Who is best suited for AOT?

Eligibility

Assisted outpatient treatment is available to adults who:

  • Do not understand they need treatment due to impaired judgment as a result of their illness (also known as anosognosia).
  • Are unable to attend to their basic physical needs as a result of serious mental illness.
  • Are unlikely to voluntarily participate in, or adhere to, treatment to keep them from harm.
  • Have a serious mental illness, not exclusively a substance use disorder (SUD) or neurological condition (such as dementia).
  • Read criteria as listed in the mental health code

    330.1401 "Person requiring treatment" defined; exception.

    Sec. 401.

    1.  As used in this chapter, "person requiring treatment" means (a), (b), or (c):
      1. An individual who has mental illness, and who as a result of that mental illness can reasonably be expected within the near future to intentionally or unintentionally seriously physically injure himself, herself, or another individual, and who has engaged in an act or acts or made significant threats that are substantially supportive of the expectation.
      2. An individual who has mental illness, and who as a result of that mental illness is unable to attend to those of his or her basic physical needs such as food, clothing, or shelter that must be attended to in order for the individual to avoid serious harm in the near future, and who has demonstrated that inability by failing to attend to those basic physical needs.
      3. An individual who has mental illness, whose judgment is so impaired by that mental illness, and whose lack of understanding of the need for treatment has caused him or her to demonstrate an unwillingness to voluntarily participate in or adhere to treatment that is necessary, on the basis of competent clinical opinion, to prevent a relapse or harmful deterioration of his or her condition, and presents a substantial risk of significant physical or mental harm to the individual or others.
    2. An individual whose mental processes have been weakened or impaired by a dementia, an individual with a primary diagnosis of epilepsy, or an individual with alcoholism or other drug dependence is not a person requiring treatment under this chapter unless the individual also meets the criteria specified in subsection (1). An individual described in this subsection may be hospitalized under the informal or formal voluntary hospitalization provisions of this chapter if he or she is considered clinically suitable for hospitalization by the hospital director.
  • Listen to Judge Milt Mack (ret.) explain the mental health code

 

Clinical assessment

Clinical assessment is an important part of the assisted outpatient treatment process. In cases where an individual has not previously received a psychiatric evaluation, one is conducted before the order is issued. Further, clinicians (often from the Community Mental Health agenc) testify in court to the individual's condition and make treatment recommendations. 

 

Guardianship vs. assisted outpatient treatment

It is important to consider guardianship before pursing assisted outpatient treatment. In some cases an individual might be better suited for guardianship than AOT. 

The best candidates for guardianship... The best candidates for AOT...
...are unlikely, even with treatment, to be able to make sound, independent decisions ...are likely, with treatment, to be able to make sound, independent decisions.
...have a limited history of autonomously functioning.  ...have a history of autonomously functioning.
...have medication allergies, contraindications, or their condition is treatment resistant. ...do not have a history of medications that are contraindicated.

 

Questions to be answered in deciding if an individual is a good candidate for assisted outpatient treatment

This list of questions is drawn from Judge Milton L Mack., Jr's training video. Watch the full training to learn more.

  1. Does the individual have a mental illness?
  2. Is the person's judgement impaired? 
  3. Does the impairment in judgement cause a lack of understanding of the need for treatment?
  4. Is the person unwilling to engage in voluntary treatment?
  5. Is that treatment necessary to prevent a relapse or harmful deterioration of the person's condition?
  6. Will this present a substantial risk of significant physical or mental harm to the person or others?

 

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