By Ali Watkins

Nearly two decades ago, in a Manhattan subway station, a mentally ill man shoved Kendra Webdale, a promising young writer, to her death in front of an oncoming N train.

It was a horrific crime that shocked the city and the nation, highlighting deep flaws in the care of seriously mentally ill people and spurring a wave of state laws that use court orders to move them into outpatient treatment.

Last week, the man who killed Ms. Webdale, Andrew Goldstein, now 49, who has had schizophrenia since his youth, walked out of prison and into a mental health system that has been heavily influenced by his crime.

But whether those reforms have fundamentally improved that system — or just patched it over — remains an issue of intense debate among lawmakers, doctors and other mental health specialists. The so-called Kendra’s Law program in New York, for example, is considered to be successful when it is used. But advocates and critics alike say it is underutilized and underfunded.