Who Can Be Ordered Into Assisted Outpatient Treatment (AOT)

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Who Can Be Ordered Into Assisted Outpatient Treatment (AOT)

This publication is a fact sheet that talks about who can be ordered into AOT under the law.

Disclaimer: This publication is legal information only and is not legal advice about your individual situation. It is current as of the date posted. We try to update our materials regularly. However, laws are regularly changing. If you want to make sure the law has not changed, contact DRC or another legal office.

 

Assisted Outpatient Treatment, also known as AOT, is court ordered outpatient treatment for people with mental health disabilities.   

This publication is a fact sheet that talks about who can be ordered into AOT under the law.

You have a right to an attorney if the county has asked the court to order you to AOT. If you want a lawyer but don’t have enough money to pay for one, you can ask the judge to give you a public defender.

To qualify for AOT under the law, the judge at the hearing must find that all the requirements are proven by clear and convincing evidence.1 “Clear and convincing” means that the judge must find that it is much more likely to be true than untrue that you meet all of the requirements to qualify for AOT.

For information about a petition and steps the county has to take to ask the court to order you to AOT, read the publication called “How You are Ordered to AOT.

Legal Requirements for AOT

If you meet all of the following criteria, the judge may order you into AOT:2

1. You are at least 18 years old.

2. You have a serious mental disorder.

You can talk to your Patients’ Rights Advocate or your lawyer, if you have one, to understand whether you meet the legal requirements for having a serious mental disorder. You can find out how to contact your Patients’ Rights Advocate under “Additional Information” at the end of this publication.

  • The law says that you have a “serious mental disorder” if all of the following things are true:
    • You have a mental disorder that is in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM).3 This most likely means a diagnosis of a mental disorder from a mental health treatment provider. The DSM is a manual used to describe and define mental disorders;
    • Because of the mental disorder, you have substantial functional impairments or symptoms, or a history that shows you would have an imminent risk of worsening to have substantial impairments or symptoms;4 AND
      • “Functional impairment” means being substantially impaired because of a mental disorder in the areas of independent living, social relationships, having a job, or taking care of your physical condition.5
      • “Imminent” means that substantial impairments are likely going to happen very soon.
    • You are likely to become so disabled as to need public assistance, services, or entitlements such as health and welfare benefits.6

3. A decision has been made, based on a clinical opinion, that either one of the following to things is true:

  • You are unlikely to survive safely in the community without supervision (like AOT) and your mental health condition is getting worse; OR
  • You need AOT to prevent a relapse or worsening of your mental health that would make you gravely disabled (unable to care for your basic needs like food, clothing, and shelter), or make you a danger to yourself or others.

4. You have not followed your treatment plan for your mental health disability before. This is true of either of the following things has happened:

  • Twice within the last 3 years (36 months) your mental health disability was the main reason why you were hospitalized, or got help in a mental health unit of a state prison or local jail.7
    • It does not count if this was right before the county asked for (petitioned) you to be ordered to AOT.
    • The key is that there have to be two commitments within the last three years.
    • This could mean that within the last three years, you were hospitalized for mental health treatment two times.
    • It could also mean that you went to jail or prison twice in the last three years and were housed in a special mental health unit.
    • Or, it could mean that you were hospitalized for mental health treatment once and also were housed on a mental health unit in jail or prison once in the last three years.
  • Because of your mental health disability, you have acted seriously violent towards yourself or others.8
    • It does not count if you it was right before the county asked for (petitioned) you to be ordered to AOT.
    • The act has to be serious and violent. So, if the act was serious, but not violent, then it doesn’t count.
    • It has to have happened within the last 4 years.
    • Threatening or attempting a serious and violent act counts.
    • If it is a serious and violent act against property only, it does not count.

5. The county gave you the chance to have voluntary treatment, but you did not, or do not participate in the treatment.   

  • The treatment you are given the chance to participate in counts only if the treatment plan has all the same treatment as AOT. If not, the county didn’t give you a chance to voluntarily participate in treatment.
  • For information on what is required for AOT treatment, you can read the publication called “Treatment Rights in AOT.

6. AOT is the least restrictive treatment while still ensuring your mental health is improving and stable.

  • “Least restrictive” means that this is the level of care that allows you the most freedom in your current condition.

7. It is likely you will benefit from AOT.

Exam by a Licensed Mental Health Treatment Provider

  • To help the judge make their decision about whether or not all of the requirements for AOT apply to you, a licensed mental health treatment provider has to examine you.9 They also have to say in the petition why all of the requirements for AOT are true for you.10 They also have to speak (testify) at the AOT hearing.11 For more information about AOT hearings, you can read the publication called “Your Rights if the County is Asking for AOT and AOT Hearings.
  • If you do not let the licensed mental health treatment provider examine you, the county can still petition you to AOT.12
  • After the petition is given to the court, the court can place you against your will in a hospital for an exam if you do not let the provider examine you. You cannot remain in the hospital against your wishes for more than 72 hours.13

The Judge’s Decision

If the judge finds that all of the requirements are true by clear and convincing evidence, they can order you to AOT for up to 6 months.14 Clear and convincing” means that the judge must find that it is much more likely to be true than untrue that you meet all of the requirements to qualify for AOT.

  • You have a right to appeal the judge’s decision. For more information about how to appeal you should contact your lawyer.
  • For more information about what your treatment rights are while you are in AOT, you can read the publication called “Your Treatment Rights While in AOT.
  • For more information about how AOT ends after you have been ordered to AOT, you can read the publication called “How AOT Ends.

Additional Information

If you need more information or have questions you can:

  • Ask your lawyer. You have a right to an attorney if the county has asked (petitioned) the court to order you to AOT. If you want a lawyer but don’t have enough money, ask the judge to give you a public defender. You will only have to pay the public defender if you have the money to.
  • Contact your county’s Patient’s Rights Advocate. To find the Patient’s Rights Advocate where you live, (916) 504-5810 and ask for your local Patient’s Rights Advocate or click on this link: https://www.disabilityrightsca.org/post/patients-rights-advocacy-directory.
  • Call Disability Rights California at 1-800-776-5746.
  • 1. Welf. & Inst. Code § 5346(a). All code sections cited below are from the Welfare and Institutions Code.
  • 2. § 5346(a)(1)-(7).
  • 3. § 5600.3(b)(3)(A).
  • 4. § 5600.3(b)(3)(B)(i).
  • 5. § 5600.3(b)(3)(B)(ii).
  • 6. § 5600.3(b)(3)(C).
  • 7. § 5346(a)(4)(A).
  • 8. § 5346(a)(4)(B).
  • 9. § 5346 (b)(5)(A).
  • 10. § 5346 (b)(5)(A).
  • 11. § 5346 (d)(2).
  • 12. § 5346(b)(5)(B).
  • 13. § 5346 (d)(3).
  • 14. § 5346(d)(5)(B).