Correlates of reinstitutionalization for SPMI adults mandated to assisted outpatient treatment

Gail S Bach, Fordham University


In November 1999, New York State enacted Section 9.60 of the Mental Health Law, which authorized court-ordered outpatient treatment, Assisted Outpatient Treatment (AOT). The AOT law, intended to reduce incidents of reinstitutionalization, established a procedure for obtaining court orders mandating that mentally ill adults with histories of psychiatric aftercare noncompliance and/or violent behavior receive and accept outpatient treatment for their mental illnesses. The effectiveness of the AOT program in New York State is not yet known. Identifying the patient characteristics and behaviors and support services that are associated with the most beneficial outcome from AOT is important in evaluating and improving the AOT program in New York State. This descriptive, cross-sectional study sought to gain a better understanding of the personal, environmental, and behavioral factors of patients mandated to AOT that are associated with incidents of reinstitutionalization. Employing secondary data analysis of a convenience, nonrandom sampling of patients mandated to AOT in New York City, the study examined client demographic characteristics (e.g., gender, age, and substance use history), environmental factors (e.g., housing factors and treatment factors), and behavioral factors (e.g., current incidents of substance/alcohol use and violent behavior). One finding, which approached significance, indicated an expected positive association between treatment compliance and reduced incidents of reinstitutionalization. No significant associations that supported the study's hypotheses were found. There were, however, significant associations between reinstitutionalization and four variables in converse directions of those hypothesized. History of substance use and history of violence were significantly associated with a decrease in reinstitutionalization. Higher levels of education and participation in supportive housing were associated with an increase in reinstitutionalization. The logistic regression model indicated that history of violence predicted reduced reinstitutionalization, and higher level of education predicted increased reinstitutionalization. Although the study's hypotheses were not supported, results suggest important areas for future study that will promote a better understanding of the factors that may be associated with the reinstitutionalization of participants in the AOT program in New York City. The dissertation concludes with a discussion of these issues.

Subject Area

Social work|Mental health

Recommended Citation

Bach, Gail S, "Correlates of reinstitutionalization for SPMI adults mandated to assisted outpatient treatment" (2004). ETD Collection for Fordham University. AAI3149099.