The Assisted Outpatient Treatment (AOT) toolkit is an evidence-based tool that promotes recovery and reduces harmful behavior, hospitalization, emergency room use, and costs. The toolkit strives to improve the practice of providing outpatient treatment under civil court order to individuals with SMI who have demonstrated difficulty engaging with treatment on a voluntary basis. When systematically implemented and adequately resourced, AOT can dramatically reduce hospitalization, criminalization and other adverse outcomes for its target population. The toolkit aims to provide general information about the process of AOT and more specific guidance for key components of the system: courts, mental health providers, hospitals (including emergency rooms and inpatient psychiatric care), individuals under AOT orders, families and advocates, and law enforcement. 

In 2020, the Treatment Advocacy Center ranked the quality of Michigan's laws that provide for involuntary treatment of psychiatric illness as third in the country, with AOT laws among the top five in the country. However, measures of mental illness identification, treatment, and diversion leave much to be desired. Michigan is #47 in public psychiatric beds per capita and #35 in criminal diversion. For every one person with SMI that is hospitalized in Michigan, there are 4.3 people incarcerated. This toolkit strives to provide tools to improve the implementation of AOT and improve our state's response to mental illness. 

Partners and contributors

This toolkit is funded by the Michigan Department of Health and Human Services Mental Health Diversion Council. Content is coordinated by the Center for Behavioral Health and Justice and the AOT Workgroup of the MHDC. 

This toolkit has been developed in collaboration and partnership with a number of individuals and agencies. 

Mental Health Diversion Council and AOT Workgroup members

Special thanks to Diversion Council members Kevin Fischer, Lauren LaPine, Hon. Milton L. Mack, Jr. (Chair), Steven Mays (Diversion Administrator), Dr. Debra A. Pinals, and Bob Sheehan.

• Christopher Becker
• Chief Jim Blocker
• Soleil Campbell
• Bradley Casemore
• Ronald Derrer

• Eric Doeh
• Meghan Groen
• Sheriff Steve Kempker
• James Samuals
• John Searles

• Marti Kay Sherry
• Sara Spencer-Noggle
• George Strander 
• Jessica Taylor
• Algeria Wilson 

Content contributors 

• Hon. Freddie G. Burton Jr
• Mark Creekmore 
• Sean Field
• Jim Grafton
• Sgt. Greg Howard

• Sojourner Jones
• Jennifer Kimmel
• Kristina Morgan 
• Natalie Nugent
• Samuel Olson

• Joanne Sheldon
• Chiara Sims
• Scott Smith
• Chavonne Taylor  

Project partners 

• Cynthia Camilleri
• Tracey Dore
• Jody Gorenflo
• Jeannie Goodrich

• Adam Hamilton
• Megan Hebert
• Elizabeth Martin
• Dan Russell

• Siiri Sikora
• Heather Willis
• Cathie Yunker 

• Genesee Health System Assisted Outpatient Treatment Program
• Henry Ford Hopsital Jackson
• Hope Network 
• Huron Behavioral Health

• Mackinac Straits Hospital
• National Alliance on Mental Illness
• NAMI Michigan
• NAMI Washtenaw

• Summit Pointe CMH
• Wayne County Behavioral Health Unit
• Wayne County Probate Court

We would also like to extend our gratitude to those who have attended the webinars and submitted feedback and questions, as this has helped inform the current and futute content of this toolkit.