Improving access to mental health services: A community systems approach

In March, 2005, the Michigan legislature passed a law giving probate court judges the power to order individuals who are the subjects of petitions to enter outpatient mental health services and comply with the full scope of treatment plans, including medication orders. These orders are known collectively as “assisted outpatient treatment” (AOT). This law is named Kevin's Law in honor of a teenager who was beaten to death in a Kalamazoo bus station in August, 2000, by an individual who had untreated schizophrenia. This individual cycled in and out of mental health institutions and the criminal justice system for years and was not taking prescribed psychiatric medications. The Oakland County Probate Court and the Oakland County Community Mental Health Authority have collaborated as a multidisciplinary team to implement Kevin's Law since its passage. The team's goals are to improve court and treatment processes as well as communication between the systems, increase the effectiveness of services, reduce the amount of cycling, reduce psychiatric hospitalizations and readmission, and ensure continuity of services. This presentation will focus on evaluation activities, including data collection and analysis between systems. Further, progress with an adjacent county that is not implementing AOT will be compared. The presentation will highlight findings to date, quantitative and qualitative methodological strategies, and the public mental health policy implications.