"Alone I Can't, But Together We Can": A Photovoice Study To Explore Insights Of Assisted Outpatient Treatment (AOT) From Providers Working With Individuals With Serious Mental Illness (SMI).

Assisted Outpatient Treatment (AOT) is a court-ordered mental health treatment program for individuals with SMI (bipolar disorder, major depressive disorder and schizophrenia) who have a history of noncompliance with treatment and are at risk of deteriorating or causing harm to themselves or others. This dissertation examined the perceptions and experiences of thirteen providers (lawyers, judges, case managers, psychiatrists, housing navigators, treatment guardians, nurse practitioners, therapists and peer support specialists with lived experience) on the AOT program for clients with SMI; and the environments that shape these perceptions, taking into account a system and community-based approach focusing on how the unique relational, structural, organizational, and policy based constraints of the AOT program shapes their ability to deliver care. Drawing on a socio-ecological model of health and the framework for recovery-oriented practices, this study employed Photovoice to investigate the lived experiences of AOT providers. Three main themes were identified from participants photos and narratives: Culture of Recovery in Dona Ana County which included the sub-themes: Personalize Recovery; Community and Connection; Instilling Trust, Safety and Belonging; and Understanding Complexity of SMI and Client Experiences. The second theme, Perceived Impact of AOT included the sub-themes Meeting Basic Needs, Opportunities for Growth and Healing, Serving as a Guide in the Recovery Journey, and Promoting Autonomy. The third theme, Recommendations for AOT programs has the sub-themes: Encourage Provider Wellness and Work-Life Balance, Interdisciplinary and Teamwork, and Continual Growth and Adaptation to Changing Environments. The findings from the study may inform quality improvement on AOT practices and systemic changes that can improve treatment adherence, reduce recidivism and incarceration; and improved service delivery for individuals living with Serious Mental Illness (SMI) in the AOT program in Dona Ana County.