New Jersey is currently one of only eight states without a law allowing for court-ordered outpatient treatment for individuals with a history of medication noncompliance. As New Jersey reexamines its mental health system and contemplates adopting assisted outpatient treatment (AOT), information from states with already successful AOT programs will be invaluable.  Following is commentary provided by officials and treatment professionals throughout the country regarding their experiences with assisted outpatient treatment.

• New York's successful AOT program, Kendra's Law, went into effect November 1999. During AOT, 74% fewer participants experienced homelessness, 77% fewer experienced psychiatric hospitalization, 83% fewer experienced arrest, and 87% fewer experienced incarceration. Individuals in Kendra’s Law were also more likely to regularly participate in services and take prescribed medication.

• A Duke University study of AOT found similar benefits: Long-term assisted outpatient treatment reduced the risk of arrest by 74%, hospitalization by up to 74%, victimization by 50%, and risk of violence by up to 50%.

• "AOT resulted in fundamental changes to New York's overall mental health system," said Sharon Carpinello, R.N., Ph.D., Commissioner of the New York State Office of Mental Health. "We have seen improved access to mental health services, improved coordination of service planning, enhanced accountability, and improved collaboration between the mental health and court systems.”

• Dr. Mary Barber, associate medical director of the Ulster County Mental Health Department in New York, summarized why she feels AOT programs are so successful, “As I've heard many people say, Kendra’s Law is so effective in part because it makes providers accountable, by both allowing and requiring communication, and by making them feel more secure in taking very risky clients. Kendra’s Law essentially said that counties now have responsibility over their most high-risk, high-need people. With that responsibility comes the opportunity to exert more centralized control over housing, treatment, and case management resources.”

• Wisconsin Circuit Court judge Ralph M. Ramirez described assisted outpatient treatment as a "win-win-win situation." Judge Ramirez explained that assisted outpatient treatment serves as a means of ensuring that individuals with a severe mental illness who need treatment but who otherwise refuse it:

                    -are not arrested by law enforcement, which reduces the risk of injury and protects public safety;
                    -are not institutionalized in jails or hospitals, which saves money; and
                    -are treated as patients in their communities, which preserves their dignity.

• Judge Randy T. Rogers, from Butler, Ohio, sees many cases involving people with severe mental illnesses. He calls AOT, "an effective tool to help sustain a group of individuals in the community with persistent impairment in decision-making who would otherwise continue to revolve through the doors of hospitals and jails."
  
• Fritz Mielke, assistant corporation counsel for Waukesha County, Wisconsin, explained that his county consistently uses assisted outpatient treatment and has seen a "net result of enhanced compliance" and "a great reduction in recidivism."

For more on Gregory’s Law, including articles on the Katsnelson family, visit http://www.gregoryslaw.org/.