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How do I know if I need therapy, intensive treatment, or if I should go to the hospital?

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It’s important to be an educated consumer of mental health care and to know what is available to you when you need support, help, and care.

When a person has a fever, pain, or notices a change within their body, they know to visit the doctor. When someone breaks a bone, it is well-recognized that the emergency room would be the best place to go. However, when a person is experiencing symptoms of depression, how does one determine whether or not the symptoms are severe enough for hospitalization, rather than outpatient therapy? These two can look very different, and when asked what the levels of care are available within the mental health care system, a person can usually be met with crickets. Although the stigma surrounding mental health is decreasing, there is still a lot to learn about mental health, mental health care, and more specifically regarding the levels of care within mental health.

Levels of Care in Mental Health Therapy

Different levels of care focus on the intensity, complexity, structure, and support that is provided in the treatment setting (“Levels of Care”, n.d.,). There are three levels of care: Inpatient, Residential, and Outpatient. Each of these vary in severity, complexity, and structure.

Inpatient Care:

Inpatient treatment is typically in a hospital setting for individuals who are experiencing chronic and severe mental illness such as schizophrenia, depression, addiction, or an eating disorder. An individual at this level of care is experiencing severe symptoms that affect their daily functioning at home, school, work, and in their relationships. Individuals will stay in a psychiatric or behavior unit. Individuals that stay inpatient typically meet with therapists, psychiatrists, nurses, and other mental health associates in order to work towards long-term recovery (“Levels of Care”, n.d.,). Treatment in this setting may include individual therapy sessions, group therapy sessions, family therapy sessions, and experiential therapy.

Residential Care:

Residential treatment can manifest in many forms, such as rehab, group homes, and structured living communities. These are settings are more home-like and may have less monitoring than inpatient treatment. Residential programs can be long-term, an alternative to inpatient treatment, or a follow up to inpatient treatment (“Levels of Care”, n.d.,). Residential treatment is typically for individuals who are experiencing severe and persistent mental illness such as schizophrenia, major depression, obsessive compulsive disorder, addiction, or a severe eating disorder. Typically, at this level of care an individual can maintain stability by participating in group therapy, individual therapy, and experiential therapy, as well as by taking medication prescribed by their doctor and/or psychiatrist.

Outpatient Care:

Outpatient treatment can be broken down into several categories that include: partial hospitalization (PHP), intensive outpatient program (IOP), outpatient therapy, support groups, and medication management/psychiatry (“Levels of Care”, n.d.,).
Partial Hospitalization Program (PHP):
Partial hospitalization programs are a step down from inpatient in which individuals are recommended to attend a structured 5-6 hour daily program scheduled 5 days a week. PHP involves group therapy, individual therapy, and can include family therapy to address mental health, substance misuse, and/or eating disorders (“Levels of Care’, n.d.,).

Intensive Outpatient Program (IOP): 

Intensive outpatient treatment is similar to PHP in the sense that IOP also includes individual therapy, family therapy, and group therapy in the hopes to move individuals towards their goals and into their daily routines. However, IOP usually meets 9-12 hours per week, thus 3-4 days or evenings per week in three hour sessions.

Outpatient Therapy:

Outpatient therapy is typically for individuals who are experiencing symptoms that are affecting part of their functioning, whether it is their relationships, work, or areas in daily living with which they are struggling. This is the level of care that we provide at Health and Healing Therapy for children, adolescents, and adults, who are struggling with anxiety, depression or need PTSD and Trauma Therapy, couples therapy. Usually, individuals in therapy attend once a week and then, once progress is made, these individuals can attend therapy bi-weekly or once a month. Often times ones out patient therapy may include an individual therapy session and a group therapy session where coping skills and support is enhanced.

Support Groups: 

Support groups are not considered therapy, as they are usually not facilitated by a therapist but rather peers. Support groups are helpful and provide a safe space for ongoing support with a group off people who have a common issue of concern. There are many different types of support groups that can cover a variety of topics such as bereavement, addiction, grief, and mood disorders. These support groups can be either online or in-person and work towards long term recovery (“Levels of Care”, n.d.,).

Medication Management/Psychiatry:

Medication management, as well as coping strategies that can be learned in therapy, can help treat symptoms of mental illness. Medication can lower the intensity of symptoms for individuals, as well as improve their quality of life (“Psychiatric Medication, 2018). Oftentimes, medication management can decrease chances of a relapse or hospital stay, as well as treat symptoms such as mood, concentration, and ability to function with daily living activities. Medication management can be utilized in each treatment setting, from outpatient therapy to inpatient treatment.

We hope this guide is helpful for you in navigating where to start and what level of care you may need. As always, we encourage you to seek a comprehensive mental health assessment by a licensed mental health profession (licensed counselor or licensed social worker). This type of clinical assessment is what we do during our initial therapy session at Health and Healing Therapy in Bartlett, Illinois. This session helps the therapist determine what type of care would be most beneficial for you and is often the first step as you seek more mental health wellness and care in your life.

Michigan Medicine (PDF). (2018, January). Psychiatric Medication Management.

Nina Iraheta wears a light blue sweater and has long dark hair streaked with blonde. She has a bright, kind smile.

About Nina Iraheta

In my free time I like to read, hang out with my cat, and attend live shows. I love a good suspense/thriller book, however I also love to spend the night singing along to my favorite artists at live shows! I also love to enjoy nature, go hiking, and it is a hope of mine to visit all of the national parks in the United States!

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