Money. State and local governments never seem to have enough to meet the demand for mental health services.
For years now, a much-touted solution to that problem has been mandatory outpatient treatment, also known as assisted outpatient treatment, or AOT. Such programs have typically targeted a small portion of the seriously mentally ill — sometimes less than two percent — who are frequent fliers in state hospitals and local jails, and thus responsible for a disproportionate chunk of public spending on those services.
Many lawmakers around the country have been persuaded of mandatory outpatient treatment’s effectiveness. Only a handful of states, including Maryland, have either not adopted or not implemented mandatory outpatient treatment laws.
In an effort to convert the holdouts, the Treatment Advocacy Center, based in Arlington, released a report Tuesday on the outcomes of established mandatory outpatient treatment programs in New York City and Summit County, Ohio, where assisted outpatient treatment has been in place since the 1990s. The researchers for the TAC study did not collect the data themselves, but rather reviewed state-funded studies that did.
The point of the report was really to help other policymakers measure the costs and savings of mandatory outpatient treatment programs, but it offered some new nuggets about two established programs.
– Both the New York and Ohio studies found that court-ordered outpatient treatment reduced the incidence of psychiatric emergency crisis services, hospitalization, and criminal justice involvement
– A 2013 study of New York’s mandatory outpatient treatment program, which began in 2000, found that in the first year, there were 41 percent fewer hospitalizations. In the second year, 16 percent fewer.
– Average annual costs for assisted outpatient treatment increased from about $6,000 per person served in the year before AOT was initiated to about $14,000-$18,000 per person served in the first year of AOT.
-Other studies showed that in Seminole County, Florida, the average number of hospital days per patient decreased by 43 percent, from 64 to 36.8. In Bexar County, TX, the number of days spent in a hospital bed has dropped by 67 percent.
An effort to pass AOT legislation in Maryland failed during the 2014 session.