Navigating the mental health system can feel overwhelming, especially when trying to determine the best level of care for yourself or a loved one. As therapists, our goal is to provide guidance and education so you can make informed treatment decisions. Understanding the different levels of care can help you feel more confident in accessing the support you or your loved one needs. Below, we’ll break down the various levels of care, what to expect, and when a therapist might recommend a change in treatment.
Outpatient Therapy: The First Step for Many
Outpatient therapy is often the first level of care individuals engage in when seeking mental health support. This setting includes weekly or biweekly therapy sessions with a licensed therapist, psychologist, or counselor. Outpatient therapy is best suited for individuals managing mild to moderate symptoms of anxiety, depression, ADHD, trauma, and other mental health concerns. It provides a safe space to explore emotions, learn coping strategies, and work toward personal growth.
What to Expect:
- 45–60-minute sessions, typically once per week
- Individual, family, or group therapy formats
- Development of coping strategies, emotional regulation skills, and behavioral interventions
- Collaboration with psychiatrists or primary care doctors if medication management is needed
When a Referral May Be Needed: If symptoms significantly worsen, interfere with daily functioning (e.g., missing school or work), or include safety concerns (e.g., self-harm, suicidal thoughts), a higher level of care may be recommended.
Intensive Outpatient Programs (IOP) & Partial Hospitalization Programs (PHP)
When symptoms are more severe and impact daily life but do not require hospitalization, an Intensive Outpatient Program (IOP) or Partial Hospitalization Program (PHP) may be beneficial. These programs provide more structured and frequent therapeutic interventions while allowing individuals to remain at home.
What to Expect in IOP:
- 3–5 days per week of therapy, lasting 3–4 hours per session
- Combination of individual, group, and family therapy
- Skills-based approaches like Dialectical Behavior Therapy (DBT) or Cognitive Behavioral Therapy (CBT)
- Medication management and psychiatric support if needed
What to Expect in PHP:
- 5 days per week, often for 6 hours per day
- Highly structured environment with intensive therapy and psychiatric care
- Close monitoring of symptoms while still maintaining some independence at home
When a Referral May Be Needed: Therapists recommend IOP or PHP when outpatient therapy alone is not sufficient, such as when symptoms prevent participation in school, work, or social activities, or if there is an increased risk of self-harm but not requiring inpatient care.
Inpatient Psychiatric Hospitalization: Crisis Stabilization
Inpatient hospitalization is the highest level of care, designed for individuals in crisis who need immediate and intensive intervention for safety reasons. This level of care is necessary when someone is experiencing severe mental health symptoms, is at risk of harming themselves or others, or is unable to function safely in daily life.
What to Expect:
- 24/7 monitoring in a hospital setting
- Immediate psychiatric assessment and stabilization
- Short-term stays, typically lasting 3–5 days
- Medication management and crisis intervention
- Planning for step-down care, such as PHP or IOP, upon discharge
When a Referral May Be Needed: Therapists refer individuals to inpatient care when there are imminent safety concerns, including suicidal ideation with a plan, severe psychotic symptoms, or an inability to care for oneself due to mental health symptoms.
Residential Treatment: Longer-Term Support
For individuals requiring a more extended and structured treatment experience, residential programs offer 24/7 care in a supportive environment. These programs focus on intensive therapy, skill-building, and medication management over weeks or months.
What to Expect:
- Live-in treatment with structured daily therapy and support
- A combination of individual, group, and experiential therapies (e.g., art therapy, equine therapy)
- Treatment for complex mental health conditions such as eating disorders, substance use disorders, and severe mood disorders
When a Referral May Be Needed: Therapists may recommend residential treatment when symptoms require long-term stabilization beyond what outpatient or IOP/PHP programs can provide, particularly if someone has not responded to lower levels of care.
Finding the Right Support
Mental health treatment is not one-size-fits-all, and different levels of care are designed to meet individuals where they are in their journey. If you or a loved one are struggling, know that help is available at every stage. For high-risk situations—such as experiencing thoughts of harming yourself or others—please call 911 or go immediately to the nearest hospital emergency department or behavioral health hospital. Once there, you’ll undergo a risk assessment where mental health professionals will evaluate your symptoms, determine the immediate level of care needed, and help stabilize your condition. If you’re unsure about what level of care is right for you, don’t hesitate to contact a mental health professional for an assessment and guidance. Seeking help is a sign of strength, and taking the right steps toward care can lead to meaningful and lasting change.
