Assisted Outpatient Treatment

​According to the Treatment Advocacy Center (TAC), Assisted Outpatient Treatment (AOT) is the practice of providing community-based mental health treatment under civil court commitment, as a means of:

1. motivating an adult with mental illness who struggles with voluntary treatment adherence to engage fully with their treatment plan; and 
2. focusing the attention of treatment providers on the need to work diligently to keep the person engaged in effective treatment.​

This is a new program in Maryland’s system that allows a court to order mental health treatment in the community for individuals that have a severe and persistent mental illness who have demonstrated difficulty engaging in treatment. 

To find additional information and resources related to the use of Assisted Outpatient Treatment (AOT) program please check out our links under Additional Resources!

The law passed during the 2024 legislative session known as HB 576 / SB 453​ Mental Health – Assisted Outpatient Treatment Programs. This law requires statewide implementation of Assisted Outpatient Treatment programs.​​​​

​Someone who 

• Is at least 18 years old;
• Has a serious and persistent mental Illness;
• Has demonstrated a lack of adherence with treatment for the serious and persistent mental illness that has:
  • at least twice in the 36 months before the filing of the petition, been a significant factor in needing either:
    • hospitalization on an inpatient psychiatric unit or a psychiatric hospital for at least 48 hours, Or
    • psychiatric services while in detention, jail, or prison;

                                Or

• at least once in the 36 months before the filing of the petition has resulted in an act of serious violent behavior towards self or others.
  

​This means if you have a loved one (family or friend) who suffers from a severe and persistent mental illness and who has been unable to stay on their treatment path in a way that ensures their health and safety, then you may be able to advocate for the person to receive AOT.

​​The legal term for the person for whom AOT is being petitioned is an AOT Respondent.

An AOT Respondent is notified of a petition once it's been filed. An AOT Respondent is also provided an opportunity to work with the Care Coordination Team on their treatment plan. They are provided with an opportunity to agree to the treatment plan prior to an AOT court hearing.

If the AOT court hearing takes place and AOT is ordered based on the information provided, the person is now referred to as the AOT Participant.

1. ​AOT Respondent - An individual who is the responding party named in a petition for AOT. 
2. AOT Participant - An individual who is court ordered to follow the treatment plan ordered by the court for a term not to exceed one year.
3. Petitioner - An individual who files an AOT petition in Maryland. This can be the director of a State-funded mental health program or any individual at least 18 years old who has a legitimate interest in the wellbeing of the respondent. 
4. Office of the County Attorney - The office tasked, per AOT law, with being notified of a petition filing. 
5. Office of the Public Defender – The office responsible for providing  legal defense services to AOT respondents who meet eligibility criteria. Respondents may also elect to have representation in AOT proceedings through a private attorney.
6. The Department - The Maryland Department of Health implements AOT in any county that chooses not to run its own program.  It establishes, manages, oversees and coordinates AOT programs and all their components. The Department also develops operational and clinical guidance, provides  legislative reports to the General Assembly and is  notified of petition filings.
7. The Care Coordination Team - The team required by AOT law to develop the treatment plan (in collaboration with the AOT participant in a person-centered approach) prior to the initial hearing.  The Team also coordinates services for the AOT participant and may  provide treatment directly when appropriate. By law, the Team must include at a minimum: ​

• ​A Psychiatrist​
• A Case Manager
• A Certified Peer Recovery Specialist (CPRS)
• Other treatment providers when clinically appropriate such as an Assertive Community Treatment (ACT) Team​