1. Ashlea Emery ASSISTED OUTPATIENT TREATMENT

2.  Program:  a civil legal procedure whereby a judge can order an individual with a serious mental illness to follow a court-ordered treatment plan in the community. AOT is intended for adults diagnosed with a serious mental illness who are unlikely to live safely in the community without supervision and treatment, and who also are unlikely to voluntarily participate in treatment  Program goal:  to improve access and adherence to intensive behavioral health services in order to avert relapse, repeated hospitalizations, arrest, incarceration, suicide, property destruction, and violent behavior ASSISTED OUTPATIENT THERAPY

3.  Study 1 Gilbert, Allison R., Lorna L. Moser, Richard A. Van Dorn, Jeffrey W. Swanson, Christine M. Wilder, Pamela Clark Robbins, Karli J. Keator, Henry J. Steadman, and Marvin S. Swartz. 2010. “Reductions in Arrest Under Assisted Outpatient Treatment in New York.” Psychiatric Services61(10):1–4. Study 2 Link, Bruce G., Matthew W. Epperson, Brian E. Perron, Dorothy M. Castille, and Lawrence H. Yang. 2011. “Arrest Outcomes Associated With Outpatient Commitment in New York State.”Psychiatric Services 62(5):504–08. Study 3 Swanson, Jeffrey W., Marvin S. Swartz, Randy Borum, Virginia A. Hiday, H. Ryan Wagner, and Barbara J. Burns. 2000. “Involuntary Outpatient Commitment and Reduction of Violent Behavior in Persons With Severe Mental Illness.” British Journal of Psychiatry 176:324–31. STUDIES

4. VIOLENCE SCALE

5. COMMUNITY NEED

6. COMMUNITY NEED CHART DATA: CNY VITALS

7.  http://cnyvitals.org/onondaga/public-safety/violent-crimes http://cnyvitals.org/onondaga/public-safety/violent-crimes CNY VITALS

8. LOGIC MODEL PROBLEM OR ISSUERESOURCESACTIVITIESOUTPUTSSHORT- TERM OUTCOMESLONG-TERM OUTCOMESIMPACT The Community NeedIn order to accomplishIn order to address ourWe expect that onceWe expect that if accomplished This is the problem weour set of activities weproblem or asset we willaccomplished thesethese activities are trying to solvewill need the following:accomplish the followingactivities will producewill lead to the following activities:the following evidencechanges in 1–3changes in 4–6changes in 7–10 years: or service delivery:years: In our community there are too many individuals being arrested for violent behavior. The rate is currently 98 per 10,000 people. It would be much better to be closer to 20 per 10,000 people. This problem is a result of adults diagnosed with a serious mental illness who are unlikely to voluntarily participate in treatment. (http://cnyvitals.org/ono ndaga/public- safety/violent-crimes) Executive Director, Accountant, Manager, County Administrators, Caseworker, Counselor, Therapist, Parole officer, Transportation, Therapy, Medication, Wellness center, Doctor's office, Pharmacy, Computers. mentally ill offenders aged 18 and older will participate in Assisted Outpatient Treatment, a program that establishes a court- ordered treatment plan within the community the outputs will be a monthly count of how many mentally ill offenders aged 18 and older sign up for and participate in the program The percent of individuals with mental illness who engage in violent behavior will be lower for those participating in the program as compared to those not participating. The percent of individuals with mental illness being incarcerated will be lower for those participating in the program as compared to those not participating. The community problem of individuals being arrested for violent behavior will decline from the current amount of 98 per 10,000 people closer to the desired lower level of 20 per 10,000 people.

9.  “Continuity of care makes a significant difference in preventing mental health relapse.”  A growing body of evidence indicates that preventing mental health relapse also protects against criminal recidivism.”  “There is a strong relationship between psychiatric disorders and disability in social, economic, and cognitive domains, reflecting the effects of psychiatric disorders on motivation, thought, and behavior. In this sense, disability may be related to the difficulties of reintegration insofar as both involve the inability to assume normal social roles.”  “Violence among individuals with severe mental illness is related to multiple variables with compounded effects over the life span.”  “ Multivariate analyses revealed that severe mental illness alone did not predict future violence; it was associated instead with historical (past violence, juvenile detention, physical abuse, parental arrest record), clinical (substance abuse, perceived threats), dispositional (age, sex, income), and contextual (recent divorce, unemployment, victimization) factors. Most of these factors were endorsed more often by subjects with severe mental illness.” LITERATURE REVIEW

10.  Dieleman, C. (2014). Mapping Community Capacity: Identifying Existing Community Assets for Supporting People with Mental Health Problems who Have Been Involved with the Criminal Justice System. Canadian Journal Of Community Mental Health, 33(3), 29-42. doi:10.7870/cjcmh-2014-021  Schnittker, J., Massoglia, M., & Uggen, C. (2012). Out and Down: Incarceration and Psychiatric Disorders. Journal Of Health & Social Behavior, 53(4), 448-464. doi:10.1177/0022146512453928  Swanson, J. W., Swartz, M. S., Essock, S. M., Osher, F. C., Wagner, H. R., Goodman, L. A., &... Meador, K. G. (2002). The Social-Environmental Context of Violent Behavior in Persons Treated for Severe Mental Illness. American Journal Of Public Health, 92(9), 1523-1531.  Arch Gen Psychiatry. 2009 Feb;66(2):152-61. doi: 10.1001/archgenpsychiatry.2008.537. Arch Gen Psychiatry. WORKS CITED

11. DATA ANALYSIS: CROSSTABS & CHI-SQUARE

12. REGRESSION

13. SUSTAINABILITY Parameters for Assisted Outpatient Treatment Draft Budget for Years (2014-2015) Assumptions: People Served: Number of mentally ill offenders aged 18 and older served this year.1500 Staffing Costs- Administrative: Executive Director80000 Accountant70000 Manager65000 County Administrators90000 Staffing Costs- Programming Staff: Caseworker35000 Counselor30000 Parole officer35000 Fringe Benefits (be sure to withold these in compliance with federal law) Social Security (%)7.15% Unemp/Disability (%)8.00% Health insurance ($/month)$200 Dental insurance ($/month)$14.70 Pension (%)3.53333333% Materials Costs (do these on a per client served basis) Transportation 400 Therapy 1000 Medication 200 Office Space (Rental costs etc.) Wellness center 25000 Doctor's office 20000 Pharmacy 30000 Revenues (Be sure to aspire to revenues appropriate to your project) Psychological Associates999000 Wegmans Pharmacy950000 Kellogg Foundation900000