Assisted Outpatient Treatment (AOT)


(For resources, this is the publication date. For programs, this is the date posted.)


Treatment Advocacy Center

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This intervention is the practice of delivering outpatient treatment under court order to adults with severe mental illness who are found by a judge, in consideration of prior history, to be unlikely to adhere to prescribed treatment on a voluntary basis. AOT laws allow courts to order individuals to comply with outpatient treatment or services as a condition of remaining in the community. AOT is a form of civil commitment for individuals who meet state-defined legal criteria, e.g. they have been repeatedly hospitalized or arrested as a consequence of treatment nonadherence. One of defined group of institutions or individuals must petition the court and include reasons why the petitioner meets the criteria for AOT as well as an affidavit from a physician. Case managers monitor compliance with the court’s order.

Designation as a “Program with Evidence of Effectiveness”

SPRC designated this intervention as a “program with evidence of effectiveness” based on its inclusion in SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP).

Outcome Reviewed (Overall Quality of Research Rating-scale of 0 to 4)*

1: Assault or threat of violent behavior (2.0)

2: Hospitalization (2.7)

3: Quality of life (2.8)

4: Suicide risk (2.5)

Read more about this program’s ratings.


* NREPP changed its review criteria in 2015. This program is a “legacy program,” meaning that it was reviewed under the previous criteria. The evidence for each outcome was reviewed and scored on a scale of 0-4, with 4 indicating the highest quality of evidence and 0 indicating very poor quality of evidence. The overall rating was based on ratings of six criteria: 1) reliability of measures, 2) validity of measures, 3) intervention fidelity, 4) missing data and attrition, 5) potential confounding variables, and 6) appropriateness of analysis.  Over time, all legacy programs will be re-reviewed using the current criteriaWhen considering programs, we recommend (a) assessing whether the specific outcomes achieved by the program are a fit for your needs; and (b) examining the strength of evidence for each outcome. 

Implementation Essentials

  • Enabling legislation in the state or jurisdiction
  • Knowledge of the specific legal process outlined in the applicable law
  • Collaboration among local mental health authorities, treatment providers, and the court with jurisdiction over civil commitments

2012 NSSP Objectives Addressed: 

Objective 9.5: Adopt and implement policies and procedures to assess suicide risk and intervene to promote safety and reduce suicidal behaviors among patients receiving care for mental and/or substance use disorders.