Legislative Findings and Intent

I Liheslaturan Guåhan finds that Assisted Outpatient Treatment

(AOT)is practiced in forty-five

(45)states as an extension of inpatient treatment, while allowing the qualified patient with a treatable mental illness or condition to receive court ordered treatment on an outpatient basis. It is also known in some states as outpatient commitment. A detailed six (6)-month study of New York’s Kendra’s Law documented a striking decline in the rate of hospitalization among participants. AOT recipients were hospitalized at less than half the rate they were hospitalized in the six

(6)months prior to receiving AOT (i.e., the hospitalization rate dropped from seventy-four

(74)percent to thirty-six

(36)percent). Further, when they were hospitalized, the COL622016 CH. 82A ASSISTED OUTPATIENT TREATMENT length of the stay was greatly reduced. demonstrated similar benefits. Studies in other states have The continued treatment and management of the patient’s condition on an outpatient basis has also been determined to greatly reduce incidents of violence and arrests. Without AOT, the patient’s condition often deteriorates directly due to a lack of treatment compliance and the continuing exhibition of “good” adherence to their medication treatment plan. Another tragic consequence for many individuals with untreated mental illnesses is homelessness. At any given time, there are more people with untreated severe psychiatric illnesses living on America’s streets than are receiving care in hospitals. In New York, when compared to the three

(3)years prior to their participation in the program, seventy-four

(74)percent fewer AOT recipients experienced homelessness (New York State Office of Mental Health 2005). New York and other states have incurred enormous costs in the provision of public assistance for housing assistance and rehospitalization. I Liheslaturan Guåhan further finds that the consequences of untreated mental illness are as apparent as they are devastating: homelessness, criminalization, suicide, violence, victimization, lost productivity, permanently decreased medication responses, and the incalculable costs of unnecessary suffering. Due to advances in recent years, treatment is now available that can eliminate or substantially alleviate the symptoms of mental illness for most who suffer from it. People with treated mental illness can now reclaim their lives. But first, there must be treatment. Treatment voluntarily embraced is always preferable. However, mental illness is a biologically based disease that attacks the brain. As a result, mental illness renders many people incapable of voluntarily entering treatment because they are unable to make rational decisions or unaware that they are ill. When this occurs, such people may require assisted treatment to protect their lives, as well as to avoid tragic personal and societal consequences. This Act is designed to be the legal framework for the provision of care to individuals who, due to the symptoms of severe mental illness, become either dangerous or incapable of making informed medical decisions concerning their treatment. COL622016 CH. 82A ASSISTED OUTPATIENT TREATMENT The procedural components of this Act are intended to create a flexible mechanism that can be used to secure treatment for those who most need it while still distinguishing those for whom intervention is inappropriate. Paramount are the strict and plentiful safeguards which this Act establishes to protect both the rights and well-being of those subject to it. It is the intent of I Liheslaturan Guåhan to provide for a missing but necessary treatment component in our mental healthcare system. As was the case in New York City in the establishment of Kendra’s Law, it took the tragic death of Ms. Kendra Webdale, a young woman who died in January 1999 after being pushed in front of a New York City subway train by a person who was living in the community at the time, but was not receiving treatment for his mental illness. On Guam, we had the recent case of ten

(10)month old baby Alexya being punched in the face while in the arms of her mother under similar circumstances by a person not receiving treatment for her mental illness.