Levels of Care in Mental Health

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The mental health system can be confusing and frustrating to navigate when you don’t have all of the information. In addition to advocacy and therapeutic intervention, I believe it’s also my responsibility to educate you  on the mental health system. When you make decision to enter treatment can be daunting to identify which level of care is best for you.

To begin, seeking treatment can either be voluntary or involuntary. Ideally, we want people to voluntarily seek services. The willingness to be in therapy or in treatment leads to the best outcomes possible. Typically,  treatment begins with a full evaluation of the person’s current mental health and safety concerns. In an outpatient setting, this is referred to as an intake. Ideally, during an intake the clinician can also assess for level of care. (There are people who require more intervention than a weekly session.) The mental health professional will recommend what type of treatment will be most helpful for the individual.

I have outlined the levels of care in mental health. Typically, it’s best to begin mental health treatment in the  least restrictive setting possible, in this case outpatient setting.
Outpatient Care

In an outpatient setting, the client comes to the clinician during their scheduled appointments. The client has a high level of functioning as eveidenced by their work/school committments, family/social relatinships, etc.  Outpatient care includes:

12-Step Programs 
ƒ -Typically very useful when trying to achieve optimal mental health
ƒ -Allows opportunity for contact with individuals with many years of recovery
ƒ -Offers support and strategies for a successful recovery

Routine Outpatient Care (ROC)
ƒ Consists of three types of care:
– Individual counseling – includes counseling sessions with a therapist
– Medication evaluation and management – includes visits with a psychiatrist or nurse
practitioner to determine if medication would be helpful
– Group therapy – includes weekly group sessions with other people with mental health issues.
In group therapy, people often learn from one another’s experiences.

Intensive Outpatient Program (IOP)*
ƒ -Structured treatment that teaches how to manage stress, and better cope with emotional and behavioral issues
ƒ -May include group, individual, and family therapy when appropriate
ƒ -Consists of frequent visits (usually 3-5 days per week) and an average of 3-4 hours of treatment per day for a set period of time (often 4-6 weeks, depending on the program)
ƒ -Many programs are structured so individuals may work and continue with normal daily routines
ƒ -The advantage of this type of program is that people have the support of the program, along with other people working on similar issues

There are situations when outpatient care is insufficient. The needs of the client are greater and a higher level of care is recommended. This incldu

Partial Hospitalization
ƒ -Intense structured program
ƒ -Typically consists of 5-7 days per week for 6 hours each day
ƒ -Similar to IOP, includes group, individual, and family therapy when appropriate
ƒ -Often includes an evaluation by a psychiatrist, who may prescribe or adjust medications
ƒ -Often recommended for those who have actively participated in lower levels of care, yet continue to experience serious emotional and behavioral problems
ƒ -Beneficial for those at risk of hospitalization, or as a step-down for those who have been hospitalized inpatient Care
Inpatient Acute Care
ƒ -Intended for people who need 24-hour care and daily doctor visits in a hospital setting to stabilize psychiatric issues
ƒ -Often recommended for people who aren’t able to care for themselves, or may be a risk to the safety and well-being of themselves or others
ƒ -Can last for a few days
ƒ -Goal is to stabilize a crisis
ƒ -Includes group therapy and meeting with a team of professionals, including a psychiatrist
ƒ -A family session is important prior to discharge to discuss aftercare plans
Inpatient Residential
ƒ -Should only be considered when all available and appropriate outpatient approaches, including intensive outpatient treatment and partial, have been tried first
ƒ -Intended to be a short-term placement to stabilize the person until they can return to the community
ƒ -Treatment should be as close to the person’s home as possible
ƒ -Intended for people who do not need medical attention
ƒ -Not appropriate for people who are unmotivated for change and recovery
ƒ -Primary treatment offered is group, individual, and family therapy in a supportive environment
ƒ -Should include weekly family therapy


I hope this is informative and allows you to make the best educated decision for you and your family. If you have any additional questions please don’t hesitate to contact me.

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