According to the Police, Treatment and Community Collaborative (PTAC Collaborative) launched in April 2017, 37 states and Washington D.C. have involuntary commitment laws for individuals with substance use disorders or alcoholism. Also known as Assisted Outpatient Treatment, these pre-arrest diversion strategies are becoming more widely accepted to address substance abuse and other disorders, according to a recent article in the Psychiatric Times.
According to the publication, Assisted Outpatient Treatment was first used in 1972 at St. Elizabeth’s Hospital in Washington, DC, by an agreement between Dr. Roger Peele, a psychiatrist, and Harry Fulton, the chief public defender.
Here are three things to know about Assisted Outpatient Treatment (AOT).
#1 There’s Federal Funding for Assisted Outpatient Treatment
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced more than $13 million in federal funding for AOT demonstration grants and has extended the funding through 2022.
“AOT has now been officially endorsed by SAMHSA and Congress, joining such groups as the National Sheriffs’ Association, the International Association of Chiefs of Police, the National Alliance on Mental Illness, and the American Psychiatric Association.”
Using federal grant funding for recovery from substance use disorders is discussed in the 2016 SAMHSA AOT funding announcement. The first $13 million in grants funded 17 AOT projects this past year.
#2 Assisted Outpatient Treatment Programs Require Clinical or Legal Criteria
AOT programs that reduce arrests generally require that a person meet clinical and legal criteria, such as a history of hospitalization or arrest.
Specific procedures vary by state. In a 2015 Massachusetts pilot, participation in AOT required dual diagnosis of mental illness and substance use disorder.
#3 Application of AOT for Pre-Arrest Diversion is Spotty
According to the Psychiatric Times, AOT is still underutilized.
- The states with the most extensive use of AOT are New York and New Jersey.
- Butler and Summit Counties in Ohio have established AOT programs. The counties’ manuals and forms are available on the Treatment Advocacy Center website.
- Laura’s Law, first implemented in Nevada County, Calif., now covers two-thirds of the state’s population.
- All states have laws permitting AOT except for Massachusetts, Connecticut, Maryland and Tennessee, but in at least 15 states, it is virtually never used.
Access clinical documents from various programs on the Treatment Advocacy Center website.
