Researchers at Duke found that treatment costs declined 50 percent in New York City after the first year of AOT, and another 13 percent the second year. Even larger cost savings were reported in five other New York counties. Previous studies have proven AOT dramatically improves care for people with serious mental illness who have trouble staying in treatment voluntarily.
During the year before mandated community treatment, 180 of the 520 New York City participants were admitted to a state psychiatric hospital, and 373 were admitted to a psychiatric unit at other hospitals. In the year after starting the program, 70 were admitted to a state psychiatric hospital and 245 were admitted at other hospitals. The program is especially important in states like New York and California that are closing psychiatric hospitals that serve the most seriously ill.
As hospitalizations fell, so did costs. People selected for the program had incurred, on average, more than $104,000 in mental health service costs during the preceding year. These costs declined to $59,924 per patient in New York City, and $53,683 among the other county participants, in the first year of the program. In the second year of the program, costs continued to decline, to $52,386 for the New York City participants and $39,142 for those in the counties.
In New York, AOT is called Kendra's Law. It has extensive support from families of persons with serious mental illness because it enables their loved ones to receive better care. It is also supported by law enforcement who believe it keeps patients, public and police safer. Some trade associations for the mental health industry object to being ordered by the courts to serve the most seriously ill. They also argued it was too expensive and diverted resources from people who are higher functioning. The new study should end those concerns since it makes clear Kendra's Law saves money thereby allowing existing dollars to serve more people.
California has an AOT program called Laura's Law, but California Senate President Pro Tem Darrell Steinberg has prevented Mental Health Services Act funds from being made readily available for the program. According to an interview with Carla Jacobs of the California Treatment Advocacy Coalition, the new study makes it even more imperative for the legislature and county behavioral health directors to come down on the side of persons with serious mental illness, rather than the mental health industry.
Learn more about Kendra's Law in New York and Laura's Law in California.
