AOT - Forced Treatment and why it should matter to you!

Written by Robin Rider-Osborne interviewing Sharon Cressinger of New York. presented to the KY PAIMI Council: Tuesday, November 04 2015

I am speaking about AOT & Murphy Bill at our meeting. — in Frankfort, Kentucky.

If people want to understand how AOT gets used in practice, they need to go to New York.

On the limitations of diagnosis, one could write forever.

In NY, of course, we are talking about Kendra's law. It has been so lethal because it came with funding. Of course, 45 or so states have AOT laws, but most came with no allocation so they are not widely enforced. Like most of the AOT laws, the criteria for commitment is "dangerousness". However, the first point I like to make is that in NY, there have been all kinds of abuse of this concept. A simple disagreement with a psychiatrist about what medication to be on can be interpreted as "it is dangerous not to comply with your medication".

It is a horror show for people who are on it.

Then, of course, there is the forced drugging. Compliance with medication can become part of an AOT order, so people may be injected with the antipsychotics or whatever if there is a reason to believe they are not in compliance with oral medication. And, of course, we know how dangerous the meds are.

In NY, people who are on an AOT order are required to meet with different members of their ACT team six times a month, at the convenience of the ACT team members. It is keeping people who want to work from getting jobs.

Also, there is MH housing (I like to call it the new ghetto) that is also tied to AOT. People are put into inpatient hospitalization until these lose their housing, and then their only option is this MH housing that is tied to AOT and treatment compliance.

It is absolutely possible and imperative to tie these issues together.

Muphy Bill and AOT and how it restricts a person's rights with a mental health diagnosis. SMI

Kendra's law is the crown jewel in the TAC AOT presentaIf you are discussing AOT, it is imperative to talk about NY. I am not an expert on Kendra's law, but I am an expert on the people it has impacted. It ties directly to my work at the Alliance.

I have not heard of anyone being forced into ECT by and AOT order, but it would be not too hard to find out if it has happened.

So, people up there are getting on AOT for minor reasons that are loosely interpreted as dangerousness, being force drugged, having their housing and their income (I forgot to mention that in addition to losing out on employment opportunities, many are required to have a payee as a part of AOT, and to pay whatever they are told if they are part of MH housing) tied to treatment compliance. And AOT is extended for many "infractions" by power hungry providers who are poorly trained. They are using peers on these ACT teams also.

It's a mess. I have personally helped people remove themselves from the county where they are court ordered, or from the entire state if necessary, and I am not ashamed.

Tying the Murphy Bill into AOT.

In the end, the most painful thing for me is that people go back. They have become so disempowered by the system that they literally go back to the situations they have take so many risks to come out of.

There are a lot of people doing the best they can, as you say.

And a lot with no voice, like all of the court ordered people I met in NY.

People get court ordered in lots of different ways. Often, there is legal involvement, as you indicate. Sometimes it is also the families, somewhere I have a form that ANYONE can submit to a court indicating that they think someone is a "danger". What I saw a lot of in NY was people who had lengthy inpatient hospitalizations and simply had nowhere to go when they got out. So they were court ordered to treatment in order to enroll them in the related services I mentioned, which of course, generate revenue for the state.

And, as you know, it is felt generally that court ordering someone to AOT keeps them out of inpatient services and saves money. In this case, it actually generates revenue...I am not well versed in NY politics generally, but I have the sense that the state is generally corrupt and that this is one of the reasons that AOT works so well there.

The AOT order is also sometimes an implicit condition for getting out of the hospital.

45 states, maybe 46 now, have AOT laws, but they are largely unfounded. The NY law came with, I'm thinking 32 million for some reason.

Ohio also has AOT. It is hardly used in most counties. No allocations. - Sharon Cressinger, New York, Advocate corresponding on Forced Treatment.

Robin Osborne -

How AOT is working in Kentucky :

Adam Horine

How it violates someone's rights.

Mental Health Courts

How it can be misused.

How there is no expiration date.

A person should have the right to choose what is best for himself same as any other medical condition?

Then I found this from last year: change mental health laws in Kentucky<https://changementalhealthlawsinky.blogspot.com/>

There is drug company money behind NAIMI and they have the largest base

Obviously, since this was written both the Murphy Bill (21st Century Cures Act) and Tim's Law (Forced AOT ) in Kentucky passed ( tho is not yet funded) We cannot and must not go back to institutionalization. We as advocates must stand together and cross-disability activism is a must.

Be careful advocating for forced treatment because it might just be used on you someday against your will. I have seen it happen in the past.