Assisted outpatient treatment (AOT) is a civil court procedure whereby a judge orders an adult with serious mental illness (SMI) to comply with community-based treatment. Developed as a less restrictive alternative to involuntary hospitalization, AOT focuses on individuals at risk of clinical deterioration or rehospitalization because they do not voluntarily comply with prescribed treatment. At present, AOT is authorized in nearly all U.S. states and territories, though statutory variation and uneven implementation of AOT means that no two implementations look exactly alike.
The purpose of the project carried out by RTI International, in partnership with Duke University and Policy Research Associates (PRA), was to conduct an implementation and outcome evaluation of SAMHSA’s Assisted Outpatient Treatment Grant Program for Individuals with Serious Mental Illness, a 4-year pilot program that funded AOT grants set forth in the 2014 Protecting Access to Medicare Act. The implementation evaluation, conducted from November 2016 to August 2017, gathered information related to the processes and practices of AOT across six of the 18 SAMHSA-funded AOT sites. The outcome evaluation, conducted from September 2017 to March 2021, addressed research questions around AOT program outcomes, client and family perceptions, and resources and costs at six of the AOT sites, three of which were retained from the implementation evaluation. Findings were augmented by comparison analyses using primary data at one locality and secondary data from three sites.
This research was conducted under a contract between HHS/ASPE’s Office of Behavioral Health, Disability, and Aging Policy (BHDAP) and RTI International, with collaboration and support from the National Institute of Mental Health and the Substance Abuse and Mental Health Services Administration. Additional research in this area is available at the ASPE Behavioral Health page and the ASPE Data page.
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Available Reports:
- Evaluation of the Assisted Outpatient Treatment Grant Program for Individuals with Serious Mental Illness: Outcome Evaluation Report
- APPENDIX A. Assisted Outpatient Treatment Characteristics Form
- APPENDIX B. Assisted Outpatient Treatment Docket Case-Monitoring Form
- APPENDIX C. Assisted Outpatient Treatment Client Interview Instruments
- APPENDIX D. Assisted Outpatient Treatment Family Satisfaction Survey
- APPENDIX E. Assisted Outpatient Treatment Cost Questionnaire
- APPENDIX F. Supplementary Quantitative Results
- Evaluation of the Assisted Outpatient Treatment Grant Program for Individuals with Serious Mental Illness: Summary Evaluation Report
- Evaluation of the Assisted Outpatient Treatment Grant Program for Individuals with Serious Mental Illness: Implementation Report
- Assessing Level of Judicial Involvement in Assisted Outpatient Treatment Issue Brief
Related Products:
- Feasibility Study for Demonstration of Supported Education to Promote Educational Attainment and Employment among Individuals with Serious Mental Illness: Final Report (2015) [HTML version also available]
- Case Study: Early Assessment of the Mental Health Block Grant Set-Aside Program for Addressing First Episode Psychosis and Other Early Serious Mental Illness (2015) [HTML version also available]
- Feasibility of Expanding Self-Directed Services to People with Serious Mental Illness (2012) [HTML version also available]
- ASPE Technical Expert Panel on Earlier Intervention for Serious Mental Illness: Summary of Major Themes (2009) [HTML version also available]
- Using Medicaid to Support Working Age Adults with Serious Mental Illnesses in the Community: A Handbook (2005) [HTML version also available]