Assisted Outpatient Treatment (AOT) is court-ordered outpatient mental health treatment for individuals with serious mental illness who are unable to live safely in the community, but who refuse to participate in treatment on their own. The law that allows court-ordered treatment is sometimes called “Laura’s Law”. SLO Behavioral Health’s AOT program started in March, 2016, and is funded by the Mental Health Services Act.
AOT is a collaborative program between the Behavioral Health Department and Transitions-Mental Health Association (TMHA). AOT outreach and treatment services are provided by a Full Service Partnership (FSP) team comprised of TMHA staff. SLO Behavioral Health staff provide assessment, program support and coordination with the court. Services offered to AOT clients include:
- Co-Occurring treatment to address both mental health and substance use disorder needs
- Rehabilitation services to assist clients in learning and utilizing skills to improve self-care, social support system, and health
- Intensive case management to support clients in accessing housing, financial, vocational, health care, and social support services, including voluntary mental health services
The AOT FSP team uses a field-based, “whatever it takes” approach to engage with clients to create their own individualized treatment plan. Supportive FSP housing can be available as part of the client’s treatment plan.
San Luis Obispo County’s Full Service Partnership for homeless individuals is a Mental Health Services Act (MHSA) program that provides outreach, assessment, and 24/7 intensive community-based wrap around services to help people achieve recovery and live independently.
Access to mental health services is the primary barrier to serving the homeless and this program focuses on outreach to unserved, difficult-to-reach populations. This will engage clients in health care, mental health treatment, and housing.
- Supportive care, case management, and rehabilitative mental health services.
- Regular appointments with psychiatrists.
- Regular access to medical services.
- Highly individualized treatment, medication and personal milestones.
- Support groups addressing other medical issues requiring maintenance and medication.
- The development of independent living skills, including cooking, cleaning, grocery shopping, conflict resolution, money management, and social skills.
- Co-occurring disorder support groups for clients who also have problems with substance abuse.
- Vocational and educational opportunities.
For more information please contact our access line at 1 (800) 838-1381
The program is conducted by Transitions-Mental Health Association.
The Mental Health Evaluation Team (MHET) assists the community, hospitals, and law enforcement with:
- Emergency psychiatric evaluation services to determine whether immediate inpatient psychiatric treatment is required;
- Crisis intervention services and mental health consultations;
- Improving access to mental health treatment services through linkage and/or referral to community services; and
- Timely post-crisis follow up to ensure linkage to appropriate resources.
IN THE CASE OF A LIFE THREATENING EMERGENCY, CALL 9-1-1
The County has partnered with Sierra Mental Wellness Group as its provider of MHET services. Interventions are client oriented, and wellness and recovery-centered, to maximize the ability of the individual to manage the crisis. Additionally, this immediate stabilization response is supplemented with a next day follow-up for non-hospitalized clients to continue support and provide assistance in following through with referrals and appointments.
The Behavioral Health Department operates a 16-bed, licensed Psychiatric Health Facility (PHF). The PHF provides observation and treatment for acute mental illness under licensed psychiatric direction.
1 (800) 838-1381
Psychiatric crisis emergency number available 24 hours a day, 7 days a week
The Psychiatric Health Facility (PHF) is an inpatient facility that treats individuals in psychiatric crisis who cannot be safely served in outpatient services.
- A psychiatric crisis is a non-life threatening situation in which an individual is exhibiting extreme mental health symptoms, considering harm to self or others, disoriented or out of touch with reality and has a compromised ability to function safely.
The PHF is operated by the County under a license issued and regulated by the State Department of Health Care Services (DHCS) as a facility for:
- 72 hours of psychiatric evaluation and treatment.
Patients have a right to refuse medication unless there is a court order for medication or the patient is displaying imminently dangerous behavior toward self or others, and the doctor orders involuntary medication (W&I code 5325.2).
There are subsequent fourteen (14) day legal holds that may be enacted if the individual continues to meet medical necessity criteria. All additional holds require judicial review. Patients have rights and are provided legal representation by the Public Defenders Office. Patients also have access to a Patients’ Rights Advocate.
The PHF is staffed by a Behavioral Health Program Supervisor, a Psychiatrist, a Registered Nurse, a Licensed Clinical Social Worker, Psychiatric Technicians and Mental Health Worker Aides. Contracted services include Rehabilitation Services and Dietary Services.
The PHF is licensed to treat 16 patients at any point in time. The PHF serves:
- Individuals who, per Welfare &Institutions Code 5150, may be involuntarily detained due to indications they are, as a result of a mental disorder, a danger to self, danger to others, or may be gravely mentally disabled
- Misdemeanants in custody of the County jail, determined by the Court to be incompetent to stand trial (per Penal Code 1370). Inmates are treated at the PHF to restore them to competency, in order for them to participate in their legal proceedings.
- Conserved individuals (gravely mentally disabled and permanently housed elsewhere) in need of stabilization.
The PHF is the only such facility within San Luis Obispo County. The nearest alternative 5150 facilities are located in Salinas, Santa Barbara, and Fresno/Bakersfield, and are often also at or near their licensed capacity. Approximately 340 individuals are transferred directly from our area hospitals to out-of-County alternative inpatient psychiatric treatment facilities every year.
PHF admission criteria is set forth in the Welfare & Institutions Code 5150, and California Code of Regulations, Title 22. Individuals are assessed by qualified professionals for admission.
Admission criteria includes:
As a result of a mental disorder*, the individual is deemed to be:
- A danger to Self,
- A danger to Others,
- Gravely Disabled (no ability to nourish oneself, obtain clothing or shelter, no third party caregiver).(Welfare & Institutions Code 5150)
*mental health conditions covered by CCR Title IX 1820.205
It is often important that individuals receive a medical clearance prior to receiving a mental health evaluation for inpatient psychiatric treatment for the following reasons:
- The PHF is free standing, with no medical support attached.
- Medical support is provided by local hospitals.
The following regulatory criteria describe persons who may not be legally retained in the PHF:
- Only persons diagnosed with major mental disorders are to be treated in PHFs.
- PHF shall not admit and treat patients with the primary diagnosis of an eating disorder.
- PHF shall not admit and treat patients when the primary diagnosis is chemical dependency, chemical intoxication or chemical withdrawal.
- Individuals with major mental disorders shall not be admitted to PHF if their treatment requires medical interventions beyond the level appropriate to a psychiatric health facility including:
- Detoxification from substance abuse
- Treatment for substance induced delirium. (22 CCR 77113)
Persons with a communicable disease that is required to be reported (per 17 CCR 2500), shall not be admitted to the facility. Examples are active treatment resistant infections (MRSA), Tuberculosis, etc.
A facility shall accept and retain only those patients for whom it can provide adequate medical care.
“…when a patient’s particular injury or disease would ordinarily be treated on an outpatient basis absent the mental disorder, the facility may admit the patient only if the facility has appropriate policies, procedures and resources to ensure the safety of other patients and staff.”
Examples of such medical conditions are some types of Diabetes, and patients requiring supplemental oxygen, dementia, and Alzheimer’s.
(22 CCR 77135)
The law precludes the PHF from housing patients who are non-ambulatory, meaning they are unable to transfer their own weight.
(Health & Safety Code Section 1275.1)
The Psychiatric Health Facility Program Supervisor can be reached at (805) 781-4752
The Patients’ Rights Advocate can be reached at (805) 781-4738
The County of San Luis Obispo's Behavioral Health Department received a federal grant from the Substance Use and Mental Health Services Administration (SAMHSA) to improve integration of physical and behavioral health care for individuals with severe mental illness, by providing medical services at a Behavioral Health Services site.
The goals of the grant are to:
- Reduce chronic disease among the severely mentally ill population through early detection, intervention and prevention education.
- Improve access to a full range of integrated health services by employing a peer wellness coach with lived experience, to support participating individuals.
- Enhance information sharing between providers through electronic health information exchange.
The Health Agency, in partnership with the Community Health Centers of the Central Coast (CHC) and Transitions- Mental Health Association (TMHA), are working together to provide the following services at the Health Campus in San Luis Obispo:
- Primary care screenings
- Chronic disease management
- Tobacco cessation services
- Nutrition and fitness education
- Substance use treatment
- Specialty care referrals
- Peer recovery support
- Integrated treatment planning:
- Mental health
- Preventive health
- Health and wellness goals
Physical health screenings and exams will take place on CHC's "Clinic On Wheels."
To enroll in the SLO Health Integration Project (SLO-HIP) please call:
(805) 788- 6894
Please leave your name and phone number and a SLO-HIP staff member will return your call.