Residential treatment programs are categorized as either medically based or socially based. In medically based programs patients receive very structured care, including such services as medically necessary supervision and psychotherapy. In socially based programs patients receive psychotherapy, but also learn how to take advantage of community support systems and increase their independence. For example, under a socially based program, patients learn how to apply for government medical assistance that will enable them to get psychiatric and medical services in the community rather than relying on hospitalization for help.

Residential care can also help patients to learn how to maintain a household, cooperate with other residents and work with social and health agencies to get the services they need. This, in turn, improves their self-esteem and confidence.

Hospital personnel pay careful attention to the physical well being of patients. Hospital physicians and nurses monitor the patient's medications, and, with those patients whose severe illnesses may make them a danger to themselves or other patients, take steps to protect them from injury. This can sometimes mean use of restraints or isolation from other patients, measures that are used to protect, not to punish, and only for very brief periods of time. Hospital personnel also work to be sure each patient understands the importance of good nutrition and knows the dietary restrictions that may be necessary because of his or her medications.

Length of Stay

Today the average length of stay for adults in a psychiatric facility is 12 days. The mental health care team and patient begin planning for discharge on the first day of admission. Because medical research has produced highly effective treatments, people who suffer from mental illness today recover from severe episodes much more quickly than in the past.

Likewise, people who suffer from alcohol and substance abuse no longer routinely stay in residential treatment centers for prolonged periods of time. Most recover with short-term stays that average 10 days, followed by partial hospitalization, outpatient and support group services.

Other Psychiatric Hospitalization Options

Once psychiatric treatment stabilizes a patient's condition, he or she may progress to a less-intensive treatment setting. The psychiatrist may recommend partial hospitalization. This option isn't limited to people who are ending a hospital stay; it also meets the needs of people who live in the community and need a higher level of care without the services of overnight, 24-hour nursing.

Partial hospitalization provides individual and group psychotherapy, social and vocational rehabilitation, occupational therapy, assistance with educational needs, and other services to help patients maintain their abilities to function at home, at work and in social circles. However, because their treatment setting helps them to develop a support network of friends and family that can help monitor their conditions when they are not in the hospital, they can return home at night and on weekends. Partial hospitalization or day treatment works best for people whose symptoms are under control. They enter care directly from the community or after being discharged from 24-hour care.

Partial hospitalization is most effective for patients who are ready for therapy and rehabilitation that can move them comfortably back into the community. It is also less expensive. A full day of partial hospitalization costs, on average, $350--roughly half the cost of 24-hour inpatient treatment, according to Health Care Industries of America, a health care consulting company.

When Children Need Psychiatric Hospital Care

Children and teenagers can have mental illnesses. Some of these illnesses--such as conduct disorder and attention deficit/hyperactivity disorder--usually emerge during these early years. Youngsters also can suffer with illnesses most people would associate first with adults, such as depression or schizophrenia. And like those of adults, children's illnesses can go into remission or worsen from time to time.

When a child's symptoms become severe, a psychiatrist may recommend hospitalization. The physician will consider several factors in making the recommendation:

• Whether the child poses an actual or imminent danger to him or herself or others;
• Whether the child's behavior is bizarre and destructive to the community;
• Whether the child requires medication that must be closely monitored;
• Whether the child needs 24-hour care in order to become stabilized;
• Whether the child has failed to improve in other, less restrictive environments.

As with adults, children receiving inpatient care will have a treatment plan that identifies the therapies and goals unique to each child. The treatment team will work with each child in individual, group and family therapy as well as occupational therapy. Youngsters are also often involved in activity therapy, which teaches social skills, and drug and alcohol evaluation and treatment. In addition, the hospital will provide an academic program.

Because the family is integral to a child's recuperation, the treatment team will work closely with parents or guardians to ensure good communication and understanding about the illness, treatment process and recovery prognosis. Families will learn how to work with their children and cope with the stresses that can develop with a serious or chronic illness.

continue: Involuntary Treatment in a Psychiatric Hospital