FAQs

Though any responsible adult can petition for assisted outpatient treatment in advocacy for a struggling individual, that person must meet specific, clinically determined eligibility criteria and receive due process in a civil court proceeding. The criteria includes evidence that the person would benefit from AOT, are unlikely to survive safely in the community without supervision, and have a history of lack of voluntary adherence that has resulted in involuntary inpatient hospitalizations or serious violent behavior towards themselves or others.

Step Down

People who are transitioning from an involuntary mental health inpatient commitment to treatment in the community and may need a layer of oversight and accountability to support recovery in the community

Step Up

People who are living in the community but decompensating and need additional support to prevent hospitalization, incarceration, and further psychiatric deterioration. This may help people get treatment before an involuntary inpatient commitment becomes necessary.

Step Over

People who are arrested and have severe mental health issues by helping to facilitate the withdrawal of criminal charges upon civil commitment, provide oversight without criminal justice consequences and/or reduce the time they may be involved in the criminal justice system.

No.

Non-adherence to the court order cannot result in criminal charges, fines or incarceration. It may trigger a civil court review hearing and/or a request for re-evaluation of the person’s current clinical needs (which may require a short-term hold for a psychiatric exam if the person meets that legal threshold).

Any responsible party may submit a petition for AOT. However, in order to be eligible, clear and convincing evidence must be presented and the courts will schedule a hearing at which the petitioner has the right to representation and to present their own evidence. The court will appoint an attorney to represent people who are subject to a petition unless they choose to acquire private defense. Every individual will be offered a certified peer specialist that is not part of the AOT process and can be a support throughout the process and after it concludes.

People subject to petitions will be notified via a summons (not a warrant). Law enforcement would not be involved in finding the person, serving the person the summons or ensuring the person comes to court.

Every effort would be made to ensure that individuals are offered voluntary services first, treatment is in the least restrictive environment and that it is recovery-oriented care. The court and public defender have the responsibility to ensure that individual's rights are being protected.

AOT encourages diligent, assertive, and active engagement with participants from a consistent provider to ensure that needs are being assessed on an ongoing, regular, basis with attention to early identification of potential problem situations and prioritization of care to address those situations in a proactive manner; including amending the AOT plan of care to add additional supports as needed.

The mental health procedures act currently allows for outpatient commitments. However, these are limited to people who are already subject to an inpatient commitment, meaning they have met the criteria of being a danger to self or others. This does not allow for earlier intervention or for non-clinical staff to petition.   

The current process does not allow for step-up or step-over. Additionally, the current involuntary outpatient commitment (IOC) process does not include ongoing court monitoring and oversight of adherence to treatment plans once the person is released back into the community.

More information can be found on the Allegheny Analytics website.