ALBUQUERQUE, N.M. — Even though New Mexico Gov. Michelle Lujan Grisham has scaled back her ask to lawmakers, the issue of competency is still monumental. In the legal system, “competency” refers to people who are mentally unfit to stand trial.

Often their cases are dismissed, and those people cycle in and out of the system.

4 Investigates has highlighted some of the complex issues involving folks in the community who live with severe mental illness. Even though the governor is pausing her original ask to expand assisted outpatient treatment, work is already being done to make that type of program available for more New Mexicans.

Assisted outpatient treatment is a way to order someone to get mental health help without forcing them into a facility. That system is already on the books, but only Doña Ana County has an active AOT program. Officials there say it is working.

The county’s Health and Human Services Director Jamie Michael helped kickstart the assisted outpatient treatment program in 2017.

“It’s very similar to an inpatient commitment but this is a commitment, a court order or a commitment to outpatient,” Michael said.

Rather than a criminal hearing, it’s a civil process for people who struggle to connect or stay engaged with services – specifically for folks living with severe mental illness, people who may be on the streets, in the hospital, or generating calls from police over and over again. The program has mobile teams to meet people where they are.

“It’s not just, you have an appointment tomorrow, you didn’t show up – it’s I’m going to reach out to you, I’m going to go to your home, we’re going to look at medication, we’ve going to look at medical history,” Michael said. “We’re going to look at your housing needs, other social supports.”

Michael says since 2017 they’ve served 200 New Mexicans, or about 35 people a year. It costs the county around $150,000 a year. The other treatment costs are covered by Medicaid reimbursement.

“Because we know it’s effective, we think it should be an option anywhere in the state of New Mexico,” Michael said.

But it’s not such a reasonable cost for all communities.

District Court in Bernalillo County started an AOT program with the City of Albuquerque in 2019, but didn’t have the money or the network of behavioral health providers to maintain it.

Aside from the special session, the City of Albuquerque is already spending close to $1 million to fund AOT starting July 1. Critically, there’s a provider already secured to do the work. But the relaunch is already facing funding issues – the city says the money dedicated is still not enough to cover all costs, and provider capacity is still an issue.