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Community Based Health Services, otherwise known as Assisted Outpatient Treatment (AOT), is the practice of providing community-based mental health treatment under court supervision, as a means of: (1) motivating an adult with serious mental illness (SMI) who struggles with voluntary treatment adherence to engage fully with their treatment plan; and (2) focusing the attention of treatment providers on the need to work diligently to keep the person engaged in effective treatment, thus ensuring continuity of care.


AOT laws allow continued treatment of people with SMI in the community, so that they can live a healthy, safe and productive life. Currently, 47 states have AOT laws. MA is one of only 3 states which does not have AOT laws.

The essential elements of an AOT program are to (Courtesy of the Treatment Advocacy Center):

  1. identify individuals within the service area who appear to be persistently non-adherent with needed treatment for their mental illness and meet criteria for AOT under state law;

  2. ensure that whenever such individuals are identified, the mental health system itself takes the initiative to gather the required evidence and petition the court for AOT, rather than rely on community members to do so (although community members should not be impeded from initiating an AOT petition or investigation where permitted by state law);

  3. safeguard the due process rights of participants at all stages of AOT proceedings;

  4. maintain clear lines of communication between the court and the treatment team, such that the court receives the clinical information it needs to exercise its authority appropriately and the treatment team is able to leverage the court’s powers as needed;

  5. provide evidence-based treatment services focused on engagement and helping the participant maintain stability and safety in the community;

  6. continually evaluate the appropriateness of the participant’s treatment plan throughout the AOT period, and make adjustments as warranted;

  7. employ specific protocols to respond in the event that an AOT participant falters in maintaining treatment engagement;

  8. evaluate each AOT participant at the end of the commitment period to determine whether it is appropriate to seek renewal of the commitment or allow the participant to transition to voluntary care;

  9. ensure that upon transitioning out of the program, each participant remains connected to the treatment services they continue to need to maintain stability and safety.

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