Assisted Outpatient Treatment (AOT)

Assisted outpatient treatment is mental health intervention that provides community-based services to individuals diagnosed with a mental illness and have a history of multiple hospitalizations or have exhibited violence toward themselves or others.

What services can the court order include through AOT? 

Such services shall include:

• Care Management or Assertive Community Treatment (ACT) Team services;

AND may also include:

• Medication
• Periodic blood tests or urinalysis to determine compliance with prescribed medications; • Individual or group therapy
• Day or partial day programming activities • Educational and vocational training or activities • Alcohol or substance abuse treatment and
• Counseling and periodic tests for the presence of alcohol or illegal drugs for persons with a history of alcohol or substance abuse;
• Supervision of living arrangements;
• Any other service within a local or unified service plan

Eligibility:

All the following criteria must be met for an individual to be considered for AOT:

• 18 years of age or older; and
• Is suffering from a mental illness; and
• Is unlikely to survive safely in the community without supervision, based on a clinical determination; and
• Has a history of lack of compliance with treatment for mental illness which has led to either:
  • 2 hospitalizations for mental illness in the preceeding 36 months, or
  • 1 or more acts of serious violent behavior toward self or others or threats of, or attempts at, serious physical harm to self or others within the last 48 months; and
• Is unlikely to voluntarily participate in outpatient treatment that would enable him or her to live safely in the community; and
• Is in need of AOT in order to avoid a relapse or deterioration which would be likely to result in serious harm to self or others; and
• Is likely to benefit from AOT.

Who can request an AOT order? 

• An adult roommate of the person;
• A parent, spouse, adult child or adult sibling of the person;
• The director of a hospital where the person is hospitalized;
• The director of a public or charitable organization, agency or home that provides mental health services to the person in whose institution the person resides;
• A qualified psychiatrist who is either treating the person or supervising the treatment of the person for mental illness;
• A licensed psychologist or licensed social worker who is treating the person for mental illness;
• The director of community services, or social services official of the city or county where the person is present or is reasonably believed to be present; or
• A parole officer or probation officer assigned to supervise the person.

How does a person receive services through AOT? 

If the individual meets the AOT criteria, he/she is examined by a psychiatrist who determines whether the individual will benefit from court ordered treatment. A court date is then scheduled. The court receives documentation including the petition and a treatment plan for the individual and then can order the person to receive assisted outpatient treatment. If the court determines that the individual meets the criteria for AOT, an order is issued to the director of community services (DCS) who oversees the mental health program of locality (i.e., the county or the City of New York mental health director). The court order will require the county (or New York City) mental health director to provide or arrange for those services described in the written treatment plan that the court finds necessary. The court could also decide that the individual does not need AOT and can dismiss the petition.

What if the person does not comply with the terms? 

If in the clinical judgment of a physician the individual has not followed the treatment ordered by the court and may be in need of involuntary admission to a hospital, the physician may request that the individual be transported to the hospital, involuntarily if necessary. The individual may be held at the hospital for up to 72 hours to determine whether the individual can be admitted, or the individual may be assessed and released.

How long does the person remain on AOT?

The first Order may be granted for up to one year. Near the end of the order, the individual is assessed again. If it is determined to be necessary and beneficial, the order can be extended for another year. These assessments would continue until the individual is determined not to be in need of the order.

For further information call:

• AOT Coordinator, Fulton, Montgomery and Hamilton Counties: 518-770-7827
• Fulton County, Director of Community Services: 518-773-3557
• Montgomery County, Director of Community Services: 518-853-3531
• Hamilton County, Director of Community Services: 518-648-6497