Is Assisted Outpatient Treatment (AOT) an effective mental health intervention to consider for Black Americans?

Black Americans who have serious mental illness (SMI) – major depression, bipolar disorder, and schizophrenia – tend to have vastly different experiences when they engage with mental health treatment and services. For example, the estimate for outpatient mental health service use among adults who have SMI is greater for white consumers compared to Black Americans (46.2% for white consumers with SMI, 40.6% for Black American consumers with SMI). This is in part because Black Americans tend to be disproportionately affected by the lack of access to mental health services. They are also usually more reluctant to seek treatment due to mental health stigma in their respective communities. In addition, racial and ethnic populations tend to be less satisfied with their professional mental health services and, as a result, tend to have higher treatment dropout rates.

Assisted Outpatient Treatment (AOT) is a mental health intervention that encompasses the practice of community-based mental health treatment under civil court commitment. AOT helps individuals who have difficulty with compliance under voluntary treatment. It also allows providers to focus on participant engagement to enhance treatment outcomes.

SMI Adviser offers a helpful guide “Engaging Black American Participants in AOT” that is developed in partnership with Treatment Advocacy Center (TAC). This guide helps you enhance engagement with Black Americans who have SMI and provide recovery oriented AOT that prioritizes the personal goals of the participants.




  • Substance Abuse and Mental Health Services Administration. (2021). Racial/ethnic differences in mental health service use among adults and adolescents (2015-2019). Retrieved from
  • Maura, J., & Weisman de Mamani, A. (2017). Mental health disparities, treatment, and attrition among racial/ethnic minorities with severe mental illness: A review. Journal of Clinical Psychology, 24.
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