About Assisted Outpatient Treatment (AOT)

Assisted Outpatient Treatment (AOT) is for a very small group of the most seriously mentally ill who already accumulated multiple incidents of hospitalization arrest or incarceration associated with their failing to stay in voluntary treatment. AOT allows judges, after full due process to require certain mentally ill to accept six months of mandated and monitored treatment as a condition for living in the community. It provides an off ramp before incarceration. As Linda Dunn said, Assisted Outpatient Treatment is like putting a fence by the edge of the cliff rather than an ambulance at the bottom. (Barnidge 2014)

The research on AOT is extensive and positive. (Mental Illness Policy Org 2013). Six months of mandated and monitored treatment has been shown to reduce homelessness 74%; hospitalization 77%; arrest 83%; incarceration 87%, physical harm to others 47%; property destruction 46%; suicide attempts 55%; and substance abuse (48%). By replacing expensive incarceration and hospitalization with less expensive community care Assisted Outpatient Treatment cuts costs to taxpayers in half. (Swanson, et al. 2013). AOT also reduces victimization. (V.A. Hiday 2002). These results are particularly outstanding because AOT is limited to the most seriously ill, often a very hard to treat population.


The mental health industry stands in the way of implementation. They claim AOT increases institutionalization when it decreases it, increases the use of ‘force’ when it prohibits it, drives people from care when those in it support it, increases stigma when it reduces it, is expensive when it saves money, and affects many when it affects few. (Jaffe 2010) They claim voluntary programs work better, but AOT is only used after voluntary programs fail.

In addition to allowing judges to order individuals into treatment, it also allows judges to order the mental health system to provide it. This likely accounts for the industry objections. It limits their ability to cherry pick the highest functioning for admission. AOT is broadly supported by the public, police, families of the seriously ill and those who experienced it. In New York it is called Kendra's Law. In California, it is called Laura's Law.
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The Helping Families in Mental Health Crisis Act (HR 3717) proposed by Rep. Tim Murphy and 95 cosponsors in both parties would provide states funds for pilot AOT programs. Ask your Representative to co-sponsor HR 3717.