Mental Health Levels of Care

Outpatient therapy is the starting point for many individuals seeking mental health support. It’s considered the least intensive level of care and typically involves weekly sessions with a therapist, lasting about 45–55 minutes.

Therapists work collaboratively with clients to set goals, manage symptoms, and explore effective coping strategies. Between sessions, clients may be given therapeutic “homework” to help practice new skills in everyday life.

Therapy can take place in-person or virtually, based on client preference, and is available through private practices, community agencies, non-profits, and online platforms.

Sometimes, during the intake process or after therapy begins, a therapist may determine that a client would benefit from a higher level of care. Below, you'll find an overview of those options—from the least to the most intensive.

An Intensive Outpatient Program (IOP) offers structured support for individuals who need more than weekly therapy but don’t require 24-hour care. Services often include individual, group, and family therapy, provided for a few hours a day, several days a week.

IOPs are time-limited, typically lasting 8 to 12 weeks, and are used to treat a variety of concerns such as mental health conditions, substance use, and eating disorders.

Some individuals begin their care in an IOP, while others may step down to this level after completing a Partial Hospitalization Program (PHP).

A Partial Hospitalization Program (PHP) is a highly structured outpatient option for individuals who need more support than an IOP provides. While still non-residential, PHP involves full-day treatment—with clients spending much of their day in therapy, several days a week.

Programs are typically short-term, lasting anywhere from a few weeks to a couple of months. PHP is often recommended for individuals experiencing more severe symptoms or difficulty functioning in daily life. It can also serve as a step down from residential treatment or a step up from an IOP, depending on a person’s needs.

Residential treatment provides 24-hour care in a supportive, community-based setting for individuals who need more intensive support than outpatient or day programs can offer. While living at the facility, clients receive comprehensive services such as individual therapy, group therapy, and psychiatric care.

Some individuals begin residential treatment after a hospital stay, while others may enter directly based on their needs. The focus at this level is on deep healing and long-term progress, with stays typically lasting 1 to 3 months.

It’s important to note that residential treatment is not intended for crisis situations—those are addressed through inpatient hospitalization, the highest level of care.

Inpatient hospitalization is the most intensive and restrictive level of mental health care. It is recommended when someone is experiencing a mental health crisis that poses a serious safety risk to themselves or others.

The main goal is safety and stabilization, with individuals receiving 24-hour monitoring and support. Stays are usually short-term, lasting anywhere from a few days to a few weeks, depending on the situation.

Mental health treatment exists on a continuum of care, and individuals can move between levels—“stepping up” for more support or “stepping down” as they improve. In some cases, someone may need to go directly to the highest level of care due to safety concerns.

For example, if a client shares thoughts of suicide during an outpatient therapy session, the therapist will conduct a risk assessment to determine the level of concern. If the client is found to be at imminent risk, the therapist will recommend an immediate mental health evaluation. This typically takes place at a local hospital emergency room or a community health center's emergency services department.

Following the evaluation, if the client is considered a danger to themselves or others, inpatient hospitalization may be recommended. If the client is not at immediate risk, a safety plan will be created, and they may continue outpatient therapy. In some cases, a higher level of outpatient care, such as an IOP or PHP, may be recommended if weekly sessions aren’t enough.

*Content adapted from: ThinkHappyLiveHealthy