The proposed project would develop an Assisted Outpatient Treatment (AOT) program to bridge the gap between inpatient and outpatient mental health services, improve treatment outcomes and reduce incidence of inpatient psychiatric and reduce criminal justice involvement. The Austin AOT program presents a practice and evidence-based intervention designed to promote treatment adherence, empower client engagement in managing their care, reduce inpatient bed stays, and involvement with the criminal justice system. The population of focus for proposed program is comprised of adult clients in Travis County who are persistently non-adherence with needed treatment for their mental illness and meet criteria for AOT under Texas state law. Clients much qualify for Assertive Community Treatment as defined by Texas State Utilization Management Guidelines (Texas Health and Human Services Commission, 2017) and meet criteria for Outpatient Commitment as defined by Health and Safety Code Section 574.035. Austin's AOT Program will bring together Integral Care, Travis County Probate Court, Travis County Clerk's Office and Dell Medical School at the University of Texas at Austin to establish a framework for identification, referral and the care and treatment of clients living with SMIs. Other community partners include NAMI Central Texas, Austin State Hospital, and Travis County Sheriff's office. All client treatment plans will employ a recovery-oriented approach. Specifically, plans will include motivational interviewing strategies, psychiatric advanced directives, and collaborative, individually tailed plans of recovery. In order to develop plans for each client, we will use data obtained from the initial ANSA and a corresponding psychosocial narrative assessment to identify clients' goals, strengths, and barriers to recovery. Across treatment plans, clients are offered evidence-based treatment, including Assertive Community Treatment, Illness Management and Recovery, Integrated Treatment for Co-Occurring Disorders, as well as practical assistance with basic needs, such as food, shelter and clothing. A peer specialist will regularly engage clients to develop trust in the program. By including a recovery-oriented approach and tools for shared decision making for future care such as psychiatric advance directives, our AOT program aims to improve therapeutic alliances and client' participation in their care. Integral Care proposes to serve a minimum of 55 unduplicated clients in the first year and a minimum of 220 unduplicated clients over the four-year project period. Project goals include increasing engagement in ongoing mental health care (measurable objectives:  beginning in year 2, 50% of program enrollees will have a Psychiatric Advance Directive,  following 1 year of services, clients will demonstrate increased empowerment in managing mental health); reducing inpatient psychiatric bed days by providing continuity of care (measurable objectives:  following one year of AOT services, clients will demonstrate reduction in risk behaviors and improved functioning), and reducing criminal justice involvement (measurable objectives:  following one year of AOT services, clients served will experience reduction in the number of jail bookings).