals, ensure that they attend therapy sessions and comply with their medication regimens. Under Kendra's Law, the state also spends $125 million annually to provide enhanced outpatient mental health services for other individuals.
For the study, researchers -- led by Duke University psychiatry professor Jeffrey Swanson -- analyzed medical costs for 634 New York residents who received court orders between January 2004 and December 2005. The researchers used annual cost data for each person over a three-year period -- the year before the court orders were issued and the two years after they were issued.
The study found that:
- Patients were less likely to return to psychiatric facilities;
- Patients were arrested less often;
- Use of outpatient treatment and refills of medications increased significantly; and
- Costs to the state's mental health system and Medicaid program declined by 50% or more.
The study also found that costs declined for patients who did meet the requirements of Kendra's Law but voluntarily used similar intensive mental health services.
Differing Opinions Persist About Law as N.Y. Extends Program Until 2017
While the study demonstrates the success of Kendra's Law, some opponents of such programs have argued that their mandated services -- known as outpatient commitment or assisted outpatient treatment programs -- impede individuals' civil liberties. In addition, the programs could increase or shift costs or services away from other individuals with mental health issues who have not been court-ordered to seek treatment, the critics argue.
However, proponents have argued that such programs compelling certain individuals to receive treatment can prevent out-of-control behaviors that can pose threats to themselves and others. Following the mass-casualty shootings in Tucson, Ariz., Newton, Conn., and Aurora, Colo., in recent years, New York lawmakers this year approved a state gun-control law that enhanced some parts of Kendra's Law and extended it until 2017, the Times reports (Belluck, New York Times, 7/30).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.