Impact of Assisted Outpatient Treatment on Local Mental Health Systems

As part of evaluating Assisted Outpatient Treatment (AOT), it is important to understand its effect on mental health systems. Some worried that AOT would divert resources away from less symptomatic individuals Others saw that as a positive outcome. Some said it would negatively impact the mental health systems. Others said it would improve it.

The NYS Office of Mental Health conducted a study on Kendra’s Law (2005) designed to answer these questions. Here is what they found:

Kendra’s Law (NYSs AOT program) increased services for all populations.

Counties and stakeholder groups statewide have reported that the implementation of processes to provide Assisted Outpatient Treatment (AOT) to individuals under court orders has resulted in beneficial structural changes to local mental health service delivery systems. New mechanisms for identifying, investigating, and assessing individuals, developed in order to fulfill the requirements of AOT, have enhanced accountability in local mental health service systems. AOT implementation has improved access to services for high need individuals, treatment plan development, discharge planning, and coordination of service planning. The implementation of Assisted Outpatient Treatment (AOT) has also supported the development of more collaborative relationships between the mental health and court systems.

Enhanced Accountability and Improved Access to Services

Assisted Outpatient Treatment (AOT) has been instrumental in increasing accountability at all system levels regarding delivery of services to high need individuals. Community awareness of AOT has resulted in increased outreach to individuals who had previously presented engagement challenges to mental health service providers. Local mental health systems began to identify the potential risk posed by not responding to individuals in need, and as a result, those systems improved their ability to respond more efficiently and effectively.

Improved Treatment Plan Development, Discharge Planning, and Coordination of Service Planning

Processes and structures developed for AOT have resulted in improvements to treatment plans that more appropriately match the needs of individuals who have had difficulties using mental health services in the past. AOT is designed to bring service providers and county administrators together in a collaborative attempt to most efficiently deliver appropriate services to these individuals. Case managers, ACT Team staff, other clinical service providers, county personnel and attorneys, recipient advocates, and family members are all among the participants in AOT related service planning.

Improved Collaboration between Mental Health and Court Systems

Implementation of Assisted Outpatient Treatment (AOT) involved the development of a petition process with specific eligibility criteria designed to identify at-risk individuals, prompted novel legal issues, and required greater interaction between the court system and the community mental health services delivery system. As AOT processes have matured, professionals from the two systems have improved their working relationships, resulting in greater efficiencies, and ultimately, the conservation of judicial, clinical, and administrative resources.

In addition to these improvements, consultations with officials of local AOT programs have identified the following improvements in collaboration:

  • There is now an organized process to prioritize and monitor individuals with the greatest need
  • Local Assisted Outpatient Treatment (AOT) program staff and local service providers meet regularly regarding treatment of AOT recipients
  • AOT ensures greater access to services for individuals whom providers have previously been reluctant to serve;
  • The AOT treatment plan serves as a comprehensive planning tool to ensure that all providers and the recipient are on the ‘same page’;

Positive treatment outcomes have been noted;

  • Decreases in the frequency and duration of hospitalizations, incarcerations, and alcohol and substance abuse have also been noted; and
  • There is now increased collaboration between inpatient and community-based mental health providers.


Prepared by
Mental Illness Policy Organization