Outpatient vs. Inpatient Treatment
Treatment of mental disorders may include medications, therapy, and other strategies including wellness-promoting activities such as exercise, proper nutrition, and mindfulness. Since some of these options are discussed elsewhere on this web site, and others are or will be addressed on the blog, this page will focus on clarifying the distinction between outpatient and inpatient treatment.
Outpatient Treatment
Most people receive mental health care on an outpatient basis. Outpatient treatment involves periodic visits to a clinician (e.g., a psychiatrist, psychologist, or social worker) for consultation in his or her office. Appointments usually last thirty to sixty minutes. During appointments, the mental health provider will likely interview the patient to update the medical assessment of the person's condition (i.e., diagnose the problem). The doctor may also provide psychotherapy or review medication (i.e., execute a treatment plan).
The frequency with which a psychiatric practitioner sees patients in treatment varies widely, from days to months, depending on the type, severity, and stability of each person's condition, and based on what the clinician and patient decide would be best.
Although some psychiatrists are trained in both psychopharmacology (i.e., prescribing medications) and psychotherapy (i.e., "talk" therapy or behavior modification), other psychiatrists focus primarily on medication management. When meeting with your psychiatrist, ask if he or she can also provide therapy, if you are interested, or if they can recommend a therapist. If you are unsure or ambivalent about medications, you can tell your doctor or mental health provider that you would like to begin with therapy, and you can consider adding medications at a later time.
Inpatient Treatment
Acute psychiatric treatment is drastically different than it was several decades ago. In the past, psychiatric patients were often hospitalized for six months or more, with some individuals hospitalized for many years. Today, the majority of people receiving psychiatric treatment are seen as outpatients. If hospitalization is required, the average hospital stay is around one to two weeks, and the goal of the hospitalization is to help the patient to be safe and stable.
Psychiatric inpatient units in the United States can be free-standing or within medical hospitals. They may be secure (or "locked," for those thought to have a particular risk of violence or self-harm), or open ("unlocked"). The people who are admitted generally need acute care. Some are admitted involuntarily, perhaps committed to a secure hospital, or in some jurisdictions to a facility within the prison system. In many countries, including the U.S. and Canada, the criteria for involuntary admission vary with local jurisdiction. They may be as broad as having a mental health condition, or as narrow as being in immediate danger to themselves and/or others. Patients may also be admitted voluntarily if they themselves feel they would be unsafe in the community.
Once admitted, patients are assessed and monitored. They are often given medication and care from a multidisciplinary team which may include physicians, psychiatric nurses, clinical psychologists, psychotherapists, psychiatric social workers, occupational therapists, and social workers. If a person receiving treatment in a psychiatric hospital is believed to be at particular risk of harming themselves or others, they may be put on constant or intermittent one-to-one supervision, and may be physically restrained or medicated. As they recover, individuals in inpatient wards may be allowed to leave for periods of time, either accompanied or on their own.
Outpatient Treatment
Most people receive mental health care on an outpatient basis. Outpatient treatment involves periodic visits to a clinician (e.g., a psychiatrist, psychologist, or social worker) for consultation in his or her office. Appointments usually last thirty to sixty minutes. During appointments, the mental health provider will likely interview the patient to update the medical assessment of the person's condition (i.e., diagnose the problem). The doctor may also provide psychotherapy or review medication (i.e., execute a treatment plan).
The frequency with which a psychiatric practitioner sees patients in treatment varies widely, from days to months, depending on the type, severity, and stability of each person's condition, and based on what the clinician and patient decide would be best.
Although some psychiatrists are trained in both psychopharmacology (i.e., prescribing medications) and psychotherapy (i.e., "talk" therapy or behavior modification), other psychiatrists focus primarily on medication management. When meeting with your psychiatrist, ask if he or she can also provide therapy, if you are interested, or if they can recommend a therapist. If you are unsure or ambivalent about medications, you can tell your doctor or mental health provider that you would like to begin with therapy, and you can consider adding medications at a later time.
Inpatient Treatment
Acute psychiatric treatment is drastically different than it was several decades ago. In the past, psychiatric patients were often hospitalized for six months or more, with some individuals hospitalized for many years. Today, the majority of people receiving psychiatric treatment are seen as outpatients. If hospitalization is required, the average hospital stay is around one to two weeks, and the goal of the hospitalization is to help the patient to be safe and stable.
Psychiatric inpatient units in the United States can be free-standing or within medical hospitals. They may be secure (or "locked," for those thought to have a particular risk of violence or self-harm), or open ("unlocked"). The people who are admitted generally need acute care. Some are admitted involuntarily, perhaps committed to a secure hospital, or in some jurisdictions to a facility within the prison system. In many countries, including the U.S. and Canada, the criteria for involuntary admission vary with local jurisdiction. They may be as broad as having a mental health condition, or as narrow as being in immediate danger to themselves and/or others. Patients may also be admitted voluntarily if they themselves feel they would be unsafe in the community.
Once admitted, patients are assessed and monitored. They are often given medication and care from a multidisciplinary team which may include physicians, psychiatric nurses, clinical psychologists, psychotherapists, psychiatric social workers, occupational therapists, and social workers. If a person receiving treatment in a psychiatric hospital is believed to be at particular risk of harming themselves or others, they may be put on constant or intermittent one-to-one supervision, and may be physically restrained or medicated. As they recover, individuals in inpatient wards may be allowed to leave for periods of time, either accompanied or on their own.