By Brittany Kelly, State Court Behavioral Health Administrator · Office of Behavioral Health
The Indiana Office of Judicial Administration, through its Office of Behavioral Health, is beginning a pilot for Assisted Outpatient Treatment programs. It has selected seven counties to join three mentor counties, with the ten making up the Hon. Michael J. Kramer AOT Program Initiative. It’s named in honor of longtime Noble County Judge Kramer—who passed away in March 2025. Judge Kramer dedicated his life to service, leading with compassion, and promoting best practices for those experiencing mental illness.
The ten county pilot cohort includes judges who will work with local community mental health providers to explore ways to deploy AOT Programs for litigants who qualify while simultaneously receiving technical assistance from the Treatment Advocacy Center, a national nonprofit organization whose mission is to eliminate the barriers to timely and effective treatment of severe mental illness through advocacy, public education, and support for the individuals affected by it.
Three AOT Programs already exist in Indiana and are automatically included in the pilot as mentor counties:
Bartholomew County
Judge Jonathan Rohde
Centerstone and Columbus Regional Health
Lake County
Judge Marissa McDermott
Regional Care Group
Porter County
Judge Michael Fish
Porter-Starke Services
Thirteen additional counties applied to join the pilot, and 7 were selected:
DeKalb County
Judge Patrick Jessup
Northeastern Center
Knox County
Judge Monica Gilmore
Family Health Center
Marion County
Judge Amy Jones
Sandra Eskenazi
Marshall County
Judge Matthew Sarber
Bowen Health and Michiana Behavioral Health
St. Joseph County
Magistrate Elizabeth Hardtke
Oaklawn
Tippecanoe County
Judge Sean Persin and Magistrate Sarah Wyatt
Valley Oaks
Vanderburgh County
Magistrate Jill Marcrum
Southwestern Behavioral Healthcare
The cohort will receive support from the Office of Behavioral Health and the Treatment Advocacy Center in implementing AOT Programs in their jurisdictions while simultaneously working toward the creation of state-level resources to assist other jurisdictions interested in pursuing AOT Programs.
AOT is a type of civil commitment for those with severe mental illness, and many counties in Indiana already utilize outpatient commitment orders. AOT programs offer structure, built around the court order, which includes an active and involved treatment team and a court/judge, who monitor an individual’s treatment progress. AOT programs also involve the input and participation of numerous stakeholders, including community mental health centers, state agencies, attorneys, police agencies, and family advocates.
“ These partnerships between courts and community mental health providers demonstrate the power of collaboration to promote safety, recovery, and community stability.”
Zoe Frantz
Collaboration between Indiana’s treatment providers and the courts is essential to this initiative. Sarah Sailors, Executive Director of FSSA’s Division of Mental Health and Addiction, explained, “This strengthens Indiana’s partnership with the judiciary to expand Assisted Outpatient Treatment statewide, ensuring individuals with serious mental illness receive stability, treatment, and support instead of continued hardship.” Zoe Frantz, President & CEO of the Indiana Council of Community Mental Health Centers adds, “These partnerships between courts and community mental health providers demonstrate the power of collaboration to promote safety, recovery, and community stability.”
AOT Programs are meant for adults with mental illness struggling with treatment adherence and/or repeated cycles of hospitalization and criminal justice involvement. The goal of this type of treatment—and its common outcome—is that with the timely and regular care and supervision AOT Programs provide, individuals with severe mental illness will experience fewer episodes of decompensation and encounters with law enforcement while also spending less time under inpatient hospitalization.
Vanderburgh Superior Court Magistrate Jill Marcum emphasized the balance of support and safety, “This gives us a powerful opportunity to provide both accountability and compassion, ensuring that individuals with serious mental illness receive the support they need while also protecting public safety. This program is not only about reducing hospitalizations and incarcerations, but about restoring stability, dignity, and quality of life for the people we serve.”
Naming the initiative after the late Michael Kramer, who served Noble County since 1991, is fitting. His wife, Angelia Kramer said, “Mike’s greatest joy and life’s work was about helping others, being a part of systems improving, and ultimately lives changing for the better. What an honor that the future will carry his fingerprints. It’s a legacy that will have a lasting impact on individuals, families, and society.”
Learn more about the AOT Program Initiative and Judge Kramer on the Office of Behavioral Health website: courts.in.gov/admin/behavioral-health/aot-initiative