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Court-ordered outpatient treatment linked to significantly improved outcomes, study finds

RTI-led study finds assisted outpatient treatment leads to range of improvements for people with serious mental health conditions


RESEARCH TRIANGLE PARK, N.C. — A new study led by independent scientific research institute RTI International has found that court-ordered assisted outpatient treatment (AOT) programs are associated with significant improvements in mental health, treatment adherence and social outcomes.

“Our study provides robust evidence that assisted outpatient treatment can play a meaningful role in improving outcomes for people with serious mental health conditions,” said Kiersten Johnson, Ph.D., a public health researcher at RTI and lead author of the study. “It highlights the potential of structured, court-ordered outpatient care to support recovery and reduce reliance on emergency and inpatient services.”

Published in Psychiatric Research & Clinical Practice, the study evaluated six AOT programs funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). Researchers from RTI, Duke University and Policy Research Associates analyzed data from 392 AOT participants, using structured interviews and administrative records to assess changes in clinical and social functioning.

The study found that appointment adherence increased by more than 24% and treatment adherence by over 20% within 6 to 12 months of entering AOT compared to pre-enrollment levels. Participants also reported better life satisfaction and stronger therapeutic relationships. Rates of violent behavior dropped by more than 19% and suicidal ideation decreased by over 24%.

Hospitalization metrics showed marked improvement. The proportion of recipients experiencing any psychiatric inpatient episodes fell by more than 40%, and the average number of nights spent in inpatient care declined by more than eight. Arrest rates dropped by more than 19%, and illicit drug use declined by over 14%. Additionally, in the six months following AOT enrollment, homelessness among participants decreased by 12%.

The evaluation also found that people who remained under AOT orders for at least six months experienced greater reductions in violence, suicidal ideation, hospitalizations and homelessness than those with shorter durations.

The research was funded by the Office of the Assistant Secretary for Planning and Evaluation (ASPE).

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