Clinical and Social Functioning Outcomes of Assisted Outpatient Treatment: Results From a Multisite Evaluation.

OBJECTIVE

This study used data from a multi-site evaluation of six assisted outpatient treatment (AOT) programs to assess the effectiveness of AOT on treatment adherence, clinical functioning, and social functioning outcomes.

METHODS

Sites provided primary data (e.g., structured client interviews across multiple timepoints) and subsets of secondary data on Medicaid/non-Medicaid service encounters, local/state arrest records, and public/private hospitalizations. One of the six sites provided primary data for a comparison population. Pre-post analyses pooled data across each of the six AOT sites and incorporated robustness checks using comparison and secondary data.

RESULTS

Among 392 AOT clients, appointment and treatment adherence increased by more than 24% and 20%, respectively, in 6- and 12-month follow-up windows relative to baseline. Symptomology, perceived mental health ratings, life satisfaction, and therapeutic alliance scores all improved significantly. Violent behavior was reduced by more than 19%, and suicidal ideation decreased by more than 24%. There was more than a 40% reduction in the percentage of clients with any psychiatric inpatient episodes, and more than an 8-night reduction in the number of nights spent in psychiatric inpatient care. The proportion of clients with arrests decreased by more than 19%, those with any illicit drug use decreased by more than 14%, and in the 6 months following entry into AOT, there was a 12% reduction in the proportion of clients experiencing any homelessness.

CONCLUSIONS

Findings point to significant improvements across a range of client outcomes upon receipt of AOT, spanning domains of treatment adherence, clinical functioning, and social functioning outcomes.