Implementation Status of Assisted Outpatient Treatment Programs: A National Survey

Objective: The authors' objective was to determine how assisted outpatient treatment (AOT) has been implemented in actual practice in the 45 states with AOT statutes.

Methods: A national survey of AOT programs was conducted to examine the extent to which AOT programs have been implemented and variations in implementation models.

Results: Although 45 states have current AOT statutes, the most active programs were identified in 20 states. These programs varied considerably in style of implementation, criteria applied, agency responsible, use of a treatment plan, monitoring procedures, and numbers of participants involved. Three implementation models were identified: community gateway, hospital transition, and surveillance (or safety net). Common problems included inadequate resources, lack of enforcement power, inconsistent monitoring, and weakness of interagency collaboration.

Conclusions: AOT is a widely applied and much-discussed mechanism for providing treatment to individuals with serious mental illnesses nationally. The uneven implementation of AOT programs within and across states highlights the ambivalence in the community, by judicial officials, and by mental health clinicians about the role and scope of AOT and the difficulties of implementation under existing funding constraints and statutory limitations.