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ALPENA — Brooke Paczkowski, a Northeast Michigan Community Mental Health (NeMCMH) court liaison, said assisted outpatient treatment (AOT) is key in preventing hospitalization and incarceration in Northeast Michigan and across the state.

Paczkowski explained that AOTs are petitioned by family, friends, or loved ones on the behalf of an individual who is believed to be struggling with mental health challenges. She said that police officers, hospital staff, NeMCMH staff, or anyone older than 18 can pursue a petition.

“Anybody 18 or older is able to petition someone for mental health treatment if they are concerned that they’re either going to be a danger to themselves,” Paczkowski said. “Or a danger to others in the near future.”

She explained that AOTs require petitioned individuals to receive treatment at CMH facilities, which are ordered by the court system. Petitioned individuals also receive a case manager who visits their residence to ensure the petitioned individual is meeting their basic needs such as showering, brushing their hair, changing their clothes, et cetera.

“Just to make sure that everything is okay,” she said.

She added that individuals are also assigned a psychiatrist who meets with petitioned individuals every three months or so.

“It depends really on their treatment needs and goals,” Paczkowski said.

She explained that AOTs last three months but continuing orders can last indefinitely.

“The longest order is a continuing order and that’s 365 days long,” she said. “But that can be continued endlessly, basically.”

Paczkowski stated that AOTs prevent hospitalizations and incarcerations in NeMCMH’s coverage area.

“What we have seen from it is fewer hospitalizations for individuals,” she said. “That means that they’re getting their treatment out in the community with us and not ending up in the hospital … there’s also fewer arrests or incarcerations because they’re really getting their treatment up mainstream through us, which leads them to not be involved in the criminal justice system.”

In 2004, former Michigan Governor Jennifer Granholm signed Kevin’s Law which allowed courts to order treatment for individuals with serious mental illness who do not meet the current criteria for involuntary hospitalization but who need outpatient mental health treatment to protect themselves and others, according to a Governor Granholm press release from 2004.

The release stated that Kevin’s Law created treatment options for individuals with “severe mental illness” who are not receiving or are not complying with recommended mental health treatment.

“Kevin’s Law will help citizens whose illness has temporarily impaired their understanding of the need for treatment,” Granholm said in the release. “It will allow families and friends of the individual to petition the court to order appropriate outpatient mental health care, reducing the risk of adverse events for both the individual and the community.”

Kevin’s Law amended the Michigan Mental Health Code by establishing criteria for AOTs under court order, and providing services through local Community Mental Health Services Programs (CMHSP).

According to Psychology Today, Kevin’s Law was created in response to the death of a graduate student, Kevin Heisinger, in 2000. Heisinger was beaten to death at a bus station in Kalamazoo by a man who had been in and out of the mental health system and was struggling with severe mental illness.

Paczkowski said that the “big problem” with individuals who have an AOT struggle to understand the severity of their mental illness.

“They do not have any insight into their mental illness,” Paczkowski said. “They do not understand the need for their treatment, why they need the treatment, what ended them up on the court order.”

She explained that once individuals begin to comply with their AOT and consistently take their medications, they have better insight into how they are struggling and why they have a court order.

“Once that medication begins to work, it finally starts to become clear to them,” she said. “Like, ‘Okay, so this is why I ended up in the hospital,’ ‘When I’m not doing well, these are the symptoms that I’m having.’ They’re able to kind of recognize when they are not doing well.”

Paczkowski added that when individuals arrive at NeMCMH with an AOT they are not “necessarily excited to be in services with us … it kind of just feels like a punishment to them.”

Paczkowski said that NeMCMH staff try to help patients with AOTs understand that they are receiving mental health services for them to get better and that their treatments are not a punishment.

“We try really hard to get them to realize that we are here to help,” she said.

Paczkowski added that some individuals request to stay on court ordered treatment services to “hold themselves accountable.”

“They might know themselves well enough that if we are not there checking in on them or making sure that they’re doing what they’re supposed to be doing, that they might fall back and end up in the hospital again.”

NeMCMH serves Alpena, Alcona, Montmorency, and Presque Isle counties. Paczkowski said that Alpena County has the largest amount of AOTs, though that is likely because of the county’s population density compared to other parts of Northeast Michigan.

She added that Presque Isle has less than Alpena, and both Alcona and Montmorency “have very little.”

Paczkowski said she couldn’t provide the exact number of AOTs per county because “they’re constantly changing.”

Kayla Wikaryasz can be reached at 989-358-5688 or kwikaryasz@TheAlpenaNews.com.