Wednesday, March 19, 2014

Is Assisted Outpatient Treatment (Laura's Law, Kendra's Law) "Forced Treatment"?

Someone suggested Assisted Outpatient Treatment (AOT) is "Forced" Treatment (and therefore presumably bad).

1. Describing AOT as "forced treatment" demonstrates a misunderstanding. AOT, by definition, is only used after voluntary treatment fails. They serve mutually exclusive populations. For those individuals who won't access voluntary treatment, perhaps because they are too psychotic or have anosognosia, AOT is a way to reduce forced treatment. It is the last off ramp before patients are put into locked into involuntary commitment wards or put behind locked cell doors. Involuntary commitment to a locked hospital ward or a jail cell is a genuine use of force. The AOT research clearly states AOT reduces the use of those forms of forced treatment.


2. AOT is almost always "coerced treatment" not "forced" treatment. The court coerces the individual to stay in treatment. AOT specifically excludes forced treatment, because the conditions under which that can be done have been well-defined in Supreme Court Decisions. Those decisions can not be and are not trumped by AOT legislation.

3. What AOT does do is allow people to be evaluated for treatment slightly earlier than they might otherwise be evaluated., i.e, when they are 'likely' to become danger to self or others, rather than after they become danger to self or others. IN addition to reducing danger to self or others, this is smart clinical practice and proven in court to be constitutional (claims of others notwithstanding) Individuals under AOT have a past history of problems that makes this an appropriateuse of state's police powers and parens  patraie powers. Better outcomes are more likely when people are treated earlier, rather than later.

4. Forcing people who have failed to comply with treatment to be evaluated to see if they meet existing commitment criteria is almost never used.  (And that is the only 'force' AOT allows.)  People in AOT do well.   Very few ever need to be removed for evaluation. Even if you want to refer to AOT as 'forced' that description  would not apply to everyone in AOT. It would only apply to the very few who fail to comply, and the subset of them who deteriorate, and the subset of that subset who are likely to become danger to self or others, and the subset of that subset who are not willing to be evaluated voluntarily, and the subset of that subset who have a case manager dedicated to helping them get help.

5. Assisted Outpatient Treatment (AOT) laws do not allow forced medication. There are no provisions in AOT to force medication. That is a myth opponents intentionally spread.

6. It is wrong to say AOT is "forced treatment"

http://kendras-law.org
 http://lauras-law.org
http://mentalillnesspolicy.org

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