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

Abstract

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.