Aided Outpatient Treatment Laws

Aided Outpatient Treatment Laws

Over a long time, mentally ill persons would occasion damage and harm in the community, and nothing would be done to rectify the menace. The dying of Kendra and Laura agitated the people of New York and California to legislate on matters of assisted outpatient treatment (AOT) to monitor mentally ill persons in society. Laura’s Law is the first law that was legislated on involuntary medication of mentally ill persons. Kendra’s Law and Laura’s are much familiar than they distinctively appear. In this study, the researchers outline the circumstances under which a court order to the effect of AOT can be issued, the people who can petition the court to issue such order, and what may happen if an individual fails to obey the court order. Toward the end of the study, there is a comparative study on what other researchers have come up with concerning the effectiveness of involuntary medical treatment.
Key Words:
Assisted outpatient treatment, civil commitment to hospitalization, Kendra’s law, Laura’s Law
The state of New York legislated a law in 1999 commonly referred to as the Kendra Law to guide on assisted outpatient treatment (AOT) (Geller, 2006). Overtime the law has been reviewed to fit the changing circumstances. Kendra law is targeted at individuals who are mentally ill and are unsafe in the community if left unsupervised. Kendra’s law establishes a procedure on how to obtain AOT orders and the type of treatment to be given to a patient (Geller, 2006).

An individual who is to be placed under AOT is examined by a physician who helps to develop a treatment plan. Before the court can give orders for AOT, all evidence that can help the court in making a decision is presented. A court is moved by way of a petition by any member of society, with locus, of proximity to the mentally ill individual (Geller, 2006). If the court is satisfied that the tabled evidence is enough to warrant the issuance of an AOT order, the court issues the same to the director of community service who is to oversee the treatment of the individual. Where an individual disobeys an AOT order, the physician or director of community services will arrange for involuntary admission to hospital of the mentally ill individual (Geller, 2006).
Kendra’s Law and Laura’s Law are not any different regarding their application to the people of the respective states (Geller, 2006). Laura’s law applies to the same individuals that Kendra does given that Kendra’s Law was the first law in the USA on AOT thus all other laws borrow heavily from New York laws on AOT. In California, there are respective offices that oversee the implementation of Laura’s Law. Laura’s law demand that it is implemented as it is by the counties whereas Kendra’s law gives the counties a choice of implementing or not (Geller, 2006). Kendra’s law does not apply to the whole of California, but Laura’s law does apply to the whole of New York (Geller, 2006). Another major difference is Laura’s law developed before Kendra’s law hence there is much borrowing by the latter from the former (Geller, 2006).
Under the New York Law of AOT, the circumstances under which an order for AOT can be issued are the individual must be of 18 years or older and such a person suffers from mental illness. There must be a possibility that such a person is unlikely to conduct him/herself in society without harm thus need for supervision (Geller, 2006). Citing of previous noncompliance with treatment for mental illnesses can help the court in reaching a decision on AOT.
A person aged 18years or older can petition the court to give an AOT order if the petitioner believes that the subject of the petition meets the requirement for assisted outpatient treatment (Geller, 2006). However, the petitioner must move the court with evidence and an affidavit from a certified physician.
The court will only give an order for assisted outpatient treatment if a physician appointed by the relevant authorities develops a treatment plan and presents the same to the court. The treatment plan should be detailed to the tinniest of details such that the facility to provide medical care has no discretion on the treatment to provide but to follow the laid out procedure. Court orders are mandatory hence the subject of the petition must obey what the court orders. A physician tasked with the care of a mentally ill patient can notify the relevant officers about the patient’s behavior such that the patient can get hospitalized to receive forced treatment.
Under the law of Kendra and Laura a person in ordered to outpatient involuntary treatment initially pending physicians report on the progress of the treatment. Where the patient chooses to disobey or he/she is mentally disturbed to be able to obey the order, civil commitment to involuntary hospitalization is recommended (Ip et.al., 2008). For a person to be committed to involuntary hospitalization, the physician, and the court must have the belief that it is for the patient’s best interest (Ip et.al., 2008). People who are committed to civil involuntary hospitalization are people who are at risk of getting hurt or causing harm to the community whether under supervision or not (Ip et.al., 2008). If a physician believes that a patient’s condition has degenerated to the extent that the patient needs hospitalization, the relevant authorities are informed. It is the relevant authorities that can move the court to grant a civil commitment to hospitalization order.
Civil commitment has received several comments either criticizing the initiative or applauding AOT (Brooks, 2007). Despite the many counter-arguments against AOT, it is the belief of the writer that AOT has proved to be effective. AOT in the form of need-for-treatment has contributed to lowered rates of homicide. In a 2011 study, state commitment to offers AOT contributed to lowered standards of homicide. Ridgely, Borum, and Petrila (2001) have proved that patients who undergo voluntary mental care are better placed to recover fully than those who get themselves in civil commitments to hospitals. However, in another setting sustained outpatient commitment order of more than 180 days makes patients increase their treatment adherence hence reduced negative outcomes (Ridgely, Borum & Petrila, 2001). To achieve reduced recidivism extended monitoring and intensive mental health care is needed. Holding up of mentally ill persons in hospitals may be condemned by civil rights activists, but it is a course worth chasing. Studies are being conducted to establish other methods that can be equally beneficial to the community apart from court-ordered treatments (Brooks, 2007). However, community initiatives come late after the damage has been occasioned; like it happened before the legislation on Laura and Kendra.

References
Brooks, R. A. (2007). Psychiatrists’ opinions about involuntary civil commitment: Results of a national survey. Journal of the American Academy of Psychiatry and the Law Online, 35(2), 219-228.
Geller, J. L. (2006). The evolution of outpatient commitment in the USA: from conundrum to quagmire. International journal of law and psychiatry, 29(3), 234-248.Ip, R., Legosz, M., Ellerman, Z., Carr, A., & Seifert, N. (2008). Mandatory Treatment and Perceptions of Treatment Effectiveness.Ridgely, M. S., Borum, R., & Petrila, J. (2001). The effectiveness of involuntary outpatient treatment: Empirical evidence and the experience of eight states. RAND.