South Central Louisiana Human Services Authority (SCLHSA), a political subdivision of Louisiana Department of Health and Hospitals (LDH), Office of Behavioral Health (OBH) in partnership with the 32nd Judicial District Court and Terrebonne Parish stakeholders will create, implement and evaluate the first Assisted Outpatient Treatment (AOT), Terrebonne AOT, in the SCLHSA region. SCLHSA will also create an additional Assertive Community Treatment team, SCLHSA ACT, to meet the need for increased capacity and for participants of Terrebonne AOT. Project Name: Terrebonne AOT. Population to be served: Adult residents, age 18 and older, of Terrebonne Parish diagnosed with a severe mental illness (SMI) and who meet the criteria for a civil commitment sited in Louisiana state law R.S. 28:66. Strategies/Interventions: (1) Build a sustainable, replicable AOT infrastructure and program for neighboring parishes to emulate; (2) Reduce behavioral health disparities by offering recovery focused, culturally competent, trauma-informed approaches to participants in the Terrebonne AOT using the ACT model. Goal 1: Create, implement and evaluate the first AOT program in the SCLSHA catchment area by partnering and collaborating with the local judicial system, hospitals, criminal justice and behavioral health treatment agencies. Objectives: (1) Establish infrastructure to develop AOT program by aligning with key stakeholders in Terrebonne parish, creating the AOT Management Team, and AOT Steering Committee and hiring qualified staff to work with SCLHSA within 3 months of obtaining grant funding. (2) By December 31, 2024, Terrebonne AOT will develop and approve all policies, procedures, and referral forms and accept its first participant into the program. (3) By the end of year 4, the AOT Management Team will create a replicable model for AOT implementation that considers the unique culture and disparities of south Louisiana for neighboring parishes in the catchment area. Goal 2: Promote self-efficacy and social connectedness in the lives of individuals living with SMI who have historically been unable or unwilling to obtain/maintain outpatient behavioral health treatment. Objectives: (1) At termination of the civil commitment, the participant will have reduced the number of arrests by 40%. (2) At termination of the civil commitment, the participant will reduce the frequency and duration of inpatient visits by 50%. (3) At termination of the civil commitment, participants will have been compliant or had improved compliance with the civil ordered treatment plan (medication adherence and compliance with plan) as indicated in the NOMS collected data at baseline (admission), follow-up and discharge, increasing each year to reach 65% compliance by Year 4. (4) At 6 months post discharge participants will have maintained compliance with discharge treatment recommendations by 60% as evidenced by treatment provider and client self-report. Goal 3: SCLHSA will meet the need for increased capacity to individuals with SMI in the AOT program by creating an additional Assertive Community Treatment (ACT) team. Objectives: (1) By the end of Year 1, become certified and credentialed as an agency to provide ACT community based services. (2) By Sept. 2025, hire, train and credential the required number (currently 10) and type of staff required to implement ACT as an EBP. Number served: 185 individuals over 4 years.