New Jersey has made substantial investments in community mental health services in recent years. Since the closing of Marlboro Psychiatric Hospital in 1998, New Jersey has used that money to create a variety of intensive services, including at least one PACT team in each county – the most comprehensive form of community treatment. “Unfortunately, the effectiveness of those services is compromised because New Jersey does not yet have AOT,” said Zdanowicz. “The PACT Model recognizes that sometimes a court order may be required to ensure that clients benefit from these services. As a consequence of not having assisted outpatient treatment, 1 out of 4 enrollees in New Jersey do not participate. Bringing IOC to New Jersey will finally allow New Jersey’s PACT services to reach a safe and adequate level.”

Assisted outpatient treatment laws are very effective at helping the small group of people who are the most ill, those incapable of rational treatment decisions because of symptoms of their illnesses. For instance, the New York State Office of Mental Health reports that during assisted outpatient treatment 74% fewer of the participants experienced homelessness, 77% fewer psychiatric hospitalization, 83% fewer arrest, and 87% fewer incarceration. Individuals in the program were also more likely to regularly participate in services and take prescribed medication. And AOT enhanced the mental health system as a whole with improved access to mental health services, enhanced accountability, and improved collaboration between the mental health and court systems.

Current New Jersey law only allows intervention when a person with a severe psychiatric disorder becomes dangerous, an exceptionally restrictive standard. Adoption of the Task Force’s proposal would allow people to be helped before they became dangerous and make available the less restrictive alternative of court-ordered community treatment.

Requiring dangerousness before intervention inevitably leads to risk-filled confrontations between people who need medical treatment and law enforcement officers. "I commend the governor's task force for recommending assisted outpatient treatment, which is proven to help protect the lives and well being of our officers and the public at large, particularly citizens with severe mental illnesses,” said Morris Plans Chief Douglas Scherzer, President of the New Jersey State Association of Chiefs of Police, which passed a resolution supporting bringing assisted outpatient treatment to New Jersey. “Law enforcement officers are often the first line of response when individuals are in a severe psychiatric crisis, and the New Jersey State Association of Chiefs of Police is confident that bringing assisted outpatient treatment to our state will help ensure that those individuals are provided with the care they need before intervention by law enforcement becomes necessary."

Getting early care is critical for public safety, but even more so to help the people who are ill.  "Assisted outpatient treatment reduces the most severe consequences of untreated mental illness, while improving the participant’s quality of life by improving treatment adherence and decreasing symptoms," said Dr. William M. Greenberg, President of the New Jersey Psychiatric Association, which passed a resolution supporting assisted outpatient treatment for New Jersey. "This, in turn, reduces the significant strain these illnesses place on caregivers. AOT achieves this by ensuring treatment for those individuals who, without a program like this, are unable to provide for their own care and live successfully in the community."

Recipients in New York endorsed the overall effect of the program on their lives. After receiving treatment, 75% reported that AOT helped them gain control over their lives, 81% said AOT helped them get and stay well, and 90% said AOT made them more likely to keep appointments and take medication.

“I wish when I had been homeless and severely mentally ill … that someone had mandated to me I either take medication in the community or I would have to go to a hospital,” said Valerie Fox in her testimony to the Task Force. “I believe I would have taken the medication and not endured the great dangers of being vulnerable and exposed on the streets."

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