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from NAMI.org
The Karen Effect It was the sense of belonging, of being cared for in this most basic way, that Karen and her family needed most.
What Im Thankful for at NAMI
NAMI Advocacy Update: November 2014
Henderson Behavioral Health Advancing Early Intervention
-more at NAMI.org-
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A SOUND PROPOSAL FOR AOT

By Jonathan Stanley, J.D.

Assistant Director, Treatment Advocacy Center

The Treatment Advocacy Center commends NAMI-NM, and particularly NAMI Albuquerque, for spearheading efforts to bring assisted outpatient treatment (AOT) to  New Mexico.  AOT is court-ordered treatment delivered in the community that can bring intensive and consistent care to individuals overwhelmed by severe psychiatric illnesses, people incapable of accessing and maintaining voluntary treatment.  New Mexico will be the 43rd state with AOT if it adopts the proposed measure, which is modeled on New York’s stunningly successful Kendra’s Law.

AOT would not cure all the ills of the New Mexico mental health system, nor does it call for a drastic reconfiguration of that system.  AOT is instead specifically designed to bring treatment only to a small segment of those most affected by a severe mental illness; it is a last resort.  Adjusting for the differences in populations, there would only be about 75 initial AOT orders issued each year should New Mexico make as extensive use of the program as does New York At the same time, AOT can bring sustained treatment to some of those most at risk because of their illnesses; individuals whose inconsistent care now results in repetitive hospitalizations that seriously deplete New Mexico’s mental health resources.

I assess any AOT proposal from an admittedly selfish perspective because I have bipolar illness with psychotic features.  I have been involuntary placed in treatment. It saved my life but was also one of the worst experiences of my life; I would never want to repeat the experience unless there was no other viable option.  

Any AOT law should have eligibility criteria that target only those for whom it is absolutely necessary, as well as safeguards against the law being mistakenly used on someone who does not meet those criteria.  The AOT proposal that NAMI-NM supports meets both of these requirements. 

In order for someone to be placed in AOT, a judge would have to find both that voluntary treatment is not an option and that there is no less restrictive option for the person’s care.   The person would also have to be unlikely to survive safely in the community and likely to eventually cause serious harm to self or others without the court-ordered outpatient care.   

People meeting that standard are simply incapable of maintaining their own treatment.   The choice thus becomes insisting on needed care for people in such a condition or abandoning them to the untreated and unchecked symptoms of their illnesses.  We either allow the disease to control the person or we do not.  Having been that sick, there is no doubt in my mind what should be done if I was again.

I am also pleased with the stringent consumer protections in the New Mexico proposal.  AOT could only be ordered in a formal court hearing preceded by notice of that hearing to the consumer, who would be represented by counsel at all stages of the proceeding.  The consumer would also have the opportunity to actively participate in creating the treatment plan that is the basis of the court’s order.  The initial AOT order would be for a six-month period, and any renewals would have to be approved in a hearing in which the person is again shown to meet that narrow eligibility standard.  A person in AOT could also ask the supervising court to stay, vacate, or modify the order at any time. 

I particularly like that anyone who makes a false statement or provides false information or testimony in an attempt to get someone in AOT is subject to criminal prosecution.  Although the abuse of such a law is rare, it should be punished and deterred.

I cannot recommend the proposal more than to wish that it or something similar would be in place to release me from the grip of my symptoms should I ever again become lost to them.

_________________________________

Supporting Documentation

The PDF files listed below provide supporting information for AOT.  "Kendra's Law" and "Duke University Study" are large files and will take time to download.  The briefing documents for these files provide a summary of the large files.  These files require Adobe ACrobat Reader, which can be downloaded at:

http://www.adobe.com/products/acrobat/readstep2.html

Related Files

Modernizing NM's Civil Commitment Law (PDF File)

Briefing AOT (PDF File)
Briefing TAC (PDF File)
Briefing anosognosia (PDF File)
Briefing Kendras Law (PDF File)
Kendras Law (PDF File)
Briefing Duke University Study (PDF File)
Duke University Study (PDF File)

 


Related Files

Briefing AOT (PDF File)
Briefing TAC (PDF File)
Briefing anosognosia (PDF File)
Briefing Kendras Law (PDF File)
Kendras Law (PDF File)
Briefing Duke University Study (PDF File)
Duke University Study (PDF File)
Modernizing NM's Civil Commitment Law (PDF File)

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