Enhancing Implementation of a Multisystem Assisted Outpatient Treatment Program to Support Positive Mental Health Outcomes in High-Need Populations

Assisted Outpatient Treatment (AOT) is a civil commitment program incorporating intensive case management and other services to support adults with a serious mental illness (SMI) and treatment adherence and ongoing engagement needs. The overarching goal of AOT programs is to minimize participants' use of emergency psychiatric care, increase their consistent use of community-based care, and reduce their potential for involvement with the legal system resulting from untreated mental health concerns. However, effectively coordinating multiple systems of care to best meet AOT clients' needs can be challenging. Thus, to better support high-need clients with SMI, the Houston AOT Program incorporated the use of multisystem liaisons, some of whom were trained as social workers, to coordinate referral, enrollment, and ongoing service provision within the Houston AOT Program. These liaisons worked closely with behavioral health providers at the local public health authority along with local probate court judges and their staff handling civil mental health commitments. Through the use of these liaisons, provider burden related to hospital and court documentation requirements were significantly reduced. Recommendations for integrating social workers as liaisons into joint mental health and civil commitment programs will be presented to support enhanced levels of client care.