Mandatory outpatient treatment policy needs reorganization, mental health experts say

The Joint Subcommittee to Study Mental Health Services in the Commonwealth in the 21st Century met this week to discuss the reorganization of Virginia’s mandatory outpatient treatment (MOT) guidelines — a policy mental health experts say is confusing, particularly for practitioners. 

The MOT policy details the procedures used by district courts or special justices to discharge patients to mandatory outpatient treatment if they do not meet the criteria for involuntary inpatient treatment. Evidence needed to refer a patient to mandatory outpatient care for mental health treatment include a history of lack of compliance with treatment, according to the Fairfax-Falls Church Community Services Board.


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One reason the current MOT policy is so difficult to navigate is that several codes are grouped together in the document, such as logistics for setting up a treatment plan, procedures within a treatment plan, and how community services boards should monitor treatment. Mental health experts urged the subcommittee to divide the code into smaller sections to provide clarity for each procedure.

Anna Mendez, executive director for Partner for Mental Health, says the policy should also clarify two definitions of MOT. First, MOT can be defined as a way for a person to avoid involuntary hospitalization if they meet that criteria. Second, MOT can refer to mandatory intervention for someone who currently does not meet criteria or can easily access inpatient treatment. She listed two “terrible outcomes” of not reorganizing the policy:

“First, individuals can’t tell if their rights are being respected. Second, families can’t tell if their loved ones meet criteria [for MOT].”

Kathy Harkey, executive director of the National Alliance on Mental Illness Virginia, says MOT can be further utilised in tandem with other health services.

“[MOT has] been an underutilized option because it wasn’t used in the way it was set up to be…breaking it down piece by piece would help people understand the information they need.”

Stakeholders also called for a number of policy changes, such as providing more funding to train practitioners. However, committee chair Del. Patrick Hope said the committee’s main focus is to reorganize the existing MOT document, rather than implement new changes. He asked that any policy changes be submitted to the subcommittee in writing.

Due to a general consensus among stakeholders and committee members to reorganize the MOT policy, the committee will put together a task force to work through the current policy. The task force will work on a new draft of the policy, identify any additional stakeholders’ input, and will report its progress to the subcommittee.