If you or a loved one suffers a psychiatric crisis – a situation which might result in self-harm or harm to others – you will likely have to quickly learn about treatment options.There are many different settings for mental healthcare, ranging from daily-visit, outpatient programs run by qualified behavioral health organizations to weeks-long stays at psychiatric hospitals or residential facilities.
“Bed-based and non-bed-based care exist in many flavors and sub-flavors,” Marc Fishman, MD, medical director of Maryland Treatment Centers/Mountain Manor Treatment Center, told MDedge. “You have to remember this is a marathon, not a sprint, and one of the most important goals of bed-based care is that it serves as a steppingstone for outpatient treatment.”
Your health insurance coverage and the nature of the crisis itself may also play a role in whether you seek inpatient or outpatient care.
Inpatient Psychiatric Hospitals
Inpatient hospitals can provide treatment for psychiatric patients in crisis in a supportive and restorative environment.
Inpatient care provides therapy for patients with significant mental health issues. Patients often become part of a highly structured environment: days may be programmed with a full schedule to incorporate therapy and counseling, meals, exercise and quiet time. Many programs focus on getting the patient back into good habits and routines with healthy diets and plenty of sleep.
According to Acadia Health, an international behavioral health service provider, “inpatient treatment provides those in need of stabilization and crisis resolution with a safe environment in which to jumpstart their recovery process.” The length of a hospital stay can vary greatly; a stay may be as little as a few days or as long as a few weeks. The current average stay is five or six days.
Patients in an inpatient facility are typically monitored 24/7 for their safety and that of the staff. For example, the psychiatric floors at the newly opened Epstein Center for Behavioral Health at North Shore Medical Center in Salem, Mass. were designed to be safe for both patients and staff. The facility incorporates science-based elements like:
- Smooth rounded edges on doors and locks
- Privacy, but with considerations for a patient’s safety
- More single than shared rooms
Psychiatric Residential Treatment Facilities
For those needing longer-term treatment, a psychiatric residential treatment facility may be a viable option.
According to GoodTherapy.org, “Psychiatric residential treatment facilities can administer inpatient care to teenagers and children whose mental health needs are not met in other settings, such as school, home, or individual therapy. They provide a structured therapeutic environment, safe but intensive treatment, plans based around the child’s needs, and treatment for chronic issues.”
These facilities must be accredited by state and federal regulating authorities and are operated under the direction of a physician. Patients must be covered by Medicaid and must be under the age of 21.
My Mental Health Crisis is Over – Now What?
As the term “outpatient” implies, this treatment does not involve an overnight stay. Outpatient programs provide an open environment with more flexibility for the patient, compared to the more structured and monitored inpatient setting.
Partial hospitalization programs or day programs are almost full-time care; patients attend the programs on most days of the week for six or more hours a day. These programs can take place either at a hospital or a free-standing facility. Patients often participate in talk therapy, education, and other counseling.
Intensive outpatient programs are often three- to four-hour sessions, which could be held during the evening. These programs are designed to “provide short-term stabilization and resolution of immediate mental health problem areas.” These programs are designed for patients who want to continue leading their regular daily lives and work/school schedules but need supportive treatment.
What to Do in a Mental Health Crisis
If you find yourself facing a psychiatric emergency, including thoughts of suicide, you should immediately go to a hospital emergency room or call 911.
The National Alliance on Mental Illness (NAMI)recommends planning ahead for those who live with a mental health condition. For example, NAMI writes that patients should talk with their treatment team to “think about where to go for intensive treatment and how to get there, how to take time off work or explain your absence to others, and what methods you can use to calm yourself in an emergency.”
If you or a loved one has been diagnosed with a mental health problem, be mindful that it could turn into a crisis. Know where to go for help.
- National Suicide Prevention Hotline 1-800-273-8255
- NAMI Help Line 1-800-950-6264
- DBSA Help Line 1-800-273-TALK or text DBSA to 741-741.