Would you know what to do if a friend or family member needed help with a mental health or drug abuse issue? What kind of help would they need? Who could help?

Not knowing what to do can be scary and confusing. But there are many things you can do to support your loved one.

Where to Start?

First, take steps to learn about what you are seeing. Ask questions to learn:

• Are they having thoughts of harming themselves or others?
• Can they stay safe?
• Are they struggling with work or school?
• Are their links with friends or family failing?

Next Steps

If you’ve found that your loved one needs help, learn about levels of care for mental health or drug abuse issues.

Levels of Care are the types of health care offered based on the patient’s symptoms.

An acute inpatient hospital is for someone:

• Having thoughts of hurting themselves or others
• Having strong withdrawal signs from drug abuse
• Needing urgent help

These hospitals are the most intensive and restrictive. They give 24-hour care. That includes handling medicines, detox and rehab.

But what if they aren’t in crisis but need around-the-clock supervision and structure?
They could seek care at a Residential Treatment Center (RTC).

RTCs offer healing care and special programs in a controlled setting. RTCs have 24-hour nursing help and doctors on call. They are for people with long-term or grave mental issues. They also help people with alcohol and other substance abuse problems. RTCs offer a high degree of safety, supervision and structure. They promote healthy habits as well as successful stabilization, detox and rehab.

Some people may go to a Partial Hospitalization Program (PHP). It is not a residential program with 24-hour supervision, but it involves intense clinical health care similar to inpatient care. 

Often, these programs are every day for at least five hours a day. These programs are highly structured to offer a safe setting. This level of care also gives in-home support or access by phone for after-hours help.

What if the person is working or in school full time?
Intensive Outpatient Programs (IOP) are less restrictive. They use group therapy to help people learn skills to handle their condition. The programs take place three days each week for at least two hours a day. That allows people to get care without neglecting daily duties. An individualized care plan in this type of program may help even if other programs were not successful.

Can less frequent care still be helpful?
Outpatient (OP) care can take place in an office. OP may be one-on-one, family or group care. It can involve psychotherapy and consultative care. Visits range from 15 minutes for help with medicines to 50 minutes for a single therapy visit. Group therapy may be up to two hours. Visits are often done once a week or more often, if needed.

Which Health Care Providers Can Help?

Your loved one may see different types of caregivers in any of these levels of care.

Psychiatrist 

• Psychiatrists have a doctoral degree and can manage medicines in all levels of care.
• Can also admit and treat people in hospital settings.    

Psychologist

• Trained in psychological theory in a doctoral program. 
• Can provide psychotherapy and give and interpret psychological tests.
• Can prescribe medicine if licensed in New Mexico, Illinois, Iowa and Idaho.

Advanced Psychiatric Nurse (APRN)

Advanced Nurse Practitioner (ANP)

Physician Assistant (PA)

• Physician assistants practice medicine on a team under the supervision of physicians or psychiatrists.
• They examine patients and give care.

Master's Level Behavioral Health Care Provider

• Have master’s degrees and a professional license to conduct psychotherapy.
• Cannot prescribe medicine.

Common titles:

• Licensed Marriage Family Therapist (LMFT)
• Licensed Professional Counselor (LPC)
• Licensed Clinical Professional Counselor (LCPC)
• Licensed Social Worker (LSW)
• Licensed Clinical Social Worker (LCSW)
• Board Certified Behavior Analyst (BCBA) (BCBAs cannot provide counseling. They provide applied behavioral analysis for Autism diagnoses.)

Source: Types of Mental Health Professionals,  National Alliance on Mental Illness, 2020

Originally published December 28, 2018; Revised 2020