Advocates dialogue on Assisted Outpatient Treatment – Defining the “T” in AOT

September 28, 2014

During this past year two proposed bills (HR 3717 and HR 4574) have been introduced to committee and have received much coverage in the press and among mental health advocacy groups. While we applaud the focus on mental health services, the Children’s Mental Health Network is concerned that advocacy groups and the public at large have become entrenched in their public positions on a key issue in HR 3717 – the use of Assisted Outpatient Treatment (AOT). This entrenchment has led to a lack of constructive dialogue and understanding of the intricacies of the AOT process and the spotlight it shines on what is needed to improve mental health services and supports for young adults and their families. It is imperative that advocacy groups, families and providers come together to address their differences on AOT and provide useful compromise solutions to help lawmakers craft meaningful legislation. 

Our upcoming dialogue is focused on clarifying the “T” in AOT. As the dialogue series evolves we will find ourselves getting much deeper into the complexities involved with the actual provision of service, which is important for congressional staff to understand if they are to write legislation that effectively highlights what is needed to help families and their young adult children in crisis. As always, our overriding goal is to open lines of communication among advocates and providers with divergent views, and to model for legislative staff that constructive dialogue can occur. 

If you are in Washington, DC on Monday, September 29th, you are invited to join the Children’s Mental Health Network for the second in a series of ongoing dialogues, with a focus during this dialogue on the specific processes involved in decision-making and treatment options available as part of the AOT process.

    Monday, September 29th, 9:00 am – 11:00 am 
    Cannon House Office Building – Room 441 

The Advocates Dialogue on Assisted Outpatient Treatment (AOT) is being conducted to achieve two primary objectives: 

  • For advocates, families and providers 
    Bring together advocates on both sides of the AOT discussion to listen to differing perspectives and share ideas for how to move the national conversation about AOT forward. Key to this effort is a focus on strategies that facilitate collaboration, civility, and improvement of services and supports for individuals with mental health challenges, their families and the communities in which they live. 
  • For congressional representatives and staff 
    Provide an opportunity for congressional representatives and staff to observe the dialogue and gain deeper insight into the perspectives and the different advocacy positions. Since legislative staff are critical to the writing of language in any proposed bill that addresses this topic, it will be beneficial for them to have a broader understanding of perspective and utilize that broadened perspective in working on compromise language. 

    We will capture key points and suggestions for moving the dialogue forward in the discussion and will prepare a written report for dissemination to members of the House Committee on Energy and Commerce for their consideration as they work toward compromise language to pass meaningful mental health legislation.

Note: For background context on the creation of the Advocates Dialogue on Assisted Outpatient Treatment, please click here

Overall purpose of the dialogue 
The goal for this meeting is not to pit “for” and “against” head to head. Quite the opposite. The purpose of the discussion is to provide an opportunity for the sharing of personal experience around the challenge of addressing this issue and the emotion it brings – precisely why this discussion will not focus on research, data or other props to support a position one way or the other. Everyone in the discussion is quite astute and could argue a position either for or against with plenty of supported data to back them up. 

How is the dialogue be structured? 

  • Scott Bryant-Comstock will facilitate the discussion. Discussants will be seated in a circle in the center of the room. Congressional members, staff and interested citizens will be invited to observe the discussion. 
  • No charts, graphs, research studies, or speeches allowed! There have been presentations of research on both sides of the issue in many different forums. And it seems to us that neither side is listening to the other, so we are gonna leave the PowerPoints behind!
  • At the end of the dialogue, observers are welcome to interact with discussants in an informal “after the meeting” environment. 
  • The goal of the discussion is not to “solve” anything – just to broaden understanding of the unique perspective each brings to the topic. Quite bluntly, our goal in this meeting is not to convince members in Congress of what the “right decision” is, but more to encourage continued and more frequent dialogue between proponents of both bills. Knowledge is power. Ignorance is bliss, which is always short lived. 
Participants in the dialogue include: 

baronStephen Baron, Director, Department of Behavioral Health, District of Columbia, Washington, DC – Steve Baron leads the development and management of the District’s mental and substance use disorder treatment services and supports. The Department of Behavioral Health provides emergency psychiatric care and ongoing community-based services and support to about 30,000 residents, including a network of private mental health rehabilitation services and substance abuse treatment providers, unique government delivered services, and Saint Elizabeths Hospital—the District’s inpatient psychiatric facility. Before joining District government, Mr. Baron was president of Baltimore Mental Health Systems, Inc. for 17 years where he developed a range of innovative community-based programs for adults, increased affordable housing for people with mental illness, and expanded school-based and early childhood mental health services.


Scott Bryant-Comstock, President & CEO, Children’s Mental Health Network – Scott has worked in the mental health field for over 30 years in a variety of roles, including therapist, trainer, mental health board chair, state level mental health official and national consultant, trainer and facilitator. Over the course of his career, Scott has incorporated learnings from policy-makers, families, providers and community leaders throughout the United States into a focused approach to improving services and supports for youth with emotional challenges and their families. Scott is the founder, President & CEO of the Children’s Mental Health Network.

enbryDennis Embry, President/Senior Scientist at PAXIS Institute – Dennis D. Embry is a prominent prevention scientist in the United States and Canada, trained as clinician and developmental and child psychologist. He is president/senior scientist at PAXIS Institute in Tucson and co-investigator at Johns Hopkins University and the Manitoba Centre for Health Policy. His work and that of colleagues is cited in 2009 the Institute of Medicine Report on The Prevention of Mental, Emotional, and Behavioral Disorders Among Young People. Clinically his work has focused on children and adults with serious mental illnesses. He was responsible for drafting of the letter signed by  23 scientists, who collectively represent scores of randomized prevention trials of mental illnesses published in leading scientific journals. In March 2014, his work and the work of several signatories was featured in a Prime-TV special on the Canadian Broadcast Corporation on the prevention of mental illnesses among children—which have become epidemic in North America.

jammieJammie Farish, Youth M.O.V.E. (Motivating Others through Voices of Experience) Oregon – Jammie Farish is the Training and Development Director for Youth M.O.V.E. Oregon. In 2009, Jammie worked with Martin Rafferty and Lisa Moody to found Youth M.O.V.E. Oregon and establish it as an independent, youth-driven organization that has had a sizeable impact at both the local and state levels. Motivated by her journey in the mental health system with her son, Jammie left the world of Special Education with the school district to pursue work in the field of peer services and advocacy. This experience led to her professional pursuits as a Family and Youth Advocate dedicated to system of care reform, community-based wraparound services, and peer delivered services, advocacy, and more. For her work, she has been awarded Oregon Mental Health Award of Excellence and the Children’s Mental Health Advocate of the Year (Oregon Council of Child and Adolescent Psychiatry). 

leahLeah Harris, Director of the National Coalition for Mental Health Recovery – Leah Harris is a mother, storyteller, survivor, advocate and the Director of the National Coalition for Mental Health Recovery. She has written widely to promote human rights, dignity, healing, and self-determination, and has spoken at advocacy/activist gatherings and conferences including NARPA, Alternatives, and the National Conference on Organized Resistance (NCOR). Her writing has appeared in publications including Off Our Backs: a Women’s Newsjournal,, CounterPunch, Street Spirit and Her spoken word album, “Take Refuge,” chronicles her journey from suicidal patient to human rights activist. 

lambertLisa Lambert, Executive Director, Parent/Professional Advocacy League (PPAL) and Children’s Mental Health Network Advisory Council member – Lisa Lambert is the executive director of Parent/Professional Advocacy League (PPAL), a statewide, family-run, grassroots nonprofit organization based in Boston. Lisa serves on a number of committees in Massachusetts as well as the Building Bridges Initiative Youth and Family Partnership workgroup. She has been instrumental in working with local and national media to highlight the concerns of families and youth. She is dedicated to ensuring that family voice is included in every state and national conversation about the policies, practices or services that impact them.

sophiaSophia Lenk, Mandatory Outpatient Treatment Coordinator for Prince William County Community Services in Prince William County, Virginia – Ms. Sophia Lenk is a licensed clinical social worker who has 25 years of experience in local health and human service agencies. Ms. Lenk’s first 22 years were with the Department of Social Services in child welfare and adult protective service positions as well as in program managing. Ms. Lenk is currently in the position of Mandatory Outpatient Treatment Coordinator for Prince William County Community Services in Prince William County, Virginia. She has long held a strong commitment to serving Virginia’s vulnerable citizens.  

lizaLiza Long, the “Anarchist Soccer Mom” – Liza Long is a writer, educator, mental health advocate, and mother of four children. She loves her Steinway, her kids, and her day job, not necessarily in that order. Her book “The Price of Silence: A Mom’s Perspective on Mental Illness” is now available in bookstores.

martinMartin Rafferty, Executive Director Youth M.O.V.E. Oregon – is the founder and executive director for a state-wide chapter of Youth M.O.V.E. National called Youth M.O.V.E. Oregon. Martin was diagnosed with bipolar II at 23 and later with PTSD but does not let diagnosis define who he is. Martin is the winner of multiple advocacy awards in the field of mental health and the author of curricula used by state leaders in Oregon to train peer support specialists. As an experienced public speaker, Martin has trained nationally since 2009. He is the primary author of the Youth Mental Health Bill of Rights and the director of an award winning documentary video called Project Invoke.

rita2Rita Romano, Emergency Services Division Manager, Prince William County CSB  – Ms. Rita Romano is a licensed clinical social worker who has been providing community behavioral health services in Virginia for the past 35 years. She currently holds the position of the Emergency Services Division Manager for Prince William County Community Services in Prince William County Virginia. Ms. Romano has nurtured a keen interest in the involuntary commitment laws for many years. She served on the Commitment Task Force that supplied information and recommendations to the Commission on Mental Health Law Reform that was commissioned by Chief Justice Leroy Hassel.  

brianBrian Stettin, Policy Director, Treatment Advocacy Center – Brian Stettin is the Policy Director of the Treatment Advocacy Center, a national advocacy organization based in Arlington, Virginia that works to remove legal barriers to the treatment of severe mental illness. In 1999, as an Assistant New York State Attorney General, Brian was instrumental in conceiving and drafting “Kendra’s Law,” landmark legislation establishing Assisted Outpatient Treatment (AOT) in New York. After leaving the Attorney General’s Office in 2007, Brian served as Special Counsel to the New York State Commissioner of Criminal Justice Services and Counsel to the Health Committee of the New York Assembly.  Since joining the Treatment Advocacy Center in 2009, Brian has worked with state legislators and policymakers across the U.S. to improve mental health commitment laws and establish AOT programs. Brian is a 1991 graduate of the City College of New York and a 1995 graduate of the University of Texas School of Law.

Questions? Please contact Scott Bryant-Comstock, 919-219-2342 /

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