June 17th, 2022
Over my 14-year career, I have often been asked to help friends/family/friends of friends navigate the mental health system. It has become pretty clear to me that unlike other realms of health care, mine is somewhat of a mystery to those outside of the field.
Most people seem to understand the basics of healthcare; if you have a cold go see your doctor, if you have a toothache see a dentist, if you break your leg go straight to the ER. What I have noticed is nothing is that easy in psych. We have a lot of confusing acronyms, so many different letters behind our names, and lots of different treatment options. The question for people often becomes, “What do I need, and how do I find it?”.
I find that people assume that mental healthcare is therapy, or medication management done weekly in an office. We call that the outpatient level of care. This is what we do at Clarity Clinic. We offer “outpatient” services; weekly therapy, monthly medication management, and some other services.
For most people, this is enough. The majority of clients who seek out treatment for their mental health only do outpatient services. They will see a therapist or psychologist on a weekly basis for “talk therapy” and possibly also see a psychiatrist for psychotropic medication every 1-6 months depending on their needs.
When someone is asking me for assistance it is usually because the outpatient level of care is not enough but they just don’t know what the other options are. At this point in my career, I have broken down the different treatment options offered in psych to clients/friends/family so many times that it has become a script for me.
So, what does it all mean? Going from the highest level of care to the lowest, below is an overview of mental health services that are available to anyone ages 3+.
Just like in other areas of healthcare, inpatient is the highest level of care. This means the patient stays in the hospital for the duration of time they have the treatment and they do not go home until they are discharged. Inpatient is for patients who are at risk to themselves/others or that have an inability to care for themselves.
This is the only level of care where someone can be admitted involuntarily although most often patients are willingly signing themselves in to get care. As providers, this is our last resort. It is the most restrictive (no cell phones, limited visiting, limited phone time, no access to anything that could be considered dangerous including belts and shoe laces) and costly of all levels of care.
The average length of stay is 3-7 days. The goal here is to stabilize and move on to a lower level of care.
This is the highest voluntary level of care. Residential treatment facilities can treat mood disorders, substance use disorders, eating disorders, and just about anything else someone could be struggling with.
When Amy Winehouse debuted her first single and told the world “They tried to make me go to rehab, but I said No, No, No”, this is the level of care she was referring to. She goes on to state “I ain’t got the 70 days” and she’s right, the average length of stay for Residential treatment is 30-90 days with some being as long as a year.
In this level of care, patients choose to admit themselves into the treatment facility and stay there for intensive round-the-clock treatment. They receive individual, group, and family therapy in addition to regularly meeting with a psychiatrist. This level of care can be quite expensive and not all insurance plans will cover it.
At Clarity Clinic, PHP and IOP are the levels of care we most often see our patients in need of. Although it is not common that we do have to refer out when we do the hope is that we are noticing our patient’s symptoms early on and can intervene before someone may need to go to inpatient or residential.
Partial Hospitalization is exactly what it sounds like, the patient is “partially” hospitalized. This means they are spending anywhere from 6-9 hours of their day, 5-7 days a week in a treatment program. When they are not in programming they are living at home.
It is best to find a program that is local to you, although now many are available via telemedicine. These programs are often linked to a larger hospital system that also has an inpatient level of care, but this is not always the case. When in this level of care, a patient generally needs to take time off from work or school for anywhere from 2-12 weeks.
PHP, at times, can also be offered with boarding, meaning patients can choose to live on-site and pay a boarding fee that is not covered by insurance.
Intensive Outpatient also is exactly as it sounds. It is a more intensive version of the outpatient services you would see offered at any clinic similar to Clarity. Patients come 3-5 days a week for 3 hours at a time. Most adult intensive outpatient programs are offered in the evening and on weekends in order to accommodate for the patient continuing to go to work during the week.
IOP programs for children and adolescents take place during the day and are done instead of school, or split with the school day the child will do ½ and ½.
This is the least restrictive level of care above outpatient and is also the most accessible due to the flexibility in hours and shorter time commitment. IOP is also the easiest level of care (after outpatient) to get authorized by insurance companies. The average length of stay is anywhere from 4-12 weeks. The goal is to work on moving the patient towards only needing outpatient services.
Throughout my career, I have had the privilege of working with patients at all the above-mentioned levels of care. Each is important in its own right and serves a different purpose in the overall scope of mental healthcare.
Outpatient is where I have spent the last 5 years of my career, with Clarity Clinic as my home. We offer individual, group, family, and couples therapy to patients ages 3+. We also offer psychological testing services and medication management. Our clients are seen weekly for therapy services and seen once every 1-6 months for medication management depending on the individual need of the patient.
If you think you or someone you love may need any of these levels of care, pick up the phone and call. All treatment centers, hospitals, and therapy practices have assessment teams who can assist in navigating treatment options for mental health.
In my follow-up article, I'll be outlining the specific benefits and what to expect when attending PHP or IOP programming.
Written By: Tara Javidan, LCPC, CADC.
At Clarity Clinic, we have highly trained staff who specialize in therapy and psychiatry services. To learn more about how we can support your mental health, call Clarity Clinic at (312) 815-9660 or schedule an appointment today.
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