Objective-This study examined whether assisted outpatient treatment (AOT) under New York's "Kendra's Law" is associated with reduced arrests for violent and nonviolent offenses.Methods-Arrest records of 183 study participants attending outpatient clinics in New York City, 86 of whom were ever and 97 of whom were never assigned to AOT, were compiled to yield 16,890 months of observation. For each month the data indicated whether an arrest did or did not occur and whether a participant was or was not assigned to AOT. Generalized estimating equations and fixed-effects analyses were used to compare arrest rates within different periods (before, during or shortly after, and more than six months after) for those ever assigned and between the ever-and never-assigned groups.Results-For those who received AOT, the odds of any arrest were 2.66 times greater (p<.01) and the odds of arrest for a violent offense 8.61 times greater (p<.05) before AOT than they were in the period during and shortly after AOT. The group never receiving AOT had nearly double the odds (1.91, p<.05) of arrest compared with the AOT group in the period during and shortly after assignment.
Conclusions-Outpatient commitment under Kendra's Law in New YorkState is associated with a reduced risk of arrest. The coercion necessitated by application of the law may forestall, at least for some people, the potentially more potent and consequential coercion they would have experienced in the criminal justice system.
DisclosuresThe authors report no competing interests.
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Author ManuscriptDetermining whether court-ordered psychiatric outpatient commitment reduces arrest among people with mental illnesses is critically important for multiple reasons. Arrest is a devastating experience for individuals and their families, and its societal costs are enormous (1). Further, given the intense debate about outpatient commitment, it is important to assess whether legally mandated outpatient treatment forestalls the subsequent and even more noxious forms of coercion that arrest brings. This possible trade-off of a milder form of coercion for a more severe one could represent useful information in considering the value of outpatient commitment.New York State established outpatient commitment in 1999 through Mental Health Law 9.60 (known as "Kendra's Law"), under which court-ordered assisted outpatient treatment (AOT) could be mandated for certain individuals with mental illness and a history of multiple hospitalizations or violence toward self or others. Specific legal criteria are required for an assignment to AOT, including a judgment based on a history of treatment noncompliance whereby the individual is considered unlikely to voluntarily adhere to treatment and has a high likelihood of benefiting from mandated treatment. Individuals entering AOT are assigned a case manager and prioritized for enhanced services that include housing and vocational services.There are several reasons why outpati...