Services Effectiveness Research Program (SERP)

Duke University School of Medicine
Department of Psychiatry and Behavioral Sciences

Current and Recent Projects

Principal Investigator(s): Marvin Swartz, MD; Jeffrey Swanson, PhD

SERP Investigators and Collaborators: Richard Van Dorn, PhD; Christine Wilder, MD; Lorna Moser, PhD; Allison R. Gilbert, PhD

Project Description:

Executive Summary of AOT Evaluation Report

In 1999, New York State created a program authorizing court-ordered treatment in the community for people with severe mental illness at risk of relapse or deterioration absent voluntarily compliance with prescribed treatment. The 2005 reauthorization of the AOT Program required an independent evaluation of its implementation and effectiveness, specifically addressing several areas of investigation . The New York State Office of Mental Health issued a competitive Request for Proposals, and the contract for the evaluation was awarded to the Services Effectiveness Research Program in the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center with a subcontract to the

Policy Research Associates, Inc. of Delmar , NY , and with additional support from the John D. and Catherine T. MacArthur Foundation Research Network on Mandated Community Treatment.

The contract required study and reporting on the following areas:

Description of AOT Program and regional variations : Are there regional and cultural differences across the state in AOT programs and their implementation?

Service engagement : What is the level of service engagement of recipients of mental health services during AOT?

Recipient outcomes : What are the out­comes for people with mental illness who are mandated into AOT versus those who receive voluntary enhanced outpatient services?

Recipient perceptions of AOT : What are the opinions of a representative sample of AOT recipients regarding their experiences with AOT?

Service engagement and outcomes after AOT ends : What is the level of service engagement of recipients of mental health services post-AOT?

The impact of AOT on New York 's public mental health system : What is the impact of AOT programs on the availability of resources for individuals with mental illness and perceived barriers to care?

To address these areas of investigation we studied existing records from several ex­tensive data sources, described in the appendices, including: AOT Program administrative data, New York State Office of Mental Health client profile surveys, hospital admissions records, case manager reports on AOT recipients and Assertive Community Treatment recipients, Medicaid claims, arrest records, U.S. Census, and Mental Health Needs Estimation Project data. In addition, we conducted statewide in-person interviews among key stakeholders to gain insight into the operation of the AOT Program and interviewed service recipients in six counties to assess attitudes about treatment, treatment experiences, and treatment outcomes.

 The full evaluation report is provided online by the New York State Office of Mental Health.