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Many individuals living with serious mental illness (SMI) do not adhere to outpatient treatment for a variety of reasons, increasing their risk for suicide and self-harm, violent behavior, substance misuse, insecure housing, high utilization of ERs, and frequent contact with law enforcement. These behaviors lead to high rates of inpatient psychiatric hospitalization and incarceration.

Assisted outpatient treatment (AOT) is a legal mechanism for providing outpatient treatment to individuals living with SMI whose non-adherence places them at risk for negative outcomes. AOT orders work by compelling the recipient to receive specific treatment that will prevent their condition from worsening and by committing the mental health system to provide treatment.

Why does AOT matter to law enforcement?

Law enforcement officers are increasingly called upon to respond to calls involving people with mental illness.  People living with serious mental illness, such as schizophrenia or bipolar II disorder, are less likely than those with mild or moderate mental health concerns to recognize they have an illness, to seek treatment or to adhere with existing treatment. When untreated, serious mental illness contributes to increased rates of violent behaviors, suicidal and self-harming behaviors, substance use, homelessness, and frequent ER visits.  AOT provides a way to compel an individual to receive the help they need.

Unlike hospitalization, AOT can be utilized prior to a crisis, keeping the individual, the community, and law enforcement officers safer.  Anyone can petition the court for an AOT, including law enforcement, with the same form used for hospitalization. Even when law enforcement is not involved in originating the order, they play an important role in the process by executing Orders for Transport issued by the court, taking an individual into protective custody for transport to a local ER or crisis center for a mental health assessment.

Action steps for law enforcement:

• Train staff on who is eligible for AOT, how to file, and transport orders.
• Identify people with frequent law enforcement contacts who may be eligible for AOT.
• Designate Crisis Intervention Team trained staff or officers with additional mental health training to conduct transport orders.
• Work with the community mental health authority to follow-up on people with AOTs in the community.

Upcoming content

In the coming months, additional content pertaining to law enforcement will be added to the toolkit, including training videos, a live webinar event, and testimonials. Contact us if you have ideas about information that should be included in the toolkit.