CMHNetwork is bringing both sides of the AOT discussion together for conversation with congressional staff

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Last week, Martin Rafferty, CMHNetwork Advisory Council member and Executive Director, Youth M.O.V.E. Oregon, joined me in meetings with staff from the offices of Representative Murphy (PA) and Representative Barber (AZ). The purpose of our visit was to continue our ongoing discussion about the efforts of members of Congress who are looking for areas of compromise between two mental health bills (HR 3717 and HR 4574) currently in committee.

We stressed the importance of dealing with some of the most contentious issues in both bills and not just settling for moving forward the non-controversial ones. There has been so much discussion this past year about the state of the mental health delivery system in America; it would be a shame to take the easy way out and put forward a bill with no teeth in it to address the growing perception of a broken mental health delivery system.

The area of focus for this particular visit was primarily on the provision in HR 3717 that requires states to authorize assisted outpatient treatment (AOT) in order to receive Community Mental Health Service Block Grant funds. The Network has posted several articles from Network faithful both for and against the Assisted Outpatient Treatment provision in the Murphy bill. Like so many things in life, the issue is much more complicated than just a yes or no answer, especially for young adult children who may be living at home with their parents.

In a recent Morning Zen post, I spoke of the "inconvenient truth" that some families face when their adult children are in a dangerous place, and they are struggling with how or if to be involved in treatment decisions. The issue is real, and passions are high for and against. Since the Network has faithful followers and contributors to Morning Zen representing both sides of the discussion, it is incumbent upon us to look for areas of agreement and compromise to help move the discussion forward.

To further drive home how serious we are about modeling rational discussion and expanded understanding of differing positions, we invited both Representatives and their staff to observe a conversation between a small group of dedicated advocates from differing perspectives on the use of Assisted Outpatient Treatment. The purpose of the meeting is not to come up with an “answer” or decision on which approach is better, but simply to create an environment of civil discussion and maybe a bit more insight among participants about the perspective of others.

When we described the structure of the meeting to both offices, each were equally encouraging of such a dialogue, and while no firm commitments were made on who from each office would attend, we were encouraged enough that we are moving forward with the meeting. Representative Barber’s office has agreed to help us secure space for the meeting, and we are looking at dates in August.

We have identified a small group of individuals representing a variety of perspectives on the issue of Assisted Outpatient Treatment. All have written Morning Zen posts for the Children’s Mental Health Network or are Advisory Council members actively involved in the discussion of the issue. Participant names are hyperlinked to their Morning Zen posts.

So far, we have the following commitments to travel to Washington, DC for this meeting:

As always with the Network, everyone pays their own way, and we appreciate the commitment and sacrifice these wonderful advocates are willing to make for this effort.

Here is the structure of the meeting, which is actually quite simple. Just the way we like it!

Pretty darned simple and basic. This meeting is not designed to move the earth. It is simply designed to get people with different perspectives in the same room for a calm and rational discussion – something that we have not seen evidence of to date.

We will keep Network faithful posted as the meeting takes shape. To borrow a phrase from the Moral Monday movement in North Carolina, “One step forward, not one step back.”


Scott Bryant-Comstock
President & CEO
Children's Mental Health Network



  1. DJ Jaffe's avatar
    DJ Jaffe
    | Permalink
    If you need a fact base for opinions, this should help
    Results of Kendra'sLaw in NY
    Results of Laura's Law in CA
    What consumers who have actually experienced AOT say about it
    Myths about AOT
  2. Psych Survivor's avatar
    Psych Survivor
    | Permalink
    "Like so many things in life, the issue is much more complicated than just a yes or no answer, especially for young adult children who may be living at home with their parents."

    I am sorry but there are a few things in life that are indeed yes/no or "black and white" if you want to put it that way. Prominently among them is anything that deals with civil rights. The US Supreme Court has said so and requires a test known as "strict scrutiny" to review policies that violate fundamental rights. This test is heavily skewed towards the individual freedom at play to point that very few policies are able to meet this stringent test. So in a way, the US Supreme Court has already spoken on this matter: civil rights are "almost" black and white.

    My contention is that AOT, understood as drugging involuntarily on an outpatient basis people who don't want to drugged and who have not been deemed legally incapacitated, does not met the "strict scrutiny" standard, making the whole discussion moot. As I said the previous entry on AOT, no other so called "involuntary medical intervention" is allowed to proceed without meeting the standard, including the drugging of people at high risk of HIV infection, regardless of whether they are minors. Parents cannot force their male gay teens on Truvada even though this is the group of people (male gay teens) at the highest risk of HIV infection.

    It is time to stop promoting the bigotry that people who have not been deemed legally incapacitated are unable to make their own decisions whenever the APA insults them with one of its invented DSM diseases.
  3. Rita Thrasher's avatar
    Rita Thrasher
    | Permalink
    My reliance on the Friday Update to "show the way" is again justified. The shared perspective approach sans slides takes us back to basic communication and forward to embracing "the whole". Thank you. I'll make use of it in community building for mental health in Boca Raton.
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