Answer:
   
   Originally, halachah allowed for a get to be given without the wife's
   consent. Around a millenium ago the Ashkenazi community accepted a
   legislation by Rabbeinu Gershom that invalidates such gittin. Sefaradi
   acceptance of this law was more recent, but at this point it's
   universal practice.
   
   If the refusal is due to insanity, or in certain other situations, the
   husband can leave the get in the hands of a court and recieve a "heter
   mei'ah rabbanim"--a permission from 100 rabbis to marry a second wife,
   despite our community's ban on polygamy. Otherwise, one needs to go to
   the beit din and see what other pressures can be applied. Many states
   in the US (including NY and NJ) have a "get law". Under such a law,
   the state mandates that a judge take into account that one spouse is
   using religion to create a barrier to the other spouse's remarriage.
   The details of such a law vary from state to state. When speaking to
   the beit din, ask if they could put you in touch with a knowledgable
   lawyer.

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