When you receive a diagnosis for a mental health disorder, you have decisions to make: one important decision is about which level of care best meets your needs, and if you have a serious or complex condition, you’ll need to understand whether you need outpatient treatment, intensive outpatient treatment, partial hospitalization treatment, or whether residential treatment for your mental health condition is the best option.
Those levels of care – we’ll explain more about what that phrase means in a moment – may be appropriate for a wide variety of mental health diagnosis, including, but not limited to:
- Depression
- Anxiety
- Bipolar disorder
- Borderline personality disorder
- Obsessive-compulsive disorder
- Personality disorders
- PTSD/Trauma
- Schizophrenia
- Schizoaffective disorder
- Self-harm/Suicidal Ideation
The phrase levels of care refers to the location of treatment and the various degrees of immersion, intensity, and duration of treatment commonly available for people who need professional support. Clinicians determine the appropriate level of care based on three primary factors:
1. Acuity
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- Acuity refers to how serious and disruptive the symptoms are right now. Patients with higher acuity generally require a more immersive and intensive level of care than patients with lower acuity
2. Severity of Symptoms
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- Most diagnoses fall into one of three levels: mild, moderate, or severe. Patients mild or moderate symptoms may not need intensive or immersive care, but patients with severe and disruptive symptoms often need intensive, immersive support.
3. Previous Psychiatric Treatment
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- Patients who receive treatment at a specific level of care without meeting goals will most likely receive a referral for a different level of care. For instance, a patient with an unsuccessful treatment experience at a lower level of care, such as intensive outpatient treatment, will likely receive a referral for a more immersive and intensive level of care, such as partial hospitalization or residential treatment.
If you have a recent mental health diagnosis, then understanding those terms will help you have productive conversations with providers when you’re making decisions about engaging in treatment, and help you determine whether residential treatment for your mental health diagnosis is appropriate.
Why Seek Residential Treatment for Mental Health Conditions?
There are several reasons residential treatment for a mental health diagnosis may be necessary – and they overlap with the fundamental reasons treatment for mental health disorders is essential. Here are the three primary reasons:
- Evidence-based treatment delivered by qualified mental health professionals helps patients manage symptoms and live full, fulfilling lives: treatment works.
- Mental heath disorders rarely resolve on their own, without treatment: untreated mental health disorders, in most cases, get more severe and disruptive over time.
- The consequences of untreated mental health disorders can be serious.
We should back up and clarify something. We assume most people diagnosed with a mental health disorder seek treatment for a more general reason than the three we list above: they want to feel better. The symptoms of a mental health disorder can be uncomfortable, disruptive, and make participating in the basics of daily life difficult.
If you’ve never experienced uncomfortable emotions, unwanted patterns of thought, or the negative feelings associated with a mental health diagnosis, please pay special attention to the information we’ll share now.
These are the consequences of three common mental health disorders, if left untreated: anxiety, depression, and post-traumatic stress disorder (PTSD).
Consequences of Untreated Mental Health Disorders
Anxiety, left untreated, can lead to:
- Reduced self-esteem/belief in self
- Depression/depressive symptoms
- Problems with work, school, and relationships
- Alcohol use disorder (AUD)
- Substance use disorder (SUD)
- Non-suicidal self-injury (NSSI)
- Suicidality: ideation, plans, attempts
Depression, left untreated, can lead to:
- Decreased self-esteem
- Disrupted relationships
- Decreased performance at work and school
- Escalating symptom severity
- Alcohol use disorder (AUD)
- Substance use disorder (SUD)
- Non-suicidal self-injury (NSSI)
- Suicidality: ideation, plans, attempts
- Disruption/impaired function in areas of the brain associated with:
- Memory
- Concentration
- Decision-making
- Escalating symptom severity
PTSD, left untreated, can lead to:
- Persistent low/depressive mood
- Aggressive behavior
- Problems with anger
- Increased isolation
- Alcohol use disorder (AUD)
- Substance use disorder (SUD)
- Non-suicidal self-injury (NSSI)
- Suicidality: ideation, plans, attempts
- Problems forming and maintaining relationships
- Decreased achievement at work and school
- Elevated risk of chronic disease
The reasons for seeking treatment are clear: treatment can help you feel better, in general, improve life across almost all significant domains, and reduce the likelihood of the serious negative consequences we list above.
Now we’ll take a closer look at the levels of care we shared in the introduction, in order to help you decide what level of care meets your needs.
Outpatient, Intensive Outpatient, Partial Hospitalization, or Residential Treatment for Mental Health?
We’ll describe these levels of care in order from least immersive to most immersive.
Outpatient Treatment
Outpatient treatment typically involves individual psychotherapy with a psychiatrist, therapist, or counselor one or two times a week – sometimes more, sometimes less – with each session lasting about an hour. This is the least immersive level of care. Outpatient treatment is appropriate for people with mild or moderate symptoms that do not cause significant disruption in daily life. Patients at this level of care most often live at home during treatment.
Intensive Outpatient Treatment (IOP)
Intensive outpatient programs the next level up, after outpatient treatment. Depending on the facility, IOP programs may involve treatment for 3-5 hours each day, three to five days per week. For instance, IOP at Crownview includes two different levels:
- IOP-3: three hours/three days per week
- IOP-5: three hours/five days per week
This level of care is appropriate for patients with symptoms that are serious and disruptive, but not so serious and disruptive that they prevent participation in work, school, or family life. Patients at this level of care either live at home or specialized housing for people in treatment.
Partial Hospitalization Treatment (PHP)
Partial hospitalization programs are the next level up, after outpatient and intensive outpatient treatment. Patients in PHP programs receive five full days of treatment per week, Monday through Friday. PHP programs are appropriate for patients with disruptive symptoms that prevent them participating in school or work. In some cases, patients in PHP programs live at home, and in others, patients in PHP programs live in specialized housing provided by the treatment center.
Residential Treatment for Mental Health
Residential treatment programs – excluding emergency inpatient hospitalization – are the most intensive/immersive treatment programs available. This level of care is appropriate for patients with symptoms so severe they make participating in the typical activities of daily life and living at home extremely challenging or impossible.
Residential programs differ from outpatient, intensive outpatient, and partial hospitalization treatment in several ways. The first is the most obvious: during residential treatment, patients live on-site at the treatment facility. The next is the level of medical support: patients in residential treatment receive around the clock monitoring, with doctors and nurses on call seven days a week, twenty-four hours a day in case of emergency. Third is the intensity and frequency of treatment. A typical day might look like this, with some variation by facility and treatment philosophy:
- Early wake up/breakfast
- Morning activity: journaling, meditation, yoga, exercise, or personal reflection on recovery.
- Morning group therapy
- Individual therapy
- Lunch
- Break
- Afternoon group therapy
- Individual therapy/counseling
- Exercise/activity
- Dinner
- Evening group
- Recovery homework
- Early bedtime
The final difference(s) between the less immersive levels of care and residential treatment for mental health are time and distance. Residential treatment gives patients the time they need to focus on healing and nothing else, and the distance from their daily routine they need to get perspective and understand how the healing and recovery process can change their life for the better. When patients have time away from responsibilities and commitments, they can make progress and achieve their long-term recovery goals.
Check List: How to Decide What Level of Care is Right for You
Keep in mind you can neither provide an official diagnosis for yourself, nor refer yourself to a level of care: only a physician or qualified medical provider can do that. You can, however, answer this series of questions to get an idea of what might be appropriate for you:
- Do your symptoms cause you significant daily distress?
- Do your symptoms make it impossible to meet daily commitments related to family, work, or school?
- Have you tried outpatient, intensive outpatient, and/or partial hospitalization programs without success, or without meeting your treatment goals?
- Do you feel like you need time away from your daily routine – and the people in it – in order to heal and grow?
If you answer yes to those questions – any or all – then you may need to consider residential treatment. If your symptoms disrupt your life, impair your relationships, and make work or school difficult, then residential treatment might be exactly what you need to restore balance, rediscovery confidence, and step forward into a new way of life.
Finding Support: Resources
If you or someone you know needs professional treatment and support for a mental health disorder, please contact us here at Crownview Psychiatric Institute: we can help. In addition, you can find support through the following online resources:
- The National Alliance on Mental lllness (NAMI): NAMI Home Page
- The National institute of Mental Health (NIMH): NIMH Treatment Help Page
- American Psychiatric Association (APA): Treatment Locator
- Substance Abuse and Mental Health Services Administration (SAMHSA): Early Serious Mental Illness Treatment Locator