Monday, 10 August 2020

ALERT: Update on Forced Outpatient Commitment in Massachusetts

Forced Outpatient Commitment (commonly referred to as ‘Assisted Outpatient Treatment’ or ‘AOT’) is a type of law allowing for individuals to be forced to take psychiatric Forceful Handmedications, attend therapy, etc. against their will, even when living in the community. Massachusetts is currently one of only a small handful of states that have refused to implement this type of law. However, in a devastating blow to local advocates, an ‘AOT Pilot’ was ordered. The decision read as follows:

The department shall expend not less than $250,000 to develop and implement an assisted outpatient treatment pilot program to treat residents who suffer from serious and persistent mental illness and experience repeated interaction with law enforcement or have a high rate of recurring hospitalization due to their mental illness, either through a voluntary agreement with the resident or by court order mandating that the resident receive the treatment described in this program; provided further, that the department shall report not later than June 1, 2015, to the house and senate committees on ways and means and the joint committee on mental health and substance abuse the progress and results of the pilot program and any identified barriers and challenges to treatment for the aforementioned treatment group.

More recently, we have learned that DMH has amended an existing contract with Eliot Human Services based in Lexington to implement this pilot.
Read the full article by clicking below.
The good news: The way in which this is being implemented looks much more like an ‘Assertive Community Treatment’ (ACT) team and there is no current plan for court involvement. In fact, at present, there is no actual authority to allow for direct court involvement in this pilot.  It appears that most funds will be spent on the hiring of an additional nurse, case manager and peer specialist to add to already available services.

The bad news:  If someone is already legally involved and has a pending court case, it’s still possible that a judge might   order participation in this program as a condition of probation.  Additionally, it’s highly questionable that someone in a ‘peer’ role be hired onto this team, as it is a violation of the integrity of that type of role to be involved with force and coercion. However, perhaps the worst news is that – even if this particular use of funds is much less concerning than it could have been– the ground work for implementing a full ‘Assisted Outpatient Treatment’ program in Massachusetts is nonetheless being laid.  Any ‘pilot’ creates a slippery slope, and so it will be important that everyone stay tuned and alert for updates and opportunities to advocate against further expansions or moves to implement forced outpatient commitment in the state.



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