The Assisted Outpatient Treatment Program is a civil specialty court program to facilitate the delivery of community-based behavioral health treatment to individuals with a serious mental disorder. Individuals receiving AOT services participate in a civil court process. To be considered for AOT, individuals must meet specific criteria, including a history of non-adherence with voluntary treatment for their mental health diagnosis.
Individuals participating in the AOT program must be able to live safely in the community with the support of comprehensive community-based mental health services. It is a 2-way commitment that requires treatment providers to serve individuals at the same time it commits individuals to adhere to their treatment plans. Through the ritual of court hearings and the symbolic weight of a judge’s order, AOT seeks to leverage a “black robe effect,” motivating the individual to regard treatment adherence as a legal obligation. AOT employs a recovery-focused approach that promotes wellness, self-management, shared decision making, natural supports, coping skills, self-advocacy, and development of independent living skills.
The goals of AOT include: preventing harmful outcomes such as relapse resulting in hospitalization, homelessness, incarceration, and trauma, while supporting individuals in maintaining stability and achieving personal goals.
AOT is recognized as an evidence-based practice by the National Institute of Justice, Office of Justice Programs; the Substance Abuse and Mental Health Services Administration (SAMHSA); and the Agency for Healthcare Research and Quality (AHRQ). Its use is also endorsed by the American Psychiatric Association, American College of Emergency Physicians, International Association of Chiefs of Police, National Sheriffs’ Association and National Alliance on Mental Illness.
What is Assisted Outpatient Treatment or AOT?
“Assisted outpatient treatment” is defined as categories of community services ordered by a district court, including case management services, care coordination or assertive community treatment team services, prescribed to treat a person’s mental disorder and to support them in living in the community, or to attempt to prevent a relapse or deterioration that may reasonably be predicted to result in harm to the person or another or the need for hospitalization. Assisted outpatient treatment may include:
- periodic blood tests or urinalysis to determine compliance with prescribed medications; or for the presence of alcohol or illegal drugs for a patient with a history of alcohol or substance abuse;
- individual or group therapy;
- day or partial-day programming activities;
- educational and vocational training or activities;
- alcohol and substance abuse treatment and counseling;
- peer support
- frequent check-ins and staffing with your treatment team
- supportive housing; and
- any other services prescribed to treat the patient’s mental disorder and to assist the patient in living and functioning in the community, or to attempt to prevent a deterioration of the patient’s mental or physical condition;
What are the specific criteria for an individual to be considered for AOT?
The person must reside or be found within the 22nd Judicial District (St. Tammany or Washington Parish)
- The patient is eighteen years of age or older.
- The patient is suffering from a mental illness.
- The patient is unlikely to survive safely in the community without supervision, based on a clinical determination.
- The patient has a history of lack of compliance with treatment for mental illness that has resulted in either of the following:
- At least twice within the last thirty-six months, the lack of compliance with treatment for mental illness has been a significant factor resulting in an emergency certificate for hospitalization, or receipt of services in a forensic or other mental health unit of a correctional facility or a local correctional facility, not including any period during which the person was hospitalized or incarcerated immediately preceding the filing of the petition.
- One or more acts of serious violent behavior toward self or others or threats of, or attempts of, serious physical harm to self or others within the last thirty-six months as a result of mental illness, not including any period in which the person was hospitalized or incarcerated immediately preceding the filing of the petition.
- The patient is, as a result of his mental illness, unlikely to voluntarily participate in the recommended treatment pursuant to the treatment plan.
- In view of the treatment history and current behavior of the patient, the patient is in need of involuntary outpatient treatment to prevent a relapse or deterioration which would be likely to result in the patient becoming dangerous to self or others or gravely disabled.
- It is likely that the patient will benefit from involuntary outpatient treatment.
Who can request AOT?
- The director, administrator, or treating physician of a hospital in which the patient is hospitalized OR an emergency receiving center in which the patient is receiving services.
- The director of the local governing entity, or his designee, in the parish in which the patient is present or reasonably believed to be present.
- Any interested person through counsel with written concurrence of the coroner in the jurisdiction in which the person is found.
- The Louisiana Department of Health
How are individuals referred to the AOT program?
Often referrals will be initiated by qualified professionals, such as a psychiatrist or psychologist. Referrals may come from hospitals with an inpatient psychiatric unit, outpatient behavioral health providers, and family members.
To refer an individual to AOT please contact:
How is “person with a mental illness” defined?
“Person who has a mental illness” means any person with a psychiatric disorder which has substantial adverse effects on his ability to function and who requires care and treatment. It does not refer to a person with, solely, an intellectual disability; or who suffers solely from epilepsy or a substance-related or addictive disorder. La. R.S. 28:2(24)
What does “likely to result in the patient becoming dangerous to self” mean?
“Dangerous to self” means the condition of a person whose behavior, significant threats or inaction supports a reasonable expectation that there is a substantial risk that he will inflict physical or sever emotional harm upon his own person. La. R.S. 28:2(7)
What does “likely to result in dangerous to others” mean?
“Dangerous to others” means the condition of a person whose behavior or significant threats support a reasonable expectation that there is a substantial risk that he will inflict physical harm upon another person in the near future. La. R.S. 28:2(6)
What does “gravely disabled” mean?
“Gravely disabled” means the condition of a person who is unable to provide for his own basic physical needs, such as essential food, clothing, medical care, and shelter, as a result of serious mental illness or a substance-related or addictive disorder and is unable to survive safely in freedom or protect himself from serious harm. The term also includes incapacitation by alcohol, which means the condition of a person who, as a result of the use of alcohol, is unconscious or whose judgment is otherwise so impaired that he is incapable of realizing and making a rational decision with respect to his need for treatment. La. R.S. 28:2(13)
What are the individual’s rights in the process?
AOT strictly defines eligibility criteria in an effort to ensure appropriate application of the law and to protect individual rights. The law specifically defines the rights of the individual who is subject to AOT, including participation in the development of a treatment plan, adequate notice of hearings, to receive a copy of the court-ordered evaluation, the appointment of an attorney, to be present at the hearing, to present evidence and call and/or cross-examine witnesses, and to appeal decisions
How long is a person committed to AOT?
A civil court can grant an AOT order for a period of time not to exceed one (1) year. Prior to the order expiring, the AOT Team may, after reevaluation of the participant, petition the court for extension of services. The order for AOT may be extended for a period of time not to exceed one (1) year.
What happens if an individual receiving AOT services does not comply with their treatment plan/the court order?
AOT Court cannot make a finding of contempt, nor can the court force an individual to take medications. If an individual participating in AOT is not complying with aspects of their treatment plan, the AOT Team will make every attempt to positively re-engage that person. If an individual is unable to positively re-engage in the AOT program and is at risk of harm to self or others, the AOT Team may request a court order for involuntary transportation for an evaluation, including inpatient hospitalization.