Inconclusive Results from HHS Assessments of Assisted Outpatient Treatment

Serious mental illnesses have affected millions of adults in the United States, with 14.6 million individuals experiencing such illnesses in 2023. Untreated mental illnesses can lead to worsening health, increased medical costs, and involvement with the criminal justice system. Assisted outpatient treatment can provide necessary care for individuals with serious mental illnesses, but its involuntary nature makes its use controversial. The Department of Health and Human Services (HHS) has awarded grants to organizations to implement assisted outpatient treatment programs, but assessments of the grant program have yielded inconclusive results due to methodological challenges.

Key Takeaways:

• The Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded approximately $146 million in assisted outpatient treatment grants to 63 grantees since 2016.
• The grants were primarily awarded in three cycles: 2016, 2020, and 2024, with a total of 17 grantees participating in the program.
• HHS's assessments of the grant program were limited by methodological challenges, including program variation and reliance on self-reported data from participants.
• Examples of challenges include voluntary enrollment of participants in an inherently involuntary program and limitations in comparing assisted outpatient treatment participants to individuals enrolled in voluntary treatment.
• State laws governing assisted outpatient treatment programs will continue to vary, making it difficult to assess the program's effectiveness.

Statistics:

• 14.6 million adults in the United States experienced serious mental illnesses in 2023 (Source: GAO).
• Approximately $146 million has been awarded in assisted outpatient treatment grants to 63 grantees since 2016 (Source: GAO).
• 17 grantees participated in the program in three cycles: 2016, 2020, and 2024 (Source: GAO).
• Six grantees were selected for a comparison of assisted outpatient treatment participants to individuals enrolled in voluntary treatment (Source: GAO).

Sources:

• Government Accountability Office (GAO), "Serious Mental Illness: HHS Assessments of Assisted Outpatient Treatment Have Yielded Inconclusive Results" (GAO-25-107526).
• Consolidated Appropriations Act, 2023.