AOT allows courts to order six months of mandated and monitored treatment in the community for a very small group of people with very serious mental illness who have previously become arrested, incarcerated, violent, homeless or hospitalized multiple times as a result of their failure to comply with treatment, often because they are so ill they don't know they are ill ("anosognosia").
More than two decades of research and practice show it works. AOT reduced hospitalizations[i], arrests[ii], incarcerations, crime[iii], victimization[iv] and violence[v] and improved treatment adherence[vi] The Department of Justice deemed AOT to be an effective evidence-based program for reducing crime and violence[vii]; AOT also produces significant taxpayer/system cost savings. New York’s program achieved savings of 50% in the first year and an additional 13% in the second year. A study in North Carolina reported similar cost savings of 40%[viii]. These savings free up mental health funds to treat more people or provide better treatment.
[i] Swartz, M., Swanson, J., Wagner, H., Burns, B., Hiday, V., & Borum, R. (1999). Can involuntary outpatient commitment reduce hospital recidivism: Findings from a randomized trial with severely mentally ill individuals. American Journal of Psychiatry 156: 1968-1975.
Swartz, M., Swanson, J., Steadman, H., Robbins, P., & Monahan J. (2009). New York state assisted outpatient treatment program evaluation. Duke University School of Medicine.
[ii]Gilbert, A., Moser, L., Van Dorn, R., Swanson, J., Wilder, C., Robbins, P., Keator, K., Steadman, H., & Swartz, M. (2010). Reductions in arrest under assisted outpatient treatment in New York. Psychiatric Services 61: 996-999.
[iii] New York State Office of Mental Health. 2005. Kendra’s Law: Final Report on the Status of Assisted Outpatient Treatment.
[iv] Hiday, V., Swartz, M., Swanson, J., Borum, R., & Wagner, R. (2002). Impact of outpatient commitment on victimization of people with severe mental illness. American Journal of Psychiatry, 159: 1403-1411.
[v] Phelan, J., Sinkewicz, M., Castille, D., Huz, St., & Link, B. (2010). Effectiveness and outcome of assisted outpatient treatment in New York state. Psychiatric Services 61: 137-143.
[vi] New York State Office of Mental Health. 2005. Kendra’s Law: Final Report on the Status of Assisted Outpatient Treatment.
[vii] National Institute of Justice, Program Profile Assisted Outpatient Treatment (AOT). Retrieved August 27, 2014, fromhttp://www.crimesolutions.gov/ProgramDetails.aspx?ID=228
[viii] Swanson, J., Van Dorn, R., Swartz, M., Robbins, P., Steadman, H., McGuire, T., & Monahan, J. (2013). The cost of assisted outpatient treatment: Can it save states money? American Journal of Psychiatry 170:1423-1432.
Swartz, M., Swanson, J., Steadman, H., Robbins, P., & Monahan J. (2009). New York state assisted outpatient treatment program evaluation. Duke University School of Medicine.
[ii]Gilbert, A., Moser, L., Van Dorn, R., Swanson, J., Wilder, C., Robbins, P., Keator, K., Steadman, H., & Swartz, M. (2010). Reductions in arrest under assisted outpatient treatment in New York. Psychiatric Services 61: 996-999.
[iii] New York State Office of Mental Health. 2005. Kendra’s Law: Final Report on the Status of Assisted Outpatient Treatment.
[iv] Hiday, V., Swartz, M., Swanson, J., Borum, R., & Wagner, R. (2002). Impact of outpatient commitment on victimization of people with severe mental illness. American Journal of Psychiatry, 159: 1403-1411.
[v] Phelan, J., Sinkewicz, M., Castille, D., Huz, St., & Link, B. (2010). Effectiveness and outcome of assisted outpatient treatment in New York state. Psychiatric Services 61: 137-143.
[vi] New York State Office of Mental Health. 2005. Kendra’s Law: Final Report on the Status of Assisted Outpatient Treatment.
[vii] National Institute of Justice, Program Profile Assisted Outpatient Treatment (AOT). Retrieved August 27, 2014, fromhttp://www.crimesolutions.gov/ProgramDetails.aspx?ID=228
[viii] Swanson, J., Van Dorn, R., Swartz, M., Robbins, P., Steadman, H., McGuire, T., & Monahan, J. (2013). The cost of assisted outpatient treatment: Can it save states money? American Journal of Psychiatry 170:1423-1432.
After 50 dam years, the mental health community has not learned anything. sad I can speak, im old and seen it all.
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