In Illinois, the civil court can mandate outpatient mental health treatment for persons with serious mental health conditions, according to the state's Mental Health and Developmental Disabilities Code.
It’s called Assisted Outpatient Treatment [AOT], and State Court Behavioral Health Administrator Scott Block said it’s “deemed to be a pretty underutilized tool throughout the entire state” and that “many people just don’t understand the process,” including those within the courts.
One of the recommendations from the Administrative Offices of the Illinois Courts’ [AOIC] Mental Health Task Force Action Plan is to increase the use of AOT across courts in the state, and recent grant funding — totaling roughly $2.9 million — from the Substance Abuse and Mental Health Services Administration [SAMHSA] should help Cook and McLean counties get a head start. AOIC is the grant recipient, and it's partnered with the counties for implementation.
The grant becomes effective in October. Block said the courts will have six months to get things operational, but he hopes to start services as soon as possible.
What the program could look like
McLean County Circuit Court Judge Rebecca Foley said she expects the program to operate similarly to the county’s problem-solving courts, which help people within the criminal justice system. She referred to the “black robe effect” these types of programs can have, where a judge’s position of authority influences willingness to adhere to treatment plans.
“Just like recovery court, drug court, veterans court, [we’ll have] a set time where these folks will come in… and they're reporting to the court how they're doing,” she said. “We get feedback from them. They get praise if they're doing well. If they're maybe not quite as compliant as we want them to be, they get encouragement from the bench.”
Foley added that increased AOT use could have ripple effects across Bloomington-Normal's health and social service providers. She pointed out that it could alleviate pressure put on emergency departments, where people in a mental health crisis often land, and it could take stressors off the homeless system.
“If they are compliant, then [participants] may be more likely to be active, productive members of the community,” she said.
Block added that it can help people who may be experiencing their first episode of psychosis.
“It's a way to kind of stimulate and mandate some care, and hope that they can, you know, have an early intervention to that process as well,” he said.
A key component of the program, Foley said, is educating the public about it, so people outside the court — including families with a loved one who is struggling with their mental health — can recommend individuals for participation.
Four-year plan
Over the next four years, Block said the plan is to serve 231 individuals, with McLean County serving between 10 and 15 individuals annually.
To do that, Block said the grant will cover a program manager’s salary to oversee operations in both counties, and in McLean County funds will go toward hiring a case manager at Carle BroMenn Medical Center. Carle BroMenn President Colleen Kannaday said the hospital will help administering outpatient services.
“This is a wonderful opportunity, from my perspective, for many organizations, for us to come together and really focus on some of the higher-risk patients with more severe mental illnesses that can oftentimes fall through the cracks,” she said.
Some grant money will also go toward related McLean County programs, such as the county’s Frequent Utilizer System Engagement [FUSE] initiative, which helps people who regularly interact with the area shelters, jail system and emergency departments. Block said he’d like to see a peer support element incorporated through FUSE.
Larger implications
Block said the county’s pre-existing interest in improving community behavioral health and programs, along with FUSE, Foley and the state’s attorney’s commitment led AOIC to select McLean County as a partner. He added that he’s viewing this collaboration as an opportunity to create a tool kit and replicable model that other counties can use to develop their own civil court outpatient services programming.
“There's definitely some potential there to expand beyond these two counties and then really have a greater impact around the state,” he said.
