Assisted Outpatient Treatment (AOT), also referred to as outpatient civil commitment, is a court-mandated program designed to motivate adults with a serious mental illness (SMI) who have challenges with voluntary treatment adherence and engagement. AOT programs are designed to focus the attention of treatment providers and those they serve on the importance of keeping participants engaged in ongoing and effective treatment. AOT programs are designed to reduce repeated emergency psychiatric care usage and decrease justice system involvement resulting from untreated mental illness while promoting treatment engagement and long-term recovery for those with SMI and/or substance use disorders. Research has found AOT programs to be effective in reducing hospitalizations and justice involvement. Yet, concerns have been raised, including limiting individual autonomy and self-determination and overrepresentation of individuals from minority backgrounds. This presentation details the evolution and implementation of the AOT Houston Model. This innovative model builds on AOT strengths and addresses limitations. The Houston AOT Model has five goals guided by the core tenets of client empowerment and self determination. This Model prioritizes six elements including housing, employment, access to public benefits, transportation, service continuity, and care coordination/communication. The AOT Houston program offers the opportunity to address existing concerns while maximizing treatment benefits for individuals who have not responded to traditional mental healthcare. Implications for practice, policy, and research are presented with strategies for successful implementation of comprehensive AOT programs in other jurisdictions.

Dr. Robin E. Gearing is a Professor and the Director of the Center for Mental Health Research and Innovations in Treatment Engagement and Service (MH-RITES) at the University of Houston. Dr. Gearing’s research focuses on improving the mental health outcomes of individuals with SMI. His research is driven by an interest in informing and improving engagement and adherence to empirically-supported treatment, and developing evidence-based interventions. Dr. Micki Washburn is a mental health/substance use researcher and Assistant Professor at the University of Texas at Arlington. Dr. Jamison V. Kovach is an Associate Dean and Professor at the University of Houston