Treatment Advocacy Center • TreatmentAdvocacyCenter.org

What is AOT?Assisted outpatient treatment (AOT) for provides court-ordered mental health treatment – including medication – in the community for those with a severe mental illness who have a history of poor outcomes caused by their inability to maintain treatment voluntarily.

THOSE MOST IN NEED: AOT serves the most severely ill, who cycle in and out of jails, hospitals and the streets because their illness prevents them from understanding they need care. Due to strict legal criteria, AOT recipients typically represent far less than .05% of a state’s popula-tion, yet, on any given day, they make up 25% or more of those living on the streets, behind bars, or in crisis care.

AOT RECIPIENT CHARACTERISTICS:

•Majorityhaveschizophreniaorseverebipolardisorder

•97%percenthadbeenhospitalizedpreviously

•47%hadco-occurringsubstanceabusedisorder

•47%didnotadheretoneededmedicationregiment before AOT

THE REVOLVING DOOR’S COSTS: Each psychiatric readmissioncostsonaverage$7,500.iMedicationnon-compliance is the number one risk factor.ii AOT greatly increases medication adherence and reduces costs from re-admission.iii

HUGE COSTS TO PUBLIC HEALTH SYSTEMS:Mentalillnessesaccountfornearly20%ofallMedicaidre-admis-sions.ivMedicaidpatientshadmorethan75,000mentalhealth re-admissions within 30 days in one year.v Nearly 25%ofMedicarepatientswithpsychoseswerereadmittedwithin one month of discharge.vi

AOT REDUCES ARRESTS & VIOLENCE

44% decrease in harmful behaviors

2/3 reduction in risk of arrest

in any given month

4x less likely to perpetrate

serious violence

1/2 as likely to be victimized

AOT WORKS: Of participants in New York’s AOT program, called Kendra’s Law:

AOT SAVES MONEY

50% cost savings in New York

40% cost savings

in North Carolina

40% cost savings

in Summit County, Ohio

$1.81 saved for ever dollar spent in Nevada County, California

77%fewer experienced psychiatric hospitalization

83%fewer experienced arrest

74%fewer experienced homelessness

87%fewer experienced incarceration

BROAD SUPPORT FOR AOT

• InternationalAssociationofChiefsofPolice

•NationalSheriffs’Association

•DepartmentofJustice

•AmericanPsychiatricAssociation

i Hauert,A.,Johnson,E.,Kirpalani,N.,Martin,J.,&Miller,D.(2012).Thecostofhealthcare, does more care = better care? Perspectives, 8.

iiMorgan,L.(2014).WhatdrivesMedicaidbehavioralhealthreadmissionrates?RetrievedMarch30,2015fromhttps://www.openminds.com/market-intelligence/executive-briefings/drives-medicaid-behavioral-health-readmission-rates.htm/

iii HealthManagementAssociates.(2015).State and community considerations for demonstrating the cost effectiveness of AOT services.Lansing,MI:HealthManagementAssociates.

iv Trudnak,T.,Kelley,D.,Zerzan,J.,Griffith,K.,Jiang,H.,&Fairbrother,G.(2014).Medicaidadmissionsandreadmissions:understandingtheprevalence,payment, and most common diagnoses. Health Affairs.RetrievedMarch30,2015fromhttp://content.healthaffairs.org/content/33/8/1337.abstract?rss=1

v Hines,A.,Barrett,M.,Jiang,H.,&Steiner,C.(2014).Conditions with the largest number of adult hospital readmissions by payer, 2011.HealthcareCostandUtilizationProject.

vi Jenks,S.,Williams,M.,&Coleman,E.(2009).RehospitalizationsamongpatientsinMedicaidfeeforserviceprograms.New England Journal of Medicine,360:1418-28.