Treatment Settings
Treatment for mental health-related issues is provided in a variety of settings. The environment and level of care will depend on multiple factors: the nature and severity of the person’s mental condition, their physical health, and the type of treatment prescribed or indicated.
The three primary types of treatment settings for mental health care are 1) outpatient, 2) hospital inpatient, and 3) residential. In addition, some mental health care services are delivered virtually.
+ Outpatient Settings
There are many types of outpatient settings, but all involve office visits with no overnight stay. Some are based in community mental health centers; others are in general hospitals where individuals visit an outpatient clinic by appointment. In addition, many individuals go to private offices to see a mental health clinician who is in solo or group private practice.
Outpatient clinics are settings where patients obtain therapy services from a group of mental health professionals. Depending on the clinic, individual therapy, group therapy and medication management may be available. Sessions are typically once a week or once a month.
Intensive outpatient programs (IOPs) are like PHPs but are only attended for three to four hours and often meet during evening hours to accommodate working people. Most IOPs focus on either substance abuse or mental health issues. IOPs may be part of a hospital’s services or freestanding.
Partial hospitalization programs (PHPs), also called “day programs,” refer to outpatient programs that patients attend for six or more hours a day, every day, or most days of the week. These programs are less intensive than inpatient hospitalization and focus on psychiatric illnesses and/or substance abuse. They commonly offer group therapy, educational sessions, and individual counseling. A PHP may be part of a hospital’s services or a freestanding facility.
Community mental health centers will provide services regardless of an individual’s ability to pay. In Texas, Local Mental Health Authority (LMHA) clinics treat persons whose incomes fall below a state-determined level. A list of LMHAs and their crisis hotlines is available here.
Practitioners in private practice offer mental health treatment/counseling at their offices. Appointments may be for individual, group, or family therapy. Many practitioners accept insurance payments, but practitioners vary in which insurance plans they will accept. Some practitioners accept only personal payment for services.
Telepsychiatry, Telemental Health Services offer remote (virtual) delivery of mental health assessments, care or support via phone, online apps or video chat. Most commonly, these services improve access to care for individuals with mental health issues living in rural areas, in areas with few treatment options, or who can’t leave home due to illness, emergencies, or mobility problems. These services also allow providers to support their patients between visits.
+ Hospital inpatient settings
Hospital inpatient settings involve an overnight or longer stay in a psychiatric hospital or psychiatric unit of a general hospital. Inpatient hospitals provide treatment to patients with more severe mental illness, usually for less than 30 days. Generally, a person admitted to an inpatient setting is the crisis phase of a mental illness and will stay for 24-72 hours for stabilization and discharged once they are no longer deemed a safety threat to themselves or others. A person who requires long-term care may transferred to another facility or a different setting within a psychiatric hospital after 30 days of inpatient treatment.
Psychiatric hospitals treat mental illnesses exclusively, although physicians are available to address other medical conditions. Some psychiatric hospitals provide drug and alcohol detoxification as well as inpatient drug and alcohol rehabilitation services and provide longer stays. A psychiatric hospital might have specialty units for eating disorders, geriatric concerns, child and adolescent services, and substance abuse services.
General medical and surgical hospitals may have a psychiatric inpatient unit and/or a substance abuse unit, although these units are not very common. They provide medical services that would not be available in a psychiatric hospital.
+ Residential Settings
Residential treatment programs provide a structured therapeutic environment where individuals reside with staff support. Services provided may include individual and group therapy, medication management, vocational rehabilitation, nutrition counseling, and family therapy. Most residential treatment settings provide medical care but are designed to be more comfortable and less like a hospital ward than inpatient hospitals. The lengths of stay in residential treatment will vary based on the type of services provided, the patient’s needs, and the availability of insurance coverage.
Mental health treatment centers are tailored to people with a chronic mental illness that impair their ability to function independently. Some facilities may provide services for those with a dual diagnosis (i.e., a mental disorder and addiction problem).
Alcohol and drug rehabilitation facilities are centers that primarily treat addictions and may or may not provide medication assisted detoxification services.
Nursing homes may provide psychiatric consultation as needed.