By Jane Lancaster
National Alliance for Mental Illness
Assisted outpatient treatment is a court-ordered program designed to bring intensive, consistent care to people overwhelmed by severe psychiatric illnesses. New Mexico is one of only eight states that do not have some form of AOT law, but that may soon change.
State Rep. Joni Gutierrez, D-Las Cruces, is advocating legislation to enable and fund AOT. Albuquerque Mayor Martin Chávez has announced his intention to push for an ordinance if action at the state level is delayed. U.S. Sen. Pete Domenici endorses AOT measures as a matter of both compassion and public safety.
The proposed Albuquerque ordinance would create a psychiatric officer to evaluate referrals and advise the Mayor's Office, which could petition District Court to order assisted outpatient treatment, including psychiatric, medical and social services and ensuring medications are taken as prescribed.
Before entering an order, a judge would have to find that there is no less restrictive option for that person's care. The person with the severe mental illness must also be unlikely to survive safely in the community and likely to cause serious harm to self or others without the court-ordered outpatient care.
Referrals for AOT consideration can come from concerned family, physicians, the police department's Crisis Invention Team (CIT), or the Albuquerque Family and Community Services Department.
Based on statistics from other states, AOT might be used in Albuquerque in 35 cases a year. These AOT orders are subject to petition, limited to a period of six months and can be extended only after review.
Albuquerque has a history of proactive mental health reform at the community level. The city was one of the first in the country to establish a CIT, groups of specially-trained police officers who respond to mental health calls. The CIT follow up such calls by making connections to social and mental health workers to ensure the individual doesn't fall through the cracks between providers.
By 2005 Albuquerque had established fully functioning mental health courts, a jail diversion program and a Program of Assertive Community Treatment (PACT) for individuals with mental illness and in trouble with the judicial system.
The mayor has announced that a second team is to be added to the program that has become a national model for integrated services.
Now the community is being asked to respond again: this time, to protect the most severely mentally ill who have no insight into their problems and who, because of their disease, cannot cooperate on their own.
Such individuals have inconsistent care that results in repeated hospitalizations or such nonexistent care that they require emergency services. Reactive responses such as these deplete New Mexico's scant mental health resources and limited hospital beds.
We can do it this year. As with the CIT and PACT teams, Albuquerque is in a position to put the AOT program in place in 2006. At least 20 percent of killings in Albuquerque in 2005 were associated with mental illness in which families, bystanders, police and the mentally ill were victims.
If the state is slow to respond, let's stop these tragedies at the city level with a proactive rather than a costly, reactive program.
Jonathan Stanley from the Treatment Advocacy Center in Arlington, Va., will speak on assisted outpatient treatment at noon Monday at Noon Day Ministry, Central and Broadway NE.
A lawyer who has suffered severe mental illness, Stanley has worked with many states to develop AOT legislation modeled after Kendra's Law in New York State. For more information about the noon event, call the Albuquerque chapter of the National Alliance for Mental Illness at 256-0288 between 10 a.m. and 1 p.m. weekdays.
Jane B. Lancaster is president of the Albuquerque chapter of the National Alliance for Mental Illness.
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