Outpatient Treatment
Outpatient Treatment is the lowest level of structure and support. Typical outpatient treatment includes meeting once a week for 45-60 minutes with a therapist. Outpatient can intensify by increasing the frequency of sessions to twice a week and/or increasing the duration of the sessions to 75-90 minutes. Extending the session duration is common with treating trauma. If someone needs to meet more than twice a week in the outpatient setting, it is likely their environment and mental health needs more support.
Intensive Outpatient Program (IOP)
Intensive Outpatient Program is technically the next level of structure and support. IOP programs are three hours long, usually five days a week. IOP programs can exist as stand-alone facilities or as part of a hospital setting. These programs will determine the frequency needed, whether it be 5 days a week or less. Now I’m going to complicate things. While this is the natural next step of structure and support, in real life, most folks need to jump to Partial Hospitalization first and then work their way down in terms of structure and support. The reasons for this are many. If you have questions about it, feel free to ask me!
Partial Hospitalization Program (PHP)
This means exactly what it sounds like – you are partially in a mental health hospital. Treatment is usually six hours a day for five days a week. Folks who attend PHP programs usually have at least one meal while at treatment but do not stay the night. Mental health hospitals are different than a regular hospital, they look like a home on the inside and only treat mental health issues as opposed to a regular hospital where people are there for all sorts of reasons. PHP programs also have a psychiatrist affiliated with them who meets weekly or twice a week with patients so it can be a good place for someone to medically stabilize while also getting the support and help they need. Usually PHP programs last between 1-3 months, and the person will step down to IOP for several weeks with the goal to prove they can maintain gains achieved in PHP level of care.
Residential Treatment
This is a facility where someone stays for an extended period of time (usually 2-3+ months) to receive mental health treatment. A residential facility has very high levels of support and is a recommended option for those with active suicidal ideation, debilitating depression, anxiety or OCD. Residential facilities orient around keeping patients safe, which can look like no access to sharps (ie- no scissors, glass objects, pens, razors, etc.) and monitored activities (timed bathroom use, timed showers, observed consumption of prescribed medicines. This is all done in an effort to support the person’s safety. Folks who participate in residential treatment are usually then transitioned down to Partial Hospitalization, then to Intensive Outpatient, landing with regular weekly outpatient sessions.
Inpatient Stabilization
Note that I phrased this as inpatient “stabilization,” and not inpatient “treatment,” because the goal of this level of care is merely to stabilize a client in preparation to transfer them likely to a residential facility. Folks end up at inpatient facilities usually following a significant attempt on their life or a significant self-injurious event. Inpatient units are within regular hospitals. It is important that people who are medically or physically recovering from such events are monitored and kept safe, so they are brought to a designated space in the hospital such as the psychiatric unit or “inpatient.” The stay at inpatient facilities can be as little as 3 days to as long as 15. This depends on the person’s physical or medical recovery as well as waiting for a spot to open up in a residential facility to receive the person after discharging from the inpatient unit.
Baker Act
A Baker Act facility refers to a facility that receives people who have been Baker Acted. To be Baker Acted in the state of Florida, a person must indicate that they are in imminent harm to themselves or someone else (i.e., active suicidal or homicidal ideation with intent and/or plan). The goal of a Baker Act is to “hold” the person for a minimum of 72 hours to help keep them safe in this short-term window. A Baker Act can be performed voluntarily (i.e., a client chooses to Baker Act themselves because they know they are unsafe and don’t trust themselves) or involuntarily if the therapist deems it necessary for the client’s safety. One is discharged from a Baker Act facility after the 72-hour mark once it is deemed they are safe; if they are not deemed as safe, their stay can be extended. A Baker Act facility is not a form of traditional treatment, it is a form of stabilization. A person’s medications may be changed during their stay.
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