The mental health system can be extremely confusing! When you are looking for help, sometimes it is difficult to know where to turn. Dr Byrne explains the different levels of psychiatric care with examples of when each level is appropriate.
Mar 8th, 2019
This is the least intense level of care. Many people use self-help to assist with mild symptoms like anxiety or low mood. Self-help can include many different components like sleep, diet, exercise, yoga, mindfulness, meditation, faith-based practices, etc. Self-help is a good fit for people who have mild symptoms, are functioning well at home and school/work, and have no medical symptoms.
Sometimes it is helpful to seek assistance from a professional. Many people participate in different kinds of “talk therapy”, or psychotherapy. This can be individual or in groups, and can have different styles, like Cognitive Behavior Therapy (CBT), Supportive, Family/Couples, etc. Psychotherapy is a good fit for people who have mild to moderate symptoms, have mild difficulty function at home and school/work, and have no medical symptoms.
A psychiatrist is a medical doctor who is able to complete thorough psychiatric assessments, which includes medical, psychological, and social components of mental health. Most psychiatrists practice in a office-setting, although some may be located in a hospital, or in a primary care practice. A psychiatrist is a good fit for people who have mild to severe symptoms, have mild to moderate difficulty functioning at home and school/work, and have some mild to moderate medical symptoms.
Intensive Day Program
These programs have programming several days a week, including both individual and group psychotherapy, as well as medication management. They are often recommended for people who have moderate to severe substance use disorders and have having severe difficulty functioning. They are a good fit for people who need more support that weekly psychotherapy can provide. They are often called SAIOP if they treat substance use disorders.
These programs typically have programming all day long, but the person returns home at night, or in some cases could stay in a local hotel. They have group and individual psychotherapy, medication management, and other forms of support and therapy. Partial hospitalization can be a good fit for someone who was just discharged from the hospital but needs alot of support. People in these programs have severe symptoms and severe problems functioning at home and in social settings.
Historically, residential treatment or long-term hospitalization was a preferred way to treat people with severe mental illness or substance use disorders. The past 50 years has showed a progressive decrease in the number of people being treated long-term in residential settings. In this setting, the person lives in a long-term residence or hospital setting for months or even years. It is a good fit for severe and persistent mental illness or substance use disorders where the person cannot function at home.
This is the most intense type of treatment for mental illness and substance use disorders. Normally, people have very severe symptoms with an acute risk of harming themselves or others. Patients in the hospital have many restrictions and our current mental health system tries to avoid inpatient hospitalization unless all other options have failed. Most people stay in the hospital setting for 3-14 days to resolve their acute crisis, then are stepped down to a lower level of care. This setting is a good fit for the patients with the most severe mental illness or substance use where their life is at risk due to suicidality, or are unable to care for themselves due to depressive, manic, or psychotic symptoms.
With over 15 years of medical expertise, Jennie Byrne, MD, PhD, is a board-certified psychiatrist with experience treating mental health conditions in adults, including dementia, attention-deficit hyperactivity disorder, anxiety, and depression. After practicing in New York City for 12 years, Dr. Byrne relocated to North Carolina in 2008; she currently cares for patients in Chapel Hill, North Carolina, at Cognitive Psychiatry of Chapel Hill. Dr. Byrne earned her bachelor’s degree at the University of Pennsylvania in Philadelphia. She then received her doctorate from New York University Department of Neurophysiology. She also has a doctorate of medicine from New York University School of Medicine. Dr. Byrne went on to complete a psychiatry residency at Mt. Sinai School of Medicine in New York. In addition to her work as a psychiatrist, Dr. Byrne has performed extensive research on attention, memory, and depression. As a board- certified adult psychiatrist, Dr. Byrne focuses on the needs of each patient to pro.