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If you are reading this post, you or someone you love is likely in need of mental health services and support. You may be feeling overwhelmed and confused about the different levels of care and what might be best for your family or child. We want to try to de-mystify some of this information for you and provide some answers to common questions.

Outpatient Level of Care for Depression and Anxiety

Outpatient level of care mental health treatment is broadly defined as any type of mental health service that does not require the patient to stay overnight in a facility. This can include therapy, medication management, and other types of support. Outpatient care is often less expensive than residential levels of care, and it allows patients to continue to live at home. For our purposes, outpatient level of care (OP) is differentiated from Intensive Outpatient Program (IOP) to mean outpatient services accessed outside of an organized program.

Benefits of Outpatient (OP) Level of Care

  • Least Invasive: typically 45 minute sessions (ranging from twice per week to every other week, with weekly being most typically recommended)
  • Lots of choice: what form of therapy (ie. individual therapy, family therapy, couples therapy, group therapy), what individual provider you work with (ie. psychiatrist, social worker, psychologist), treatment focus (ie. depression, anxiety, trauma, addiction) and provider theoretical orientation (ie. CBT, DBT, EMDR, MBSR)
  • Flexible appointment times
  • Opportunity for longer-term, and potentially deeper work, when functioning is not severely impaired and symptoms are stable

Is outpatient level of care right for me?

This is a difficult question to answer without knowing more about your unique situation. In general, outpatient level of care is recommended when:

  • You are not experiencing suicidal ideation or behaviors
  • You are not engaged in self-harm
  • You are able to maintain stable housing
  • You are able to meet your basic needs without assistance (food, water, shelter)
  • Your depression or anxiety is not severely impairing your functioning
  • You have a support system

Intensive Outpatient (IOP) level of care for depression and anxiety

Intensive Outpatient Programs (IOP) are a level of care that sits in between outpatient services and residential treatment centers. IOP is often recommended for those who are suicidal, are experiencing severe depression, or are not responding to outpatient treatment. IOP provides a more intensive level of care than outpatient services and is less restrictive than a residential placement. IOP typically consists of 3 hours of therapy per day for 30 treatment days spread over 12 weeks, but can be shorter or longer depending on the individual’s needs. Sessions are generally done after school or work and can involve a variety of treatments such as group therapy, individual therapy, and family therapy. Patients in IOP programs usually live at home and continue to work or go to school. The goal of an IOP program is stabilization of symptoms in order to participate in a lower level of care. Aftercare is an important part of IOP and includes continued support and care after the program has ended.

Benefits of Intensive Outpatient Programs (IOP)

  • Increased support in the short term to provide necessary containment in crisis, while providing a “starter motor” for the life-long process of coping with stress
  • The ability to continue working or attending school while in more intensive treatment
  • More support for the system (ie. family therapy, parent support and education)
  • Intense support while remaining exposed to “real life” stresses (ie. school, peers, family)
  • A structured program with a set curriculum crafted and executed by a multi-disciplinary team of professionals
  • A focus on skills-building and learning new coping mechanisms at a pace that allows faster exposure to, learning about, and practicing these skills in real-time with peers and family while having the support of a therapy team

Is IOP right for me?

IOP level of care is often recommended when:

  • You are experiencing suicidal ideation or behaviors
  • You are engaged in self-harm
  • Level of support at OP level of care is insufficient or ineffective
  • You are not able to maintain stable housing
  • Your depression or anxiety is severely impairing your functioning at school, work, or with your family or friends
  • You do not have a support system

Partial Hospitalization Program (PHP) level of care for depression and anxiety

Partial hospitalization programs (PHP) provide a higher level of care than IOP, but allow patients to return home at the end of each day. PHP typically consists of six to eight hours of therapy per day, five days per week. Patients in a PHP program live at home and may or may not continue to work. The goal of partial hospitalization is to stabilize symptoms and prepare the patient to return to a lower level of care.

Benefits of PHP

  • A higher level of care and support than IOP, while still allowing patients to return home at the end of each day
  • Includes consultation with a psychiatrist or psychiatric nurse practitioner for possible medication prescription and management
  • For students, program includes time and support for school work each treatment day

Is PHP right for me?

PHP level of care is recommended when:

  • Level of risk of suicidal intent or level of suicidal ideation exceeds what can be contained by the client or their family over the longer breaks in treatment at IOP level of care
  • Student is unable to participate in school due to their mental health symptoms

Residential Treatment Center (RTC) Level of Care for depression and anxiety

Residential level of care is the most intensive type of mental health treatment. It typically involves 24-hour supervision and typically lasts for 30-90 days, although there are longer term options available. Inpatient treatment is often recommended for people who are experiencing severe depression or anxiety, and who have not been able to find relief through outpatient care or require acute stabilization from immediate and acute symptoms of anxiety or depression. RTCs are often confused for hospitalization. RTC’s are generally operated out of a residential home, are comfortable and well-furnished. There is a range of specialty and specific RTCs for what they treat (ie. substance abuse, depression, eating disorders) and population (ie. gender, age).

Benefits of Inpatient Level of Care

  • 24-hour supervision and support
  • Psychiatric support for medication management
  • Educational support while away from school
  • The ability to take a pause from work, school, the family environment, or other responsibilities that may be stressful
  • 24-hour supervision and support
  • Psychiatric support for medication management
  • Educational support while away from school
  • The ability to take a pause from work, school, the family environment, or other responsibilities that may be stressful

Is inpatient level of care right for me?

Inpatient level of care is often recommended when:

  • You are experiencing suicidal ideation or behaviors and the containment provided by lower levels of care are not sufficient
  • The breaks from treatment (weekends, overnight) pose a safety risk or there is insufficient support available to contain symptoms overnight or on weekends

Voluntary and Involuntary Hospitalization

Hospitalization is the most intensive level of care for mental health. It is typically used as a last resort when all other levels of care have been unsuccessful in alleviating symptoms or when there is an imminent threat to the safety of self or others. Hospitalization can be voluntary or involuntary. Voluntary hospitalization occurs when the individual agrees to be hospitalized and involuntary hospitalization occurs when the individual is evaluated by a professional or agent such as the county’s Crisis Response Team and deemed to be either a danger to self, danger to others, or gravely disabled. In this case, they are initially put on a 48-hour hold while evaluations take place to determine necessary treatment.

Benefits of Hospitalization

  • Intensive level of immediate or emergency care and support
  • 24-hour supervision
  • Psychiatric support for medication management
  • Can be involuntary which may be necessary when an individual is a danger to themselves or others

If you are feeling overwhelmed, we encourage you to reach out to your mental health provider or call a suicide hotline for assessment and support. You are not alone in this journey and there is help available. If you are in our local area, we offer complimentary assessments to help determine which level of care would be appropriate.

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