This case involves the constitutionality of an involuntary outpatient commitment ("IOC") law that can operate to violate a mentally ill patient’s right to direct his own treatment without risk of detention. In 1999, New York became the 37th state to enact an involuntary outpatient commitment ("IOC") law. Enacted as § 9.60 of the Mental Hygiene Law, the New York IOC law is commonly referred to as "Kendra’s Law." Involuntary outpatient commitment orders under Mental Hygiene Law (MHL) §9.60 ("IOC" orders) typically involve judicial decrees that compel the administration of psychotropic drugs and require participation in other mental health services. These orders subject presumptively competent individuals to a highly intrusive invasion of personal liberty and bodily integrity. A § 9.60 order may involuntarily compel medication, therapy, rehabilitative services and blood and urine testing. None of the subjects of these orders have been adjudicated incapable of making treatment decisions, and many are in fact competent to decide for themselves. In addition, an individual who is deemed non-compliant with the provisions of the order is subject to summary arrest and a 72-hour period of detention in a psychiatric facility, during which time the person is evaluated as to whether he or she may meet the standards for involuntary commitment under various other provisions of the Mental Hygiene Law.
The NYCLU has participated, as amicus curiae, with The Bazelon Center for Mental Health Law, New York Lawyers for the Public Interest, and Disability Advocates, in the Mental Hygiene Legal Service’s challenge to the statute – first at the invitation of Supreme Court, Queens County and then at the Appellate Court, Second Department and the New York Court of Appeals. In its submissions to the courts, the NYCLU and amici advanced two arguments: first, if § 9.60 is not construed to require a finding of incapacity before an involuntary outpatient commitment order may be issued, it must be found unconstitutional under Rivers v. Katz, 67 N.Y. 2d 485, 496 (1986), a New York Court of Appeals case upholding the right of a competent but mentally ill person to direct the course of his or her medical treatment; second, under the Fourth Amendment, there must be probable cause to believe that an individual has become dangerous to oneself or others before he or she may be seized and confined for a 72-hour hospital evaluation pursuant to MHL §9.60(n). In a unanimous decision dated Feb. 17, 2004, the New York Court of Appeals rejected both challenges to the statute. In doing so, the Court held that Mental Hygiene Law § 9.60 does not authorize forced medical treatment, but as to the detention for refusing treatment, the Court concluded that no further process is due a recipient of an IOC order prior to the execution of a §9.60(n) detention order.
The Court reasoned that the risk of an erroneous deprivation pending the limited period during which an examination must be undertaken to determine whether a persistently noncompliant patient is in need of involuntary care and treatment is minimal and outweighed by "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."
State Supreme Court, Queens County, Index No. 500748-00 (amicus)