Beyond Therapy: When to Consider More Intensive Mental Health Treatment

In the world of mental health treatment, there are multiple levels of care that can be utilized to help one recover or heal from their diagnosis. With so many options, it can be difficult to know when to take the next step in seeking help. For many, the lowest level of care, outpatient therapy, and medication management provide the support they need to maintain mental wellness. However, there are times when this level of care is no longer enough to manage one’s symptoms or encourage recovery. Recognizing when you need a higher level of care is crucial for ensuring that you receive the appropriate level of care to support your mental health. This blog aims to explore the signs that indicate it might be time to seek more intensive care, and how to make that important decision when it feels overwhelming.

Understanding Mental Health Care Levels

Within the world of mental health care, there are five levels of care. From least intensive to most intensive they are: outpatient care, intensive outpatient program, partial hospitalization program, residential, and inpatient. Each of these levels of care come with their own requirements for admission as well as what they provide for treatment. Let’s take a closer look into each of these levels and what they offer.

• Outpatient Care

  • This level of care is what everyone thinks of when they think about therapy. When you go online or talk to a friend about starting therapy, this is the level you are looking at getting into. At this level of care, most people are going to therapy once a week, maybe two times at most. Group therapy would also fall under outpatient care and can be done simultaneously with individual therapy in order to provide more support for whatever you are going through. You may also see a psychiatrist regularly to prescribe medication in conjunction with the therapy.

• Intensive Outpatient Program (IOP)

  • The IOP level of care is more intensive than the outpatient level due to the amount of time you spend in therapy a week and the structure of the treatment. At this level of care, you have demonstrated that you need more than 1-2 days of one hour sessions a week in order to maintain safety and function in life. This level of care can look a few different ways. For some programs, it can be 3 hours of group therapy 3 days a week plus an individual session. Each group has a specific topic or theme to address the presenting concerns of the patients. For example a mood and anxiety program may have a DBT skills group, an exposure group, and a social/emotional learning group for their patients to attend each week. Other IOPs may spread the hours each week out among the week where the patients go daily to programming.

• Partial Hospitalization Program (PHP)

  • The PHP level of care is a more intensive day program than IOP. At this level of care, you have demonstrated that you need even more support in order to maintain your safety and/or to be able to complete your activities of daily living. Most PHP programs are between 5-7 days a week with programming lasting around 6-8 hours a day. During this time, you engage in multiple groups daily, have access to individual therapy multiple days a week, and have time for work or homework during the day. PHP is very intensive and allows one to be able to focus solely on taking care of their mental health without the added stressors that work or school can provide.

• Residential Care

  • Residential level of care happens when you need constant supervision and support in order to maintain safety. At this level of care one is living, eating, and doing all life events at a residential facility. Patients receive around the clock care and their days can be very similar to a PHP level of care, with the exception of going home at the end of the day.

• Inpatient Care

  • Inpatient care is the highest level of care one can receive and occurs when one is in need of being hospitalized to maintain safety and stability. At this level of care, one is unable to care for themselves without the assistance of a medical team who ensures their safety, that they are eating, and that they are taking meds. Inpatient does typically includes therapy, but the main focus here is the health and safety of the patient.

Signs You May Need a Higher Level of Care

Recognizing that you may need a higher level of care for your mental health can be a challenging and exhausting process. To help you navigate that process, here are four signs you may qualify for a higher level of care.

1. Worsening Symptoms

   1. If you have been in outpatient therapy for some time and are noticing your symptoms of depression, anxiety, bipolar disorder, restrictive eating, binge/purge behaviors, or any other disorder are worsening, you may need more intensive treatment. This could be an increase in mood swings, persistent sadness, or panic attacks. If you feel any of your symptoms have become unmanageable, seeking more help can be beneficial.

2. Inability to Function in Daily Life

   1. We all have activities of daily living (ADLs) that we need to complete in order for us to function in a healthy way. This includes getting out of bed, showering, changing clothes, brushing teeth, eating well rounded meals, etc. If you find yourself unable to complete these activities on a daily basis, you may be in need of a higher level of care. By seeking more support, you will be given more accountability for these tasks, which helps one to be able to complete them more regularly and effectively.

3. Lack of Support or Resources

   1. Lack of support or resources can come from your personal life as well as from your outpatient treatment team. If you feel you are needing more time with your therapist for support, then you may need a high level of care. This can also look like not having many family or friends who you can rely on for help (i.e. emotionally, financially)  in your day to day life.

4. Self-harm or Suicidal Thoughts

   1. Many people who are struggling with their mental health have thoughts of wanting to harm themselves or thoughts of suicide. While this can be managed at the outpatient level of care, if you notice an increase in these thoughts or desires then a higher level of care is necessary. A higher level of care provides one with more support which can be helpful in maintaining one’s safety.

How to Seek Higher Level Care

If you have determined that you are in need of a higher level of care, there are multiple ways in which you can go about finding the right level of care for you. The two most common ways people find a higher level of care are reaching out to your current therapist or doing a google search for popular treatment programs in your area.

If you are currently working with a therapist at the outpatient level of care, then talking with them is the best first step you can take. Many times, if your outpatient therapist is aware of the worsening of your symptoms or the intensity of them they may suggest a higher level of care to you. After speaking with your outpatient therapist, they should be able to make recommendations to programs they know to be successful for whatever your specific diagnoses are. They are also able to reach out to other providers to find the right treatment program for you if needed as well.

For those of you who are not currently working with an outpatient therapist, you have a few options available to you. You can do your own research and find programs in your area that have good reviews and treat what you believe you need help with. By speaking directly with a treatment program, they will be able to assess your current status and determine what the best level of care for you is. You could also reach out to local outpatient therapists that you might like to work with to establish care with them first before seeking a higher level of care. By doing this, they can help you assess what level of care would be best for you as well as be there to support you through your time in treatment and after treatment.

If you or someone you love is in need of a higher level of care, please reach out to us today. At Integrated Care Clinic, all of our highly trained professionals can help you navigate the world of mental health and find the best level of care for you.

If you or someone you love is experiencing any thoughts of harming themself or suicide, please contact 911 immediately or take them to a local hospital for an evaluation.  Tap here to reach out and start the process today.