Outpatient Commitment in the United States: Utilization, Benefits, and Patient Perspectives

Abstract

Assisted outpatient treatment (AOT) is a form of care that utilizes court orders to mandate treatment for individuals who suffer from severe mental illness and deteriorate due to nonadherence. AOT programs exist for select patients in many countries but in the United States are used extensively in only a minority of jurisdictions. While statutory frameworks are relatively similar, the resources available within AOT programs and the extent of utilization vary markedly by state. Evidence for efficacy comes primarily from mirror-image studies that follow patients before and after program enrollment, as well as certain sophisticated cohort studies performed in jurisdictions in which AOT is well resourced and where court orders are often in effect over extended periods of time. While mandated care inherently involves coercion, qualitative studies indicate that many patients enrolled in AOT programs identify some benefits of AOT when their symptoms improve. [ Psychiatr Ann . 2024;54(5):e141–e145.]