Assisted Outpatient Treatment (Laura's Law)

Friends huggingWhen a person is dealing with a serious mental health challenge, they may neglect to seek help. They may even struggle to acknowledge they need help to get well. AOT is an intensive case management service to help people overcome these barriers. 

AOT begins with staff conducting intense outreach to clients. They encourage them to start and stick with treatment. When this outreach and engagement fails, then the County has the option to file for a court order. This would require the client to participate in ongoing outpatient treatment. There is a strict set of criteria that must be met for this to happen. Such services and programs are often referred to as Laura’s Law. However, when AOT outreach and engagement is conducted as required, most people participate in treatment voluntarily.

What is Laura’s Law?

Laura’s Law was enacted in 2002 by the state of California. It allows counties to establish (AOT) programs to create an additional way to engage people who are resisting mental health treatment. In 2017, Shasta County HHSA created a plan to provide AOT and contracted with Kings View Behavioral Health Systems to run the treatment side of the program.

What is Assisted Outpatient Treatment?

In addition to intensive case management, AOT also provides traditional mental health services such as therapies, groups, and skill building. Clients are assigned to a team of a mental health clinician and a case manager. Because the program requires frequent visits with the clients, each team works with a caseload ratio of 1:10. This gives mental health providers the opportunity to build a stronger therapeutic relationship with the individual.

Can someone who is receiving Assisted Outpatient Treatment be forced to take medication?

No, forced medications are not part of any individual's treatment plan.

Who qualifies for Assisted Outpatient Treatment?

To qualify for AOT, people must have a serious and persistent mental illness. They also have proven over a period of time to be very difficult to engage in services.

Staff assess if the person would benefit from AOT, and that they have consistently declined offered services.. The AOT team will work with an individual over a period of time to build trust and a therapeutic alliance. If this fails, the County can then file mandatory paperwork with the court, and a date for the hearing is set. Once this paperwork has been filed, the individual will be assigned a Public Defender.

NOTE: Only the county Mental Health Director (or his or her designee) can file a petition with the court.

An individual must meet all nine of the following criteria "by clear and convincing evidence", for a court to order AOT:

  1. 18 years of age or older;
  2. Has a “serious mental disorder” that is persistent in duration and causes “behavioral functioning” that interferes substantially with activities of daily living;
  3. There has been a clinical determination the person is unlikely to survive safely in the community without supervision;
  4. Has a history of not complying with treatment that has resulted in either: a) two involuntary hospitalizations within the last 36 months, or; b) due to mental illness has committed, or threatened to commit, at least one act of violence against self or others within the last 48 months;
  5. Has been offered to participate in voluntary mental health treatment but continues to fail in following through;
  6. The individual’s condition is currently considered to be substantially deteriorating;
  7. Participation in AOT would be the least restrictive placement that leads to recovery and stability;
  8. In view of individual’s history and current behavior the person is in need of AOT to prevent relapse or deterioration that will lead to their meeting 5150 criteria (danger to self/others, or grave disability);
  9. It is more than likely the individual will benefit from AOT.

Who can refer a person to Assisted Outpatient Treatment?

The following people may request that an individual be assessed and considered for enrollment in AOT. The Mental Health Director, or designee, will assess appropriateness for referral and enrollment into "outreach and engagement" AOT program.

  • Any adult (18 or older) currently living with the individual;
  • Parent, spouse, sibling, or child 18 years or older of the individual;
  • Director of any public or private agency who is currently providing mental health services to the individual;
  • Director of hospital where the individual is currently hospitalized;
  • A licensed mental health treatment provider who is currently involved with providing mental health treatment to the individual, or;
  • A peace officer, parole officer, or probation officer assigned to the individual.