Assisted Outpatient Treatment for Los Angeles (AOT-LA)

For questions related to AOT-LA, please email AOTLAOE@dmh.lacounty.gov or call 213-738-2440.

Assisted Outpatient Treatment (AOT), also known as Laura’s Law, was established in response to the tragic 2001 death of Laura Wilcox, who was killed by an individual suffering from severe, untreated mental illness. In 2002, Assembly Bill 1421, authored by former Assemblywoman Helen Thompson, officially created the Assisted Outpatient Treatment Demonstration Project Act.

This legislation allows counties to provide court-ordered outpatient treatment to individuals with serious mental illness who have a history of treatment non-compliance and are at risk of deterioration or harm.

In Los Angeles County, the Department of Mental Health (DMH) implements this law through the Assisted Outpatient Treatment for Los Angeles (AOT-LA) program. AOT-LA evaluates individuals who meet Laura’s Law criteria and determines whether court-mandated treatment can help stabilize their condition and prevent further crises.

  • Serves individuals at substantial risk of psychiatric deterioration and/or detention under WIC 5150 due to poor treatment compliance.
  • Provides outreach and engagement to encourage voluntary participation in Full Service Partnership (FSP) or Enriched Residential Services (ERS).
  • If voluntary services are refused, AOT-LA may petition the court to mandate psychiatric outpatient treatment through FSP or ERS.
  • Promotes collaboration among agencies including the Superior Court, County Counsel, Public Defender, Patients’ Rights, and local law enforcement.

Who Is Eligible for AOT-LA Services?

To qualify for Assisted Outpatient Treatment (AOT-LA), a candidate must meet the following eligibility criteria:

  • 18 years of age or older
  • Diagnosed with a severe mental illness
  • History of non-compliance with treatment that has resulted in at least one of the following:

    • Two or more hospitalizations and/or forensic mental health episodes within the last 36 months
    • One or more acts, threats, or attempts to cause serious physical harm to self or others within the last 48 months
  • Clinical determination based on treatment history and current behavior, including at least one of the following:

    • Unlikely to survive safely without supervision and is substantially deteriorating
    • In need of AOT-LA to prevent relapse or deterioration likely to lead to grave disability, or harm to self/others
  • Failure to engage in treatment
  • AOT-LA is the least restrictive placement to support recovery and long-term stability
  • Likely to benefit from AOT-LA services

Who Can Refer an Individual to AOT-LA?

Referrals to Assisted Outpatient Treatment (AOT-LA) can be made by qualified individuals who are closely connected to the candidate’s life or treatment plan:

  • An adult with whom the individual resides (co-habitant aged 18 or older)
  • Close relative: Parent, spouse, sibling, or adult child of the individual
  • Licensed Mental Health Treatment Provider who treats or supervises the individual’s mental health treatment
  • Director of a public or private agency, treatment facility, or licensed residential care facility where the individual is receiving mental health services
  • Director of the hospital where the individual is currently hospitalized
  • Peace Officer, Parole Officer, or Probation Officer
  • Superior Court Judge

Goals and Benefits of AOT-LA

  • Civil Court Oversight: Outpatient mental health treatment is mandated by civil court instead of criminal court.
  • Court Monitoring: The court oversees an individual’s treatment compliance for a 6-month period.
  • Public Safety & Reduction in Criminalization: Designed to reduce violence, crime, and the criminalization of individuals living with mental illness.
  • Earlier Intervention: Enables intervention based on psychiatric deterioration (WIC 5346(f)), not just imminent risk (WIC 5150).
  • Reduced System Impact: Aims to decrease hospitalizations, incarcerations, police contacts, and homelessness.
  • Support Toward Recovery and Wellness:
    • Improve the ability to function independently and at optimal levels
    • Encourage reintegration into the community
    • Reduce behavior that may lead to harm or threats toward self or others
    • Enhance quality of life, including daily living skills, medication compliance, and engagement in services
    • Promote meaningful connections with family, friends, and the community
    • Reduce social withdrawal and isolation

How does AOT-LA work?

Assisted Outpatient Treatment in Los Angeles (AOT-LA) follows a structured process designed to support individuals through voluntary or court-ordered outpatient care.

  • Referral Submission: Referrals are submitted through an
    online form or by phone call.
  • Initial Review: The AOT team gathers information about the individual’s mental health history and contacts family or current providers if appropriate.
  • Referral Review Team: Referrals are reviewed weekly by a dedicated team to assess eligibility and potential fit for the program.
  • Outreach & Engagement: If accepted, the AOT team conducts a minimum of 30 days of extensive outreach to determine eligibility and encourage voluntary participation in services.
  • Service Linkage: Individuals are offered connections to programs like Full Service Partnership (FSP) or Enriched Residential Services (ERS) on a voluntary basis.
  • Court Involvement: If voluntary treatment is declined and criteria are met, AOT may file a petition with the
    Mental Health Court. If granted, the court orders outpatient treatment and monitors progress through hearings and reports over six months (renewable for an additional six).
  • Monitoring & Collaboration: Compliance is enforced through progress reports that include medication adherence and attendance. The program fosters collaboration among the court, mental health services, public defenders, family advocacy groups, and law enforcement.

Petition Process

Candidate receives an offer for a structured treatment plan
Behavioral Health Professional submits a formal declaration
County Counsel prepares and finalizes the petition
Petition is submitted to DMH for Director’s approval
County Counsel files petition with Mental Health Court
Court schedules and confirms the official hearing date

How to Complete an AOT-LA Referral

If you believe someone may benefit from Assisted Outpatient Treatment (AOT) in Los Angeles County, you can initiate a referral by following the steps below. This process is open to family members, caregivers, service providers, or concerned community members.

📄 Step 1: Download the Referral Form

Start by downloading the official AOT-LA Referral Form:

Download the AOT-LA Referral Form (PDF)

✍️ Step 2: Complete the Form

Fill out the referral form with as much detail as possible. Include any relevant information such as:

  • The individual’s mental health history
  • Prior treatment attempts or refusals
  • Recent behaviors or incidents indicating risk
  • Recent hospitalizations or contact with law enforcement

Clear and thorough documentation helps the AOT-LA team assess eligibility efficiently.

📧 Step 3: Submit the Referral

Once completed, submit the form by one of the following methods:

Note: Do not include sensitive information in the email body. Attach the completed form securely.

📞 Need Help?

For questions or assistance with the referral process:

Common Misconceptions about AOT-LA

  • AOT is not conservatorship
    AOT provides structured outpatient treatment, but it is not a legal guardianship. Individuals maintain their legal rights and decision-making abilities.
  • AOT cannot lead to conservatorship
    Participation in AOT does not automatically initiate or result in conservatorship proceedings.
  • AOT does not force or mandate medication
    Medication is not involuntarily administered through AOT. Treatment focuses on voluntary compliance and engagement.
  • AOT cannot mandate involuntary long-term hospitalization
    AOT emphasizes outpatient care. It is not a pathway to prolonged or involuntary psychiatric holds.
  • AOT cannot place individuals in long-term residential care
    While residential services may be offered, AOT cannot mandate placement in long-term facilities.
  • AOT cannot instantly provide housing or mental health services
    Access to these supports depends on availability and coordination through community resources. AOT facilitates, but does not guarantee, immediate placement.
  • AOT is not a hospital or program discharge plan
    AOT is a standalone outpatient engagement strategy—not a follow-up plan for hospital discharges.

Frequently Asked Questions

What are the potential benefits of AOT?
Most importantly, AOT can dramatically reduce hospitalization and criminal legal involvement for its target population. As a corollary, AOT can dramatically reduce the cost and strain to treatment systems struggling to serve individuals “caught in the revolving door” of hospitalization, incarceration, and homelessness. AOT has also been shown to reduce a range of harmful behaviors and improve participants’ sense of personal engagement in their treatment. For more information on the research showing these and other benefits of AOT, check out the AOT Resource Library!
Who is appropriate to participate in AOT?
AOT is not appropriate for all (or even most) individuals with severe mental illness. It is an intervention designed for the small subset who have demonstrated an inability to maintain treatment engagement on a voluntary basis (often due to anosognosia — an inability to recognize their own illness and need for treatment), resulting in repeat hospitalizations and/or arrests. Many state AOT laws are limited in application to individuals with this personal history. Although AOT can benefit many individuals who struggle with substance use disorders in addition to their mental illness, there is no research supporting the efficacy of AOT when a substance use disorder is the primary diagnosis.
How does an individual get into an AOT program?
In communities where AOT has been implemented as a formal program, the mental health system itself — as represented by a government agency, community-based provider or treating hospital — takes the initiative to identify an individual who meets the legal criteria for AOT and bring the matter to court. Most typically, individuals are referred to the program for AOT consideration upon their discharge from a hospital or jail, or after being determined to not currently meet criteria for hospital commitment despite a clear need for better engagement with outpatient care. Many states allow family members (and sometimes other private parties) to petition the court for an AOT order. However, in areas where AOT programs are in place, family members are usually content to express their wish for AOT to program representatives and leave it to the program to take legal action.
How are AOT court orders enforced?
It is not unusual or alarming for an AOT participant to miss one or more scheduled appointments, or even to stop taking prescribed medication, in violation of the AOT court order. This alone would not be legal grounds to revoke outpatient status and commit the person to a hospital. (With or without AOT, hospital commitment requires the same findings of need under state law.) Nor should it ever be grounds to hold a participant in contempt of court (a counter-therapeutic response prohibited in many states) or to forcibly administer medication. Instead, non-adherence to the court order should trigger a re-evaluation of the person’s current clinical needs (which may require a short-term hold for a psychiatric exam) and a re-appearance before the judge to consider a change in legal status. Experience shows that this is all the “teeth” an AOT order needs to be effective.
Is it expensive for a community to operate an AOT program?
It should be well within the means of any community offering outpatient mental health services to individuals with severe mental illness to operate an AOT program – at least on a small scale. The costs of the AOT program itself are modest, and mostly limited to the costs of monitoring participants and providers combined with the court resources devoted to holding hearings and (optional) additional oversight. Since AOT neither brings new individuals into the public mental health system, nor requires greater outlay for outpatient services than would otherwise be incumbent upon the community to provide, it should not be viewed as a driver of service cost. (Which is not to suggest that AOT can be effective without high-quality treatment — only that treatment systems have an independent responsibility to provide this to all clients.)

Resources & Support

If you have additional questions about Assisted Outpatient Treatment (AOT) not addressed in these materials, please contact us:

If you or a loved one is in crisis and needs immediate help:

If someone does not meet the criteria for AOT, there are still many options for support through the Los Angeles County Department of Mental Health.

Support for Families and Caregivers