Flaws with assisted outpatient treatment
In late April, changes to the Pennsylvania Mental Health Procedures Act will take effect. The law is referred to as assisted outpatient treatment. Under this law, families and friends can petition a judge to order outpatient treatment for a loved one.
This law came about due to frustration with our current system. Families felt hopeless finding care for their relatives suffering from behavioral health conditions. Before AOT, those at risk had only one choice, involuntary commitment, when there’s evidence of a very clear and obvious danger to themselves and/or others.
In theory, families can seek AOT for those who are mentally ill and/or suffer from addiction when the person is unlikely to survive without supervision, they are at risk of harming themselves or others, and/ or they have a history of refusing to participate in treatment.
Here are the problems: A person loses the right to choose his or her own fate. Judges have no prior training in behavioral health and there are no repercussions if the individual doesn’t follow court orders. Even if the judge orders outpatient treatment, it does not guarantee the person will receive it. A 2016 report released by the Health Resources and Services Administration (HRSA) projected the supply of workers in selected behavioral health professions to be approximately 250,000 workers short of the demand by 2025. Additionally, there is no funding to address the additional strain on an already overextended court system.
Instead of putting more stress on an already fragmented system, we should focus on allocating our current resources toward prompt access to behavioral health programs. Wait times for services are often months long. We should also spread awareness about alternatives. For example, people have the right to request an advanced directive as part of their living will. This allows a person to designate a family member to make health care decisions for them if they are no longer mentally capable to do so. If more families put this into place, there would be no need to turn to AOT.
JONI SCHWAGER
Squirrel Hill
The writer is the executive director of the Staunton Farm Foundation.