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Understanding Levels of Care: The Difference Between Outpatient vs. Inpatient vs. Residential Treatment

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Treatment for teenage mental health, depression, teen anxiety, and other challenges takes time and care. Different stages of the healing process may require different levels of care. Therefore, it’s helpful to understand the difference between inpatient vs. residential treatment, as well as inpatient therapy vs. outpatient care.

Optimal treatment takes into account an adolescent’s individual needs and history, as well as their severity of their diagnosis. Following an in-depth assessment, experts can recommend the best approach for each phase of treatment. Hence, teens might receive treatment first in an inpatient mental health unit of a hospital, transfer to a residential setting, step down to an outpatient program, and then receive weekly therapy and/or attend support groups at a community teen mental health center.

Given all these options, it can be hard for parents to distinguish the difference, let alone understand what their child needs to recover. Let’s look more closely at the various levels of care.

Levels of Care: Outpatient vs. Inpatient vs. Residential

About one in five teens has a diagnosable mental health disorder, such as depression or anxiety. Treatment for these issues is much more likely to be successful when a teen is placed in the right level of care. The main levels of care include:

  • Weekly therapy, online or in person; which may include medication prescribed by a psychiatrist or physician
  • Outpatient programming—at an outpatient clinic or community mental health center.
  • Inpatient care—in a psychiatric hospital or the psychiatric unit of a hospital, usually for no more than 30 days
  • Residential care—in a homelike setting, preferably for 90 or more days.

Within those categories are more subtle differences. Let’s take a look at the difference between inpatient and residential treatment, as well as inpatient vs. outpatient mental health programs.

What’s the Difference Between Inpatient and Residential Treatment?

The main differences between inpatient vs. residential treatment are where it takes place, the length of stay, and the overall treatment goals. Inpatient teen treatment involves an overnight or longer stay in a psychiatric hospital or the psychiatric unit of a hospital. Typically, inpatient treatment is for teens who are in the acute stage of a mental health disorder and need continuous support. Inpatient stays often follow a teen emergency room visit for a suicide attempt or other crisis situation. Thirty days is usually the maximum time for inpatient teen mental health treatment.

Psychiatric hospitals employ both psychiatrists and physicians to treat mental health conditions such as anxiety and depression. Some hospitals provide substance abuse treatment as well. In addition, a psychiatric hospital might have a specialized unit for eating disorders. Generally, the goal of inpatient treatment is to stabilize the patient and ensure they are not a danger to themselves or others.

Following inpatient treatment, adolescents who require long-term care are often transferred to teen residential treatment, sometimes referred to as residential inpatient treatment centers. When comparing inpatient vs. residential treatment, it’s helpful to understand that residential treatment focuses on long-term healing as opposed to crisis management. Because teens stay for one to three months in residential care, there is more time to address the root causes of mental health and behavioral issues.

Teen Residential Treatment Programs

Residential programs typically provide an educational component in addition to a structured schedule of clinical and experiential therapy. Teens attend individual, family, and group therapy, as well as Adventure Therapy, art and music therapy, yoga, and other approaches. Many of these modalities are typically not available in a hospital-based program.

Residential treatment programs are live-in healthcare facilities that provide a structured environment. A residential schedule for teens includes clinical care, experiential activities, and academics. While in residential treatment, clients live in a comfortable, homelike setting and are supervised by trained staff. Staff members include psychiatrists, therapists, counselors, nurses, dietitians, and experiential therapy practitioners.

As we have seen, residential care is the next step in a teen’s healing journey after inpatient care in a hospital. However, residential care is also appropriate for teens who are in outpatient care or weekly therapy but need more support than these options provide. Research shows that residential programs are an effective approach to treating teen depression, anxiety, substance abuse, and eating disorders. Furthermore, experts recommend at least 90 days of residential treatment for the most successful outcomes.

Newport Academy Treatment Resources: types of mental health treatment

Integrated Residential Care

According to research, residential treatment is most effective when it takes an integrated approach—addressing all aspects of an adolescent’s well-being, including:

  • Relational
  • Social
  • Educational
  • Physical
  • Psychological.

review study of 10 years of research examined the outcomes of residential treatment for children and teens. The researchers found that the best residential treatment provides multiple modalities—for example, Cognitive Behavioral Therapy; Dialectical Behavioral Therapy; family therapy, such as Attachment-Based Family Therapy; and EMDR. In addition, most teen residential programs include academics. Teen treatment at Newport Academy includes a minimum of 30 hours of clinical and experiential therapy each week and about 20 hours weekly in academic study and tutoring.

“Results showed that children and adolescents with severe emotional and behavior disorders can benefit and sustain positive outcomes from residential treatment that is multi-modal, holistic, and ecological in its approach.”

—Journal of Child and Family Studies 

What’s the Difference Between Inpatient and Outpatient Treatment?

The main difference with inpatient vs. outpatient mental healthcare is that teens live at home while receiving outpatient vs. inpatient treatment that takes place while they are living at a hospital or a teen treatment center. However, outpatient treatment provides clients with many of the same clinical and experiential modalities they receive at a residential or inpatient facility.

Outpatient treatment for mental health conditions and substance use disorders varies in the level of structure and the number of hours of programming. Depending on the level of outpatient care, teens may attend their home school and go to outpatient are in the afternoon. Or they may spend the full day in outpatient care that includes an educational component. Let’s look at the various options for outpatient treatment.

Partial Hospitalization Programs

Teens in a Partial Hospitalization Program (PHP) live at home and receive treatment all day, five days a week, in an outpatient clinic or in a psychiatric hospital or the psychiatric unit of a hospital. PHP schedules are designed to help teens transitioning from residential treatment continue their recovery in a structured and secure environment.

A PHP typically includes:

  • Group therapy
  • Individual therapy
  • Psycho-educational sessions
  • Parent support groups
  • Experiential activities, such as art, music, and Adventure therapy.

Intensive Outpatient Programs

Teen Intensive Outpatient Programs (IOPs) are similar to PHPs. But clients attend for fewer hours—three to four hours a day, up to five days a week. An adolescent IOP may be part of a hospital’s services or an extension of a residential program.

An Intensive Outpatient Program for teens includes:

  • Individual therapy sessions
  • Experiential therapies
  • Group sessions
  • Psychiatric and medical management
  • Therapeutic activities such as yoga, meditation, creative arts, hiking, kayaking, and more.

Studies show that intensive outpatient treatment is effective for the underlying issues catalyzing depression, anxiety, substance abuse, and other mental health and co-occurring disorders. A teen can gradually decrease their IOP hours as they regain lost ground in terms of mental health, social-emotional development, and overall well-being. After completing a youth outpatient program, teens move from the IOP to a lower level of care, such as weekly therapy in a therapist’s office.

Newport Academy Treatment Resources: types of mental health treatment

Continuing Care after Treatment

Whether a teen is in residential, inpatient, or outpatient treatment, continuing care after discharge is essential. Once an adolescent is on the path of healing, ongoing support and therapy help maintain health and well-being. Below are some options for continuing care.

Community Mental Health Centers: Many towns and cities have centers that provide therapeutic groups and educational sessions to help people stay in recovery. In addition, some mental health centers offer yoga and meditation classes, as well as other experiential approaches to maintaining mental health.

Private Practitioners: After residential and/or outpatient treatment, teens may work with a private mental health clinician. Regular individual sessions help adolescents to firmly establish new, healthy behaviors. Furthermore, family therapy sessions support families to build on new ways of connecting and communicating.

Support Groups: Parent support groups and teen support groups offer encouragement and the wisdom of peers. Some community mental health centers and other community centers offer ongoing support groups.

Alumni Support: Many residential and outpatient teen mental health treatment programs offer alumni programming after discharge. Special events, group activities, and get-togethers keep former clients connected so they can support each other on the journey of recovery.

Know the Facts.

By 2030,

the global cost of mental health care is expected to rise to $6 trillion—greater than the costs of diabetes, respiratory disorders, and cancer combined. The Lancet

58%

of teens report that they personally know someone who has considered self-harm or suicide. Forbes.com

1 in 5

Mood swings are common during the adolescent years, but approximately one in five adolescents has a diagnosable mental disorder, such as depression and/or teen anxiety disorders. hhs.gov

Treatment works.

Effective treatments for mental health disorders, especially if they begin soon after symptoms appear, can help reduce the impact on an adolescent’s life. hhs.gov

2 out of 3

66 percent of teens have experienced at least one traumatic event in their lifetime.

2x

Rates of suicidal ideation among adolescents have doubled since 2019. American Academy of Pediatrics

Find the Right Level of Care: Outpatient vs. Inpatient vs. Residential

In summary, there are a number of important differences between what is inpatient and outpatient treatment, as well as inpatient vs. outpatient mental healthcare. Teens benefit from these various levels of care—inpatient, residential, and outpatient—as they progress through the recovery process. Ultimately, the right level of care can support young people to find sustainable healing, so they can successfully take the next steps into young adulthood and beyond.

To find the right level of care, the first step is an in-depth assessment by a mental health expert. Newport Academy’s experts offer confidential mental health assessments at no charge. One we understand what your family is going through, we can recommend the level of care that has the best chance of helping your teen heal. Contact us today to schedule an assessment.

Sources:

US Dept. of Health & Human Services

Psychiatr Serv. 2014 Jun 1; 65(6):718–726.

J Child and Family Studies. 2005 Dec;14(4):551–575.