N.Y. Law Raises Issues of States' Reach in Patient Care

The statute was accompanied by $32 million a year in state funding, much of it for medication and more caseworkers.

The law also affects a small population. Last year, about 1,800 New York residents fell under its guidelines at any given time, out of more than 400,000 mentally ill adults in the state, New York state health officials said.

"You have to consider the increase in services. It's not a slam-dunk to say that just because of the law itself, we have these better results," said Peter Beitchman, a longtime advocate for the mentally ill in New York City.

As opponents of the law have said, Andrew Goldstein, the schizophrenic man who pushed Webdale, had been denied outpatient services before the incident. He was told that there was no room for him at local treatment centers.

The issue of forced outpatient treatment resonates in Virginia because of the Virginia Tech shootings. Cho had been given an outpatient treatment order 16 months before the rampage. But it was never enforced by the local community services board or Virginia Tech's counseling center, and it was never specified which one was required to do so.

"Sometimes, those that need mental health treatment don't know they need help," said state Sen. Henry L. Marsh III (D-Richmond), who has unsuccessfully submitted bills like Kendra's Law in previous years and will do so again next month. Marsh will be chairman of the Senate Courts of Justice Committee next year, which will consider the legislation.

Staff writer Tom Jackman contributed to this report.

Virginia is going through an unprecedented examination of its mental health system after the slayings at Virginia Tech. This is one in an occasional series of reports about problems in the system.