Assisted Outpatient Treatment Named an Evidenced-Based Practice by Federal Agency

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State policymakers have a clear signal that passing and implementing AOT laws is a reasonable means of improving outcomes for people with severe mental illness, said the Treatment Advocacy Center

Acknowledging a substantial body of research, the federal agency that oversees mental health services and substance abuse treatment has recognized court-ordered outpatient treatment as an evidence-based intervention for people with severe mental illness who struggle with voluntary treatment adherence.

The Substance Abuse and Mental Health Services Administration (SAMHSA) last week added the practice commonly known as assisted outpatient treatment (AOT) to the National Registry of Evidence-Based Programs and Practices (NREPP).

“The federal agency charged with coordinating programs for adults with mental illness reviewed the evidence and found that AOT is an evidence-based intervention for reducing the dire consequences of nontreatment like repeat hospitalization, violence and suicide,” said Doris A. Fuller, executive director. “Policymakers have another clear signal that passing and implementing AOT is a reasonable means of improving outcomes for people with severe mental illness.”

AOT provides court-ordered treatment in the community to people with serious mental illness and a history of treatment non-adherence and commits service providers to delivering appropriate care to the most high-risk, high-need individuals. The federal agency added outpatient commitment to NREPP after an independent assessment concluded the program met its requirements for demonstrating positive outcomes in multiple, rigorous peer-reviewed studies.

The value of the intervention for qualifying individuals is also recognized by the American Psychiatric Association, the National Sheriffs’ Association and the International Association of Chiefs of Police.

SAMHSA’s designation follows recognition of AOT by the US Department of Justice, whose Office of Justice Programs deemed it to be an effective and evidence-based practice for reducing crime and violence in 2012. Forty-five states and the District of Columbia currently authorize the use of some form of court-ordered outpatient treatment for individuals with the most severe psychiatric diseases.

“This impartial assessment adds further weight to the voices of advocates across the country seeking to implement AOT laws to save lives,” said Fuller. “Far too many communities face tragic outcomes because of a failure to effectively use this common-sense solution to serve those who are most severely mentally-ill.”

The National Registry of Evidence-based Programs and Practices is a publicly available online database of mental health and substance abuse interventions. To be recognized as evidence-based, interventions must meet NREPP’s requirements for review and be independently assessed and rated for quality of research and readiness for dissemination, according to the agency’s website.


The Treatment Advocacy Center is the only national nonprofit dedicated exclusively to eliminating legal and other barriers to treatment for people with severe mental illness. The organization does not accept funding from companies or entities involved in the sale, marketing or distribution of pharmaceutical products.

The American Psychiatric Association awarded the Treatment Advocacy Center its 2006 presidential commendation for "sustained extraordinary advocacy on behalf of the most vulnerable mentally ill patients who lack the insight to seek and continue effective care and benefit from assisted outpatient treatment.”

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Jamie Mondics
Treatment Advocacy Center
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