What is Level of Care in Mental Health? Getting the RIGHT Help When You Need It.

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Learn about mental health levels of care—from outpatient therapy to hospitalization—and how to choose the right support for your unique needs.

What is mental health level of care? Getting the help when you need it... you deserve to feel better.

When someone is struggling with their mental health, there are different levels of care available to help—depending on how much support they need. Think of it like a ladder, with each step offering more help than the one before. Different combinations work for different people. The first five options mentioned are NOT the only options, but I’m going to list them first as a segue into more information about deciding on the right level of care.

Please make an appointment through the patient portal or call 443-300-6094 if you’re interested in pursuing therapy in Howard County, Maryland through Happy Honeysuckle Healing Center. If you have a psychiatric or medical emergency, please contact 911 or go to your nearest emergency room.

This blog is for educational purposes only. This information is best case scenario, at least within the scope of my knowledge and experience at the time I write the post. Not only does everyone have different approaches to parenting and life- and my way may not be your cup of tea, but also- I am not perfect, nor do I want anyone to imagine that I am. Despite being a therapist and having a whole host of really cool techniques for all the mental health related things, I am constantly learning and trying to do better.

I’m hoping that this blog can help you. When we share what works for us, we can help others develop their own toolkit for improving their mental health. As an affiliate with Amazon and other affiliate networks, I may earn from qualifying purchases made with product links on this site. If you’re a current client of this practice, you have access to therapist-created resources free of charge.

Quick Overview of Levels of Care

1. Outpatient Therapy

This is the most common level. You meet with a therapist once a week (or so) to talk and work on goals. You live at home and go about your regular life.
🧠 Best for: Mild to moderate symptoms

2. Intensive Outpatient Program (IOP)

You go to therapy several times a week for a few hours at a time. It’s more support than regular therapy but still lets you live at home.
🧠 Best for: When weekly therapy isn’t enough

3. Partial Hospitalization Program (PHP)

This is like going to a day program—usually 5 days a week for most of the day—but you still sleep at home. It’s structured and includes group and individual therapy.
🧠 Best for: Serious symptoms that need daily support

4. Residential Treatment

You live at a mental health facility and get 24/7 support. There are daily therapy sessions, activities, and care from a team of professionals.
🧠 Best for: Ongoing issues that need more than outpatient care

5. Inpatient or Hospital Care

This is the highest level of care. You stay in a hospital for a short time (usually a few days) to stay safe and stabilize during a mental health crisis.
🧠 Best for: Danger to self or others, or very severe symptoms

Stepping Up and Down

Going to therapy for the first time is hard- and also REALLY easy compared to making the choice to be hospitalized. Even if you’ve done therapy for years, I think the struggle that most people have is that the jump from outpatient therapy to inpatient hospitalization feels so extreme. It’s a big, scary thing to admit we need that much help. 

It’s also hard to know where to draw the line. When is that time that it is important to go? When you’ve been struggling with mental health issues potentially for a long period of time or even your whole life, making that call is really confusing. “I survived before? It’ll be fine this time, right?”

I think having options before going from once a week therapy to hospitalization is important. In a perfect world, we step up or down to varying level of services depending on our need at the time.

As you can see in the image below, there are roughly seven categories that I’m giving you. I left off residential… if you get to the point where residential is necessary, you’re usually under a lot of guidance from psychiatrists and have had multiple prior hospitalizations. I haven’t seen someone jump from therapy to residential. The jump is generally from hospitalization to a longer term residential program.

Mental Health Increasing Level of Care Hospitalization Intensive Outpatient Program Psychiatric and Therapy Services: Increased Frequency Psychiatric and Therapy Services Reduced Therapy Services Mental Well Being Arrow pointing to scale saying "ideally, the goal is to step up or down ONE LEVEL as needed. Life can feel easier or harder at times. Sometimes we need more help. Sometimes we need less."

Ideally, if we start feeling mentally unwell, we go to our PCP to rule out any medical issues while also making an appointment with a therapist and/or psychiatrist (medication management).

If that isn’t enough, we can increase the frequency of therapy and/or psychiatric services. Then if the symptoms worsen, we step up to IOP, then PHP or hospitalization.

How to Hack the Levels of Care to Work for YOU

That was the simplified version, but everyone has different needs.

For example, an intensive outpatient program can be quite helpful, but this might look like therapy five times a week. That might be great for some people, but for others it might be a little too big of a jump due to the time commitment or due to feeling like you don’t quite need that level of support.

Scenario 1, Susan: Susan loses their father and they’re coping with a lot of grief symptoms, as well as psychiatric symptoms that they previously had been dealing with. The combination feels like too much and they need additional support to manage their daily life successfully during this period of time.

Potentially Helpful Treatment:

  • Twice a week individual therapy (on different days of the week with spacing between sessions)
  • Once a week grief and loss group with others also coping with the loss of a parent.
  • Psychiatric care scheduled base on how well the medication is working (frequency is increased when the patient isn’t stable on their current dose).

Scenario 2, Joseph: Joseph has been struggling with depressive and anxiety symptoms. He takes medication and sees a therapist weekly which is helpful, and his symptoms are controlled in most areas of his life. His family, however, has been a major stressor that often triggers substantial changes to his mood due to miscommunication or not having his needs met.

Potentially Helpful Treatment:

  • Continued individual therapy, possibly with the option of seeing the therapist on an emergency basis when possible right after a family disagreement.
  • Continued psychiatric care.
  • Family therapy, when appropriate, possible, and the family is receptive.
  • Alternatively, supporting the client to transition to an independent living environment if the home environment is toxic.

Scenario 2, Sally: Sally was recently diagnosed with ADHD and is struggling with emotional regulation skills, paying attention in school, and sitting still during class. Her parents are frustrated and unsure of how to support her. They’re also neurodivergent so it’s difficult to manage all of her different needs and juggle the frequent phone calls from school.

Potentially Helpful Treatment:

  • Individual therapy for the child
  • Continued psychiatric care/medication management, as needed.
  • Working with an educational advocate to ensure that Sally’s IEP/504 plan helps ensure that her needs are being met in school.
  • Individual therapy for the parents (or a therapy group for parents of neurodivergent kids) to process their own mental health needs and the frustrations of parenting a neurodivergent child. Neurodivergent kids are awesome, but the world (and all of the typical parenting advice) is made for neurotypical people and this can be such a major stressor for parents.
  • Parent sessions with the child’s therapist (every two weeks or once per month) to help work on skills the help support their child.
Infographic titled “Mental Health Level of Care,” displaying a vertical scale of symptom severity and corresponding levels of care. The background is color-coded from red (most severe) to green (least severe), and lists eight levels of care from top to bottom: Hospitalization (Red) – Client needs 24/7 supervision to ensure safety. Partial Hospitalization Program (PHP) (Orange-Red) – Client is safe enough to attend a program during the day but sleeps at home. Intensive Outpatient Program (IOP) (Orange) – Client receives a high level of support while living at home; therapy is usually daily. Psychiatric and Therapy Services: Increased Frequency (Yellow-Orange) – Psychiatrist meets more often, medication use is evaluated, and outside supports may be added. Psychiatric and Therapy Services (Yellow) – Psychiatrist sees client less often, medication remains the same, and therapy is less frequent. Reduced Therapy Services (Light Green) – Appointments are infrequent (monthly or less), medication stays stable, therapy is minimal or discontinued. Mental Wellbeing (Green) – Client is stable, functions independently, and may use occasional supportive services. On the right side, five vertical bars represent types of support: Medication Management (longest, spanning all levels) Individual Therapy Family Therapy Group Therapy Supportive Activities and Other Resources (spanning all levels)

I’m not delving into the whole spectrum of options though- there’s occupational therapy and physical therapy available. Some people try acupuncture and yoga. There are wellness retreats that I think would be AMAZING for an adult who is on the verge of needing IOP/inpatient, but who is able to finance that sort of trip and successfully take advantage of the services there (versus staying in your room and not utilizing the services because you’re so burned out or feeling so anxious/unwell).

Ultimately, therapy options and levels of care CAN be tailored to the person. As you can see with my practice, there are different modalities of mental health therapy that can work better or worse for an individual- animal assisted, mindfulness based therapies, cognitive or dialectical behavioral therapies, EMDR for trauma, etc.

Frequently We Ignore Our Needs and Delay a Higher Level of Care

Inpatient is still the best option when it comes to mental health problems that are a direct result of chemicals in your brain not doing what they need to, and you becoming a risk to yourself or others. 

But in a perfect world, we catch our mental health symptoms earlier + find psychiatric care to get medication to help us feel better before we end up in a place where we need hospitalization.

Hospitalization is useful when we don’t have time to do that because the emergency is NOW. It’s the gushing wound if we’re talking in relation to physical health.

What often happens though is that we access a lower level of care, such as weekly therapy, and then let our mental health deteriorate because the once a week therapy simply isn’t enough.

We progress well past adding on psychiatric care… and then past IOP… and finally our therapist says, “You aren’t safe. You need to get assessed at the hospital.” Or alternatively, we have to make that call ourselves.

Infographic titled “Mental Health: Increasing Level of Care.” It features a vertical scale with color-coded blocks indicating different levels of mental health care, ranging from green at the bottom (least severe) to red at the top (most severe). The levels are: Mental Well Being (dark green) Reduced Therapy Services (light green) Psychiatric and Therapy Services (yellow) Psychiatric and Therapy Services: Increased Frequency (orange-yellow) Intensive Outpatient Program (IOP) (orange) Partial Hospitalization Program (PHP) (red-orange) Hospitalization (red) A red arrow curves from "Psychiatric and Therapy Services" and jumps directly to "Hospitalization," skipping intermediate steps. Red handwritten text on the right reads: “Unfortunately, too often, we end up going from once a week therapy to hospitalization.” “Stepping up is scary, expensive, and/or we minimize our needs.” “So we wait until it's too late to take one step— and we need to take 3 giant scary steps instead.” The image emphasizes the danger of delaying care due to fear, cost, or denial, leading to a crisis jump from minimal therapy to full hospitalization.

We can save a lot of money and heartache by increasing our services when we need to, instead of waiting until we have an emergency.

Questions to Ask Yourself

Here are the questions to ask yourself: 

  • What am I capable of accomplishing on my own? 
  • Am I an immediate threat to my own safety or the safety of others? 
  • Do I have the energy to put additional services in place to help improve my mental health? 
  • Are the services I need available immediately? Or is there a wait that’s longer than I can sustain myself?
  • What do I think I need to feel better?
    • Do I need more support from other people?
    • Do I need psychiatric medication?
    • Do I need to stop using substances that could be making me feel worse? 

Frequently, the hardest part of changing levels of care and stepping up frequency is finding services immediately. If it will take 8 weeks to get into a psychiatrist, you may want to see if anyone has an appointment sooner or pursue a higher level of care in the interim.

Options for Assessment:

  • Emergency room/911
  • Crisis Response Service in your area
  • Psychiatric Urgent Care
  • 24/7 Suicide and Crisis Lifeline: Call 988
  • Trevor Project Hotline for LGBTQ+ young people has a phone line, text line, or web chat option: https://www.thetrevorproject.org/get-help/
  • Contacting your psychiatrist and/or therapist to see if they have availability for an emergency visit (please remember that they may not see that email or message immediately so try another resource if you don’t hear back quickly).

Ultimately, when in doubt go to the emergency room for an assessment. They will help walk you through this process. They will also help you find supports if they don’t think hospitalization is necessary.