Resources

• PHP VS. IOP TREATMENT
• NATIONAL ALLIANCE ON MENTAL ILLNESS SUPPORT & HELPLINE
• SUICIDE & CRISIS LIFELINE
• NATIONAL INSTITUTE OF MENTAL HEALTH
• SUICIDE PREVENTION
• MENTAL HEALTH DISORDERS
• LGBTQ CRISIS AND SUPPORT RESOURCES

What Does it Mean When Your Counselor Says You Need a Higher Level of Care?

The right level of care matches to the severity of your condition. The highest level of care is what you need when you’re in crisis. The lowest level of care is what you need when you want to make an improvement in your life, but don’t face any immediate risk of harm if you don’t. Below are the different types of levels of care with definitions:

Lower Levels of Care

Lower levels of care are appropriate when your symptoms and/or your concerns are minor. They can be the right choice when you’ve just started experiencing an issue and aren’t sure how bad it is or how long it will last. Lower levels of care are somewhat self-directed and can help you explore and learn more on your own. They can also work when you’ve already received treatment and started to recover, but still need a little bit of support to continue improvement.

Self-help encompasses anything you can do to improve your mental health without working with a peer or professional. Self-help can take many forms. For example, you might:

• Take a self-paced online course,
• Complete a do-it-yourself workbook
• Read a book or manual that includes exercises or action steps.

Self-help can also be a great place to start when an issue is new, and you haven’t done anything to address it yet. If the issue responds to self-help alone, that may be all you need. If not, you may need a higher level of care.

Support groups are group meetings led by peers who come together to discuss issues they have in common. These groups are not designed to provide therapy. Instead, they help people share advice, resources, and emotional and social support. Everyone has time to talk about their own experiences and to get feedback from others, usually in a structured way. Overall, going to support groups is a good choice when you want more help but aren’t sure if you need formal treatment.

Individual weekly therapy can be the right fit when you don’t have any symptoms but just want to work on personal growth. It can be the right fit for treating moderate to severe depression or anxiety symptoms. Individual therapy can help you with relationship problems, work stress, or existential questions. You might need a higher or lower level of care, but if you’re not in crisis or at immediate risk of harm, it’s usually the likely recommendation.

Group therapy is its own unique modality. It’s not “more” or “less” than individual therapy—it’s just different. While individual talk therapy helps you dive deep into your personal issues, group therapy helps you experience your “self” in dialogue with others. It can help you heal how you feel and see yourself in relationships. The therapist who leads the group helps everyone learn from each other in the moment, through the group process itself.

Psychiatry or medication management offers the same level of care as weekly talk therapy. Like group therapy, psychiatry is not “more” or “less” than individual therapy—it’s just different. Whether you want or need therapy or medication (or both) will depend on your personal preferences and the symptoms or condition you have.

Intermediate Levels of Care

Intermediate Levels of Care provide a higher level of care than weekly talk therapy but a lower level of care than hospitalization. They can be a good choice when you are recovering from a crisis or need more structure and support throughout the week.

Intensive outpatient treatment (IOP) programs are a higher level of care than weekly talk therapy, but a less intensive level of care than inpatient treatment or partial hospitalization programs. They focus on group therapy sessions, which are held two to three times each week. Most IOPs also offer individual therapy on a weekly, as-needed, or by-request basis. Other services vary from program to program and may include psychiatry and therapeutic activities. You can usually choose either day or evening groups so you can still work while receiving a higher level of care than you would with individual talk therapy alone.

Partial hospitalization program (PHP) or day treatment is one of the highest levels of care you can get outside of a hospital. Going to day treatment is like going to school or a job. You spend several hours (often 5-6) at the program each day (usually with weekends off), then go home. The program consists of group and individual therapy along with psychiatric care and a mix of therapeutic activities.

PHP programs are often used as step-down care, or care that helps you readjust to life after inpatient treatment. They are the right level of care when you’re ready to be discharged from the hospital but need more than standard outpatient treatment. It can also be a good option if you have a complex condition and need intensive programming to address all aspects of it.

Highest Levels of Care

Inpatient treatment is also known as psychiatric hospitalization and is the highest level of mental health care. It’s designed to help you get through a mental health crisis safely. Inpatient treatment takes you out of stressful life circumstances and places you in a secure environment where you receive psychiatric care around the clock. Inpatient treatment usually consists of a combination of group and individual therapy, medication administration and management, and therapeutic activities. It usually lasts for 3-15 days.

Residential or long-term inpatient treatment is usually only recommended if short-term inpatient treatment doesn’t stabilize you. It consists of the same kinds of activities as acute inpatient treatment, but often on a larger campus that includes outdoor and recreational spaces. This allows the facility to provide more types of therapeutic recreation and rehabilitation.

Your counselor will openly discuss with you your options and their recommendations as well as answer any questions about the process.