Can my loved one be court-ordered to participate in outpatient mental health treatment?

What keeps people from seeking treatment on their own?

If your loved one is experiencing mental health or substance use symptoms that make it difficult for them to stay safe, stay out of trouble with the law, or function well in their roles and relationships, they may benefit from participating in treatment to get the help and support they need to be well. It's best when a person decides to seek treatment on their own, but some symptoms make it hard for people to recognize the need for treatment.

Anosognosia is a symptom of serious brain conditions like schizophrenia, bipolar disorder, and Alzheimer's disease that causes an inability to recognize one’s own illness. People with mental illness who experience anosognosia are less likely to seek treatment because of difficulty recognizing their illness and its impact on their wellbeing.

Other people may not be ready or willing to engage in outpatient treatment for mental health or substance use concerns. They may not find their symptoms to be a problem, or they may not think that treatment will help.

Can a judge order someone to participate in treatment?

When someone can’t or won’t participate in treatment on their own, a judge may have the authority to order that person to participate in outpatient treatment.

If someone who has a mental health or substance use condition has been accused of a crime, a judge may order that person to participate in treatment instead of facing criminal penalties like a criminal record, fines, probation, or time in jail or prison.

Because people generally have the right to choose whether or not they seek medical care, a judge must have a compelling reason to order treatment. The following things may affect a judge’s willingness and/or ability to order your loved one to participate in outpatient treatment:

The laws in your loved one’s state
Court practices in your loved one’s area
What court-ordered treatment programs are available in your loved one’s area
The severity of your loved one’s condition
Whether your loved one's symptoms have caused or are likely to cause safety and/or legal concerns

What programs can I explore?

Below are a few types of court-ordered treatment programs you may consider exploring. Note that the name, structure, and availability of each program will vary by state.

Assisted Outpatient Treatment (AOT)

Assisted Outpatient Treatment involves a civil court order that requires someone to participate in a mental health treatment program. AOT programs are partnerships between mental health agencies and county or circuit courts. Assisted Outpatient Treatment is a civil court process, not a criminal court process.

The type of treatment program offered through AOT varies. It often involves a team approach that includes therapists, psychiatrists, case managers, housing specialists, and peer support specialists.

AOT is designed to support people with anosognosia and others who might find it difficult to stay in treatment. AOT may be included as part of someone’s discharge plan after they have been involuntarily hospitalized or as part of their release plan when getting out of jail or prison.

Mental Health Courts

Mental health courts describe programs in which the court offers someone the chance to participate in mental health treatment to avoid further involvement with the criminal justice system. The goal of these programs is to encourage people whose crimes may be related to a mental health condition to participate in treatment rather than face criminal penalties.

Drug Courts

Like mental health courts, drug courts describe programs in which the court offers someone the chance to participate in substance use disorder treatment to avoid further involvement with the criminal justice system.

In addition to treatment participation, drug courts often involve drug testing, keeping a job, and other requirements related to the person's situation (e.g., parenting classes). The goal of drug courts is to encourage people whose crimes may be related to a substance use disorder to participate in treatment rather than face criminal penalties.

While mental health courts and drug courts are usually voluntary (people can choose whether or not to do it), those who choose not to do treatment may face criminal penalties. If someone who does not want to participate in treatment becomes involved with the criminal justice system, these court-ordered programs can help encourage them to seek the care they need to be well.

What can I do?

It’s best to speak to a legal professional in your loved one’s area to explore what options may be available to them. If your loved one has recently been arrested, consider contacting their attorney and asking about options for having your loved one court-ordered to participate in treatment as an alternative to jail time or other criminal penalties. You may also consider exploring court-ordered treatment options like AOT if your loved one has been released on probation and needs help staying in treatment.

The Treatment Advocacy Center (TAC) maintains a section of its website dedicated to Civil Commitment Laws in Each State, which has valuable information and resources to help you learn more about laws, programs, and potential options in your loved one’s area. TAC also has an AOT Programs by State directory on their website.

The National Treatment Court Resource Center maintains an interactive Treatment Court Map that shows the number of treatment courts in each state. This tool may help you find and discuss options with your loved one and/or a legal professional.

You can also search online for “court-ordered mental health treatment” or “court-ordered substance use treatment” in your loved one’s county and state or contact their local NAMI to ask about options that may be available in the area.

What if my loved one needs treatment right now?

Many states have involuntary treatment laws for situations involving immediate risk to self or someone else. Visit the following HelpLine Knowledge Articles for more information:

Hours of operation: Monday-Friday, 10 a.m. – 10 p.m. EST

Call: 800-950-NAMI (6264)

Text: 62640

Email: helpline@nami.org

Website: www.nami.org/help