MYTH: AOT is ineffective because there aren’t any consequences for treatment non-adherence.

REALITY: Judges are not allowed to punish AOT recipients for non-adherence, but there can be consequences. The judge periodically meets with the recipient to reinforce the order. The length of the AOT program can be extended. The judge could order an emergency psychiatric evaluation. Rehospitalization on an inpatient unit might occur. 

MYTH: AOT is not person-centered and doesn’t align with the recovery model. 

REALITY: Although self-direction is limited at the beginning of the order, principles of the recovery model and person-centered care are used daily in AOT. Self-direction is preferred and should be maximized. Person-centered care can be emphasized even when recipients are not adhering to treatment. Using such an approach increases the chance of treatment adherence and positive outcomes. AOT does not necessarily lead to an increased sense of coercion. 

MYTH: AOT is too expensive. 

REALITY: Costs of AOT are small in comparison to the cost of inpatient care and incarceration. AOT is an evidence-based tool that typically results in fewer hospitalizations, fewer arrests, a decrease in homelessness, and fewer incarcerations. AOT saves money because hospitalization is far more expensive than outpatient care. 

MYTH: Comprehensive outpatient services that are voluntary would eliminate the need for AOT.

REALITY: Many people with serious mental illness are incapable of engaging in treatment voluntarily because of their illness. Many of them have anosognosia, which is a lack of awareness of one’s own illness. By obligating mental health agencies and courts to engage them, AOT ensures that treatment interventions will be used for people who are most sick. 

AOT is a humane, reasonable, and evidence-based tool for people with psychosis who’ve had difficulty adhering to treatment. Widespread research has shown that AOT improves the overall functioning of its recipients.

For those interested in learning more about AOT and how it is used to help those most at risk for the negative and sometimes deadly consequences of not receiving treatment, additional reading follows:

• A 2 page overview of AOT published by Treatment Advocacy Center (of particular note, for participants in New York’s AOT program, called Kendra’s Law: 77% experienced fewer psychiatric hospitalizations, 74% fewer experienced homelessness, 83% fewer experienced arrest, and 87% fewer experienced incarceration)
• Personally Speaking: Assisted Outpatient Treatment Saved My Life, an article by Eric Smith, MSW, mental health advocate, and public speaker on matters of mental illness
• Powerful OpEd, Gabe Damour's Death Was the Worst Nightmare Come True for Families Like Ours, by Jeanne Gore, Yaicha Provencher, Joe Pickering, Jr published in Sun Herald January 1, 2023 speaking to why there is an urgent need to expand and utilize Maine's AOT program

India is a big diverse country with people from many different cultures and religions. Having a mental illness (or, what is really, a brain disorder) is still considered a taboo in many religions.

​Traditionally, people with mental illnesses are seen as being possessed by evil spirits. Some believe that these people must have done something bad in their past life so they are have been given this curse and will have to suffer their entire life. These beliefs are embedding in our culture, creating a barrier in getting treatment.

​Depression is not new to India and most see that as a weakness and expect a person to fix it themselves by meditation or yoga. When a person has a serious illness like bipolar disorder or schizophrenia, he/she/they have a hard time accepting the diagnosis and getting help.

In India, even being a psychiatrist is stigmatized. They are considered crazy and inhumane people who give shock treatments. This traditional thinking has changed quite a lot but still we have psychiatrists in major cities only, with none in and remote areas.