AOT: Effective but underused

As regular TAC Blog readers know, 42 states have Assisted Outpatient Treatment (AOT) laws that permit a court to order community based treatment for some people with severe mental illness who meet the state’s strict eligibility requirement. This legal mechanism has been proven to reduce consequences of nontreatment like hospitalizations, incarcerations, victimization, and violence.

Florida passed its law - known in that state as “The Baker Act Reform” and “Involuntary Outpatient Placement” - in 2005. At the time the legislature was considering the measure, opponents asserted that the law would affect several thousand people resulting in a total hardship on the courts, public defenders, and the mental health system. As it turns out, the reality is that it is used for a very select few individuals and to great benefit.

But the most important question to ask is, “Does assisted outpatient treatment help some people with severe mental illness to achieve better outcomes?” And the answer in Florida, as in other states and in the research, is a solid “YES.” Results from the most used program in Florida were recently published in a letter in Psychiatric Services. For patients in the program, when the length of time in the program was compared to an identical length of time before the patient entered the program:

• The average number of hospital days per patient decreased from 64.0 to 36.8, a 43% decrease.
• The savings in hospital costs averaged $14,463 per patient.
• The average number of days incarcerated per patient decreased from 16.1 to 4.5, a 72% decrease.