What You Need To Know About Mental Health Treatment

You’ve just been hit hard lately with a lot of stress.  Usually you can manage but things keep piling up and you need some help.  As you’ve started looking around you realize that there are a bunch of different types of mental health treatment and you don’t even know where to start!  Fortunately, I can help you understand the different types of mental health services available to you here in California.

I would like to point out that there can be a stigma around mental health treatment that, in my opinion, is unwarranted.  So please keep this in mind as you read on - there is no shame in getting the help you need - just like there is no shame in going to a physician for a health condition!

I like to describe mental health services in a continuum - the lower levels of care (such as outpatient treatment) are much less intensive vs. the higher levels of care (such as inpatient psychiatric hospitalization).   Actually, most people think those are the only two levels of care in mental health treatment!  Fortunately, you have some options in between these two.  I’ll start with the lowest levels of mental health treatment and guide you through to the highest and most restrictive levels of care.  For your own treatment, you can start at any level of care and go up or down in intensity of services based on your unique needs.  There are treatment services available for mental health only, substance abuse only and a hybrid combo (called “dual diagnosis”).   For each level of care I go through - know that these three options are available to you - and there are wonderful programs here in San Marcos for you to choose from!  

Outpatient Treatment

Most people are familiar with this level of care. This is when someone sees an individual treatment provider on a weekly basis to address issues that are upsetting to them, but are not affecting their lives to the point where they need to take time away from work, etc.  This is the most common type of mental health treatment, and there are different types of counselors (click here for a run down).  Sometimes, when things are more stressful than usual, you might see your therapist twice a week for a little added support.  If you find that you need even more help, you move on to Intensive Outpatient Programming (IOP).

Intensive Outpatient Program (IOP)

This level of care is three days a week, three hours at a time and people live at home.  This can occur in morning, afternoon or evening hours (for those who work during the day).  This level of care typically lasts 2-3 months.  This treatment typically occurs as group therapy where you learn coping skills and connect with other people who are also struggling. This group connection is exceptionally helpful and allows people to realize that they are not alone in their feelings.

Many Intensive Outpatient Programs will assign you a case manager or primary therapist who you will see on a weekly basis.  This level of care is also helpful if you also need medication management. As you will have mental health providers monitoring you throughout the week, the program’s psychiatrist can be notified if you need a medication adjustment.  Another bonus, if you find that you are having side effects or that the medications aren’t helping, you have access to the psychiatrist much more quickly than if you were trying to have a medication adjustment on an outpatient basis!

If your symptoms are still not improving, you can move up a level of care into a Partial Hospitalization Program (PHP).

Partial Hospitalization (PHP)

In this level of care, individuals still live at home but attend treatment 5 days a week for about 6 hours a day.  This occurs during the morning through afternoon hours. This level of care typically lasts a few weeks and you typically go to the same facility or treatment team as Intensive Outpatient Programming.   If more help is needed, the next level of care is Residential treatment.

Residential Treatment

This level of care is typically several weeks to a month where you live onsite with 24 hour supervision. Most people know this level of care as drug and alcohol “rehab,” but this is also available for other types of needs as well.  Some examples are for Obsessive Compulsive Disorder, Borderline Personality Disorder and Eating Disorders.  This level of care is for the individual who is not symptomatic enough for inpatient psychiatric hospitalization, but they are unable to function at a lower level of care.  

Inpatient Psychiatric Hospitalization

This level of care is for individuals whose mental health symptoms have intensified to the point that they need to be hospitalized.  Typically, this person is very depressed and may have had thoughts and plans on how they might harm themselves.  Other people might be having hallucinations (most often auditory) or have increased symptoms of mania. Sometimes the symptoms of these conditions have become so unmanageable that someone may be unable to provide food, clothing or shelter for themselves.

Inpatient psychiatric hospitalization can also be for individuals who require detoxification from alcohol, opioids (heroin, other pain medications), or benzodiazepines (Xanax, Ativan, Valium, etc). If someone has been using a moderate amount of a substance on a daily basis for at least seven days, they may need detoxification.  Many individuals can detoxify at a residential level of care as well – however if someone has had a seizure while detoxifying in the past, hospitalization is highly recommended.  This level of care is typically more short term (one week or so).

Psychiatric Emergency Response Team or Welfare Check 

I always like to inform people about the Psychiatric Emergency Response Team (PERT) or the ability to call your local sheriff’s department for a welfare check.  This is for those emergent psychiatric situations where you are concerned for the health and safety of someone else.  If someone is suicidal, homicidal, or gravely disabled (unable to provide for their own food, clothing or shelter), this is who you call.  A police officer trained in managing these types of needs is dispatched to the location and ensures the safety of the individual.  Many times, an officer AND a mental health clinician will go together.  

Many people feel like they can or should manage these situations on their own.  Or they feel guilty about sending the cops to someone’s house. Remember, you are trying to protect them - and in trying to take care of this yourself, you could actually come to physical or emotional harm.  If someone voices thoughts of self harm and they are unable to tell you that they can keep themselves safe, do not hesitate to call for a Welfare Check. 

When they answer the phone, ask for a welfare check, briefly explain why you are concerned for this person’s  safety and give them the address. Once they have completed a check, they often call you back to tell you what happened.  Sometimes they take someone to an emergency room to get help. Other times they ensure safety and then offer appropriate mental health referrals.  What happens really depends on the state of the person when they get there.  

I hope this primer helps you access the mental health treatment you need.  If you are not sure what type of help you need, I’m happy to chat with you.  I’ve been doing these types of assessments since 2002 so I can point you in the right direction.

If you find you need outpatient mental health treatment for complicated grief, trauma, or anxiety management, click here to book a free 15 minute video consultation for online EMDR treatment in California.

Online EMDR Therapy and Trauma Counseling in California and Carlsbad, CA.