Integral Care, the Local Mental Health and Intellectual and Developmental Disability Authority for Travis County, recently launched a new Assisted Outpatient Treatment (AOT) program, which will use practical, evidence-based interventions to build health and well-being for adults in Travis County who live with serious mental illness (SMI). The innovative AOT program is designed to improve adherence to mental health treatment plans, which reduces inpatient psychiatric stays and criminal justice involvement – and ultimately helps participants reach their full potential and thereby engage more fully in their communities. The program is a collaboration between Integral Care, Travis County Probate Court, Travis County Clerk’s Office and Dell Medical School’s Department of Population Health at the University of Texas at Austin. It will be funded by a U.S. Substance Abuse and Mental Health Services Administration grant award of $1 million per year, over the next 4 years. Together, these organizations will construct a framework of well-being through identification, referral, care and treatment of AOT clients who are weathering life’s storms.


“This grant brings together stakeholders across the community who are committed to building a healthier and stronger Travis County for all by ensuring that people living with serious mental illness are able to access and maintain the treatment they need,” said David Evans, CEO of Integral Care. “Together, we will provide intensive, specialized services that support the health, well-being and recovery of over 200 program participants.”

When experiencing a serious mental health condition, it can sometimes be difficult to maintain treatment that supports the ability to function in daily life and in the community. This can contribute to a range of challenges including alienation from family and friends, homelessness, and involvement with the criminal justice system. Studies show that by improving adherence to treatment services, AOT reduces arrests, hospitalization and incarceration of individuals living with serious mental illness by approximately 70%. These interventions save taxpayers 50% of the cost of care and most importantly improve the quality of life for individuals living with SMI. With this new grant funding, AOT will support individuals who have experienced multiple episodes of hospitalization, arrest, incarceration and homelessness due to the challenges of adhering to mental health treatment. Through this program, the Travis County Probate Court, presided over by Judge Guy Herman, which has primary jurisdiction over mental health hearings, will place individuals in court-supervised treatment while they continue to live in the community.


“The Travis County Probate Court is pleased to partner with Integral Care and the Dell Medical School to participate in the newly created Assisted Outpatient Treatment Program, which is designed to provide greater supervision for persons living with serious mental illness once they have left the hospital or jail and returned to the community, in the hopes of lowering the rates of recidivism in our hospitals and jails,” said Judge Guy Herman. “As the Presiding Judge of Travis County’s Probate Court, I am fully aware of the difficulty this population faces after being discharged from a hospital or jail, and I believe this program will fill a gap in service that could make a more stable life for our loved ones. The Probate Court has been attempting to establish an assisted outpatient treatment program for nearly ten years, and this grant will allow it to become a reality.“


Integral Care will monitor the individual’s treatment plan and help ensure their ongoing participation in the AOT program, facilitating their transition from inpatient hospitalization to community-based care through proactive relationship building, case management, therapy, medication, drug and alcohol treatment, and other services that support and maintain recovery. These tools will establish a foundation so clients have the stability to adhere to their treatment. Additionally, collaborative opportunities for clients will include the creation of Psychiatric Advanced Directives (PAD), facilitated by Dell Med. A PAD is a communication tool that promotes patient autonomy giving capacitated adults, living with serious mental illnesses, the legal authority to—in advance of a health care crisis – memorialize their preferences for care and to designate a proxy decision maker.


Respecting the autonomy of persons living with serious mental illness is the principle upon which this project is built,” said Virginia A. Brown, Ph.D., Assistant Professor Department of Population Health at Dell Med. “Collaborating with Integral Care to help improve the lives of persons living with SMI brings us one step closer to creating a more just and equitable community for all,” Brown said.


Progress happens when partners from different specialties come together to provide the building blocks of health for everyone in our community. Other collaborators include Austin State Hospital, Disabilities Rights Texas, Housing Authority of the City of Austin, NAMI Central Texas, and Travis County Sheriff’s Office.