An AOT should never be your first step. An individual should always first be offered the opportunity to participate in services voluntarily; an AOT is not appropriate for an individual who is voluntarily participating in mental health services. If the person needs to go to the hospital and they will voluntarily go, this is always the best option. A court order mandating them to treatment not only takes away their freedom of choice, but it also has other implications, such as being in the Law Enforcement Information Network (LEIN) system. If the individual is participating in outpatient services, but not at a level you believe they should, using motivational interviewing and encouragement should be implemented first and an AOT should only be used as a last resort to prevent harm to self or others. 

If the individual has no history of harm to self or others and is not currently a risk of harm to themselves or someone else, then an AOT is usually not appropriate. It is important to acknowledge that the goal of AOT is to prevent harm, not to force treatment on someone.  

The intervention for an individual not following their AOT order or adhering to their treatment plan is to be involuntarily hospitalized to stabilize, which means there should be a medication intervention that will help that individual. If psychiatric hospitalization would not be required to stabilize an individual’s mental health symptoms, then AOT is likely not an appropriate intervention. 

AOTs are only for individuals with a mental health diagnosis. “An individual whose mental processes have been weakened or impaired by dementia, an individual with a primary diagnosis of epilepsy, or an individual with alcoholism or other drug dependence” does not qualify for an AOT (MCL 330.1401 (2).), although they can be involuntarily hospitalized if needed. If the individual only has a substance use disorder causing the risk of harm, then the process for filing a petition for substance abuse treatment should be followed. This process is outlined in the Michigan Mental Health Code.