AOT Program Status
OMH maintains an evaluation database to monitor AOT program status, the characteristics of AOT recipients, service delivery under AOT, and program outcomes. OMH Central and Field Office staff record basic information on each court order issued and the status of each court order. Case managers serving AOT recipients complete standardized assessments for each recipient at the onset of the court order (baseline) and at 90 day intervals thereafter. The resulting database includes information on:
- general demographic characteristics of individuals, status of individuals in such areas as living situation, education and employment, services received, engagement in services, and adherence with prescribed medication;
- incidence of significant events such as hospitalization, homelessness, arrest and incarceration; and
- functional assessments in the areas of self-care, social skills and task performance, and the incidence of behaviors harmful to the individual or others.
Volume of AOT Investigations, Court Orders and Service Enhancements
From November 1999, through December 3, 2002, 7,938 individuals have been referred to local AOT coordinators for investigation to determine potential eligibility for an AOT court order. Thirty-three percent or 2,559 of these have resulted in petitions filed for the issuance of an AOT court order; of these, 95% or 2,433 resulted in a court order being issued. Twenty percent (1,541) of the total number of investigations have resulted in service enhancements rather than court orders.
Court orders and service enhancements have been issued in all regions of NYS. Sixty-five percent of all court orders and service enhancements and approximately 77% of court orders occur in New York City. More than half of all court-orders issued (55%) are renewed. Table 1 summarizes data on outcomes of the judicial procedures associated with AOT.
Table 1
Outcomes of Judicial Proceedings Associated with AOT
New York State (Through December 3, 2002)
| Number of Referrals/Investigations | 7,938 |
| Number of Petitions Filed | 2,559 |
| Number of Petitions Granted | 2,433 |
| Percentage of Petitions Granted | 95% |
| Number of Orders Eligible for Renewal | 2,038 |
| Number of Orders Renewed | 1,120 |
| Percentage of Orders Renewed | 55% |
Figure 2 displays the distribution of total time spent under court order. On average, individuals who are issued court orders are in that status for nearly 11 months. As of December 3, 2002, the longest any individual had received services under an AOT court order was 35 months.
Figure 2
Distribution of Time Spent Under AOT Court Order
November 1999 - December 2002
| Number of Months | Percent |
|---|---|
| 6 months | 50% |
| More than 6 months - 12 months | 14% |
| More than 12 months - 18 months | 22% |
| More than 18 months - 24 months | 10% |
| More than 24 months | 4% |
* These data do not include individuals who are currently receiving services while under their initial 6 month court order.
Characteristics of AOT Recipients
Demographics . Table 2 below displays data on the age, sex, race/ethnicity, marital status and living situation of AOT service recipients. On average, persons under AOT are 37 years of age and two-thirds (68%) are male. Most are unmarried and are living in independent settings in the community. Sixty-one percent are living in such settings, alone or with parents, spouses, friends or other relatives.
Table 2
Demographic Characteristics of AOT Recipients
| Age | Marital Status | |||
| Mean Number of Years . | 37 years | Single, never married .... | 74% | |
| Gender | Divorced | 11% | ||
| Male . | 68% | Married .. | 6% | |
| Female . | 32% | Other .... | 9% | |
| Race/Ethnicity | Current Living Status | |||
| Black (Non-Hispanic) | 40% | Lives alone | 16% | |
| White (Non-Hispanic) ... | 29% | Lives with others ... | 45% | |
| Hispanic | 21% | Supervised living or Assisted/supported living | 20% | |
| Asian/Asian-American .. | 3% | Other .... | 19% | |
| Other | 5% | |||
The racial and ethnic composition of the population receiving court-ordered treatment is diverse. Forty percent of individuals under AOT are Black, 29% are White and 21% are Hispanic. The racial and ethnic characteristics of AOT recipients are similar to those of other individuals receiving intensive case management services. A comparison of AOT courtordered individuals in New York City with a similar population of individuals receiving intensive case management services prior to the implementation of AOT show that there are no statistically significant differences between these populations in regard to race and ethnicity.
Diagnoses . Most individuals (70%) receiving an AOT court order have a diagnosis of schizophrenia. Thirteen percent have a bipolar disorder diagnosis. A majority (60%) of AOT individuals are reported as having a co-occurring mental illness and substance abuse condition with mental illness as a primary diagnosis.
Table 3
Incidence of Hospitalization,
Homelessness and Arrest and
Incarceration Three Years Prior
to Issuance of Court-Order
| Psychiatric Hospitalizations | |
| Mean number in last 36 months. | 2.94 |
| Percent hospitalized (at least one episode)... | 91% |
| Number of admissions (range)... | 0-5 |
| Homeless Episodes | |
| Mean number in last 36 months. | 0.27 |
| Percent homeless (at least one episode). | 20% |
| Number of episodes (range) ... | 0-5 |
| Arrests | |
| Mean number in last 36 months. | 0.50 |
| Percent arrested (at least one episode). | 29% |
| Number of arrests (range) . | 0-8 |
| Incarcerations | |
| Mean number in last 36 months. | 0.25 |
| Percent arrested (at least one episode). | 18% |
| Number of incarcerations (range). | 0-5 |
Incidence of Hospitalization, Homelessness, Arrest and Incarceration
Table 3 summarizes the incidence of hospitalizations, homelessness, arrest and incarceration for persons under AOT prior to court-ordered treatment. In the three years prior to the court order, 91% of individuals had at least one psychiatric hospitalization. On average, these individuals had been hospitalized nearly three times during that period with some individuals having had as many as five hospitalizations. Twenty percent of individuals had experienced at least one episode of homelessness in the three years preceding their court order. Twenty-nine percent were arrested at least one time in the three years prior to AOT. These individuals had as many as eight arrests during that time. Eighteen percent were incarcerated at least once in the three years prior to their court order. Some individuals had as many as 5 incarcerations in those three years. When compared with a similar population of mental health service recipients, persons under AOT were twice as likely to have had contact with the criminal justice system prior to their court order and 50% more likely to have had a previous episode of homelessness. In addition, individuals who have received an AOT court order were 50% more likely to have a co-occurring substance abuse problem.