Outpatient therapy, intensive outpatient programs (IOP), partial hospitalisation (PHP), inpatient care, and telehealth — what each level offers and how to choose.
The pediatric ED at Stanford Children’s admitted Anneliese Toomey at 5:42 a.m. on a Sunday in October 2024. She was 16, weighed 78 pounds at 5’5″, and had a resting heart rate of 36. Her potassium was 2.8, her phosphorus was 1.6, and her ECG showed a prolonged QT. The intake nurse told her mother … Read more
Damien Halsey arrived at a 28-day program in Bend, Oregon, in February 2024, three days after his last methamphetamine hit. He had been smoking ice for nineteen months, lost a CDL job, and was sleeping in his Subaru when his sister drove him to the facility. The program had a single substance-use track. Day one: … Read more
U.S. eating disorder treatment guide: levels of care, average costs, what insurance must cover under parity, evaluating centers, and free or low-cost resources.
Sergeant First Class Marcus Eriksen completed his fourth deployment in 2017 and spent the next six years quietly disintegrating in a rental house outside Fayetteville, North Carolina. He started drinking after the third deployment and never really stopped. He startled at fireworks, at car doors, at his daughter dropping a plate. He could not sit … Read more
The Phase Most Patients Underestimate Discharge from inpatient psychiatric hospitalisation is the moment most mental health care narratives end. The patient was in crisis, then in the hospital, then home, and the story is over. The clinical reality is the opposite. The discharge is the start of the most consequential phase of the recovery arc. The decisions … Read more
Why Substance Use Has Its Own Levels of Care The continuum of mental health care has a parallel continuum specifically for substance use disorders, with its own terminology, its own clinical structures, and its own evidence base. The American Society of Addiction Medicine, often called ASAM, has codified this continuum into a set of levels that providers, … Read more
Reece Tomlinson had survived two combat deployments to Helmand Province with the Marines and the homicide of his older brother in 2019. By the time the 38-year-old San Antonio veteran walked into a Sheppard Pratt admissions office in December 2024, he had completed two 30-day stays that had not held. The first program in Arizona … Read more
Hannah delivered her first child on a quiet Tuesday morning in Chapel Hill, North Carolina, and by the following Sunday she was no longer sleeping. By the second week she was hearing her grandmother’s voice telling her the baby would be safer with someone else. Her husband, who had been reading every postpartum article he … Read more
Adolescent Mental Health Care Is Its Own System The continuum of mental health care for adolescents looks superficially similar to the adult continuum, with outpatient therapy, intensive outpatient, partial hospitalisation, residential, and inpatient levels. The actual experience inside each level is dramatically different. Adolescent programs incorporate school components, family work, developmental considerations, and identity-formation issues that adult … Read more
Devon was nineteen, halfway through his second semester at a community college outside Rochester, New York, when his mother first noticed that something had shifted. He stopped sleeping. He papered the windows of his bedroom with aluminum foil because he believed the neighbours were filming him. By March he was no longer attending class, and … Read more