Psychiatric Hospital Vs. Residential Mental Health Treatment

It’s a common misconception to assume that psychiatric hospitals and mental health treatment centers offer the same services. While both types of facilities provide inpatient mental health treatment for emotional, behavioral, and mental disorders, they are not the same.

While psychiatric hospitals help people with urgent, severe conditions, residential mental health treatment centers are designed to support long-term recovery. There are differences in regard to the types of care administered, level of supervision, average length of stay, and more.

Keep reading to learn about the differences between psychiatric hospitals and mental health treatment centers, including the types of treatment offered and the goal of care.

Stopping The Stigma: The Prevalence Of Mental Health Care

Mental illness doesn’t discriminate; it touches everyone. One in every two people worldwide will experience a mental health disorder over their lifetime, according to a Harvard Medical study. In the U.S., one in five adults and one in six children and teens, ages 6 to 17, have a diagnosable mental illness in any given year, according to the National Alliance on Mental Illness (NAMI).

Only half of the U.S. population with a mental illness will receive treatment. For those who receive treatment, it takes an average of 11 years from the onset of symptoms to do so, NAMI reports. Like other health conditions, mental health disorders tend to worsen over time if left untreated.

There is an ongoing effort in the media and through the work of nonprofits to remove the stigma surrounding mental illness. Nonetheless, there is still much progress to be made. Stigma stands in the way of people receiving the help they need. Remember, total-body health consists of both physical and mental fitness, and that pertains to us all.

An Overview Of Mental Health Treatment

Mental health exists on a spectrum. This spectrum is the reason why some days you may feel better than others. It’s also the reason why no two people with a mental health condition will be totally alike.

Mental health is influenced by a number of factors, which include but are not limited to:

• adult trauma, e.g., military combat, a near-death experience, etc.
• age
• bereavement
• childhood trauma
• diet
• discrimination, e.g., racism, sexism, etc.
• domestic violence
• drug and alcohol abuse
• family history
• homelessness
• isolation
• quality of sleep
• physical activity
• physical health, including physical causes, such as a head injury
• poverty
• severe or long-term stress
• unemployment

When you receive treatment for mental health, whether that treatment is administered in an inpatient mental health treatment center or from an outpatient facility, trained clinicians consider all these factors. Specialized treatment entails resources that support several areas of a person’s life, such as providing vocational training to help with employment and/or providing family therapy to help with family issues.

Because life is ever-changing, it’s also impossible to determine whether a set of circumstances can affect someone differently from one day to the next. For this reason and many more, mental health is applicable to everyone—and it’s important to know what options are available if intervention is needed.

Serious Mental Illnesses (SMIs)

About one in 20 Americans, or 5.5% of people, will experience a serious mental illness (SMI) in their lifetime, according to NAMI. While mental health disorders can interfere with a person’s day-to-day functioning, SMIs cause serious behavioral, physical, psychological, and/or behavioral impairments, which can significantly constrain a person’s activities and life quality. Likewise, SMIs are diagnosed according to the level of disablement. Symptoms of SMIs typically present themselves in early adulthood.

There are nearly 300 mental illnesses represented in the The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the official handbook used by health care providers to assess, diagnose, and treat mental health issues. SMIs represent a small fraction of this figure.

Examples of SMIs include:

• bipolar disorder
• borderline personality disorder
• major depression with psychotic features
• obsessive-compulsive disorder (OCD)
• panic disorder
• post-traumatic stress disorder (PTSD)
• schizoaffective disorder
• schizophrenia

Because mental health exists on a scale, it’s possible to experience a less severe or more severe case of an SMI. It’s also possible to have comorbid SMIs and/or other mental illnesses, or features of other mental illnesses.

Some of the symptoms of SMIs may include:

• bizarre behaviors
• delusions
• extreme mood highs and lows
• hallucinations
• isolation
• paranoia
• psychosis
• self-injury
• self-neglect, e.g., an inability to maintain personal hygiene
• significant fatigue

SMIs can be lifelong. However, with treatment, it can be possible to live a rich and fulfilling life.

What Is A Psychiatric Hospital?

A psychiatric hospital specializes in the treatment of clients with mental health issues, including emergency situations. Hospitalization is provided to stabilize people in the short-term, which can range from several days to several weeks. Supervision is provided 24/7 by a credentialed staff, which includes psychiatrists, psychologists, and nurses.

People can enter a psychiatric hospital voluntarily or involuntarily. If a person has concerns about their mental health and/or level of safety, they may consider treatment at a psychiatric hospital. It’s also possible to enter a psychiatric hospital through treatment at an emergency department, e.g., in the event of a suicide attempt. According to the U.S. Centers for Disease Control and Prevention, mental health concerns account for 12.3% of all emergency department visits made by adults.

Health care workers like psychiatrists can involuntarily commit a person if they feel there is a danger to safety. Repeat criminal offenders can be involuntarily committed as an alternative to jail time if their crime(s) resulted from a mental health disorder. There are time limits that determine how long a person can be involuntarily held against their will, and it differs by state. On average, about 357 per 100,000 people are involuntarily committed, according to the Cicero Institute.

Psychiatric hospitals are typically divided into separate units to serve specific populations and/or levels of care. Crisis stabilization units (CSU), for example, are intended for people in active crisis. Medium-term psychiatric hospitals may keep clients for several weeks as they monitor how a client responds to new medication, as it takes time for medications to take effect. Juvenile wards, on the other hand, are designated for people under the age of 18 who are experiencing a mental health crisis. There may also be separate units for men and women, LGBTQIA+ people, and people with specific disorders, such as eating disorders.

Psychiatric Hospitals Vs. Psych Wards

Although the terms “psychiatric hospital” and “psych ward” are often used interchangeably, they represent different treatment environments.

Psychiatric hospitals are standalone facilities, with the entire facility serving to treat clients with mental health issues. Psych wards may exist in separate wards or floors within a larger hospital. These units can provide care in the case of emergencies or may be reserved for patients receiving treatment in the hospital who also have mental health issues that require care. Some psych wards only accept involuntarily administered clients.

Psych Hospitals And Stigma

Contrary to the image of psychiatric hospitals depicted in Hollywood movies, these facilities are not frightening or neglected—quite the opposite. While movies may show flickering lights, dulled, gray surroundings, and chipped paint, psychiatric hospitals are designed to be calming, inviting, and supportive.

Remember, the Hollywood portrayal is a theatrical attempt to paint a certain picture, usually within the horror movie genre. These movies only contribute to the stigma that mental illness is “scary,” as are the facilities that treat them. In reality, people with mental health disorders simply require medical care, and these facilities are rehabilitative environments that can help.

What To Expect During A Psychiatric Hospital Stay

Psychiatric hospitals treat people who are experiencing SMIs and are in an active crisis, often with the possibility of harming themselves or others. Because of the sense of urgency, there is a high level of supervision.

Clients are monitored continuously in this type of inpatient mental health treatment center. Hospitals are staffed by trained professionals, including psychiatrists, psychologists, and nurses. Depending on the needs of the client, a typical stay can range from a few days to a few weeks. Visits are typically restricted to immediate family members at designated times and are supervised.

Once admitted, treatment begins immediately to regain stabilization. The client will undergo psychiatric assessments and physical assessments. Assessment results will help inform whether medications are prescribed and if mental health issues may be triggered by underlying conditions. Clients will also participate in individual and/or group therapies, such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). Individualized treatment is provided based on the client’s condition.

Days in a psychiatric hospital are structured. Clients are given three meals a day, at the same time each day, and typically participate in therapies at the same time each day. Clients are also allowed some free time to watch TV, do artwork, reflect, and/or relax.

Keep in mind that the amenities, treatment, and recreational activities will differ depending on the type of facility you enter. A private psychiatric hospital will usually have more options than a public psychiatric hospital, though it’s costlier. These hospitals may also accept fewer people, which allows for more attention to be devoted to each individual client.

What Is Residential Mental Health Treatment?

Whereas crisis management and stabilization is the goal in a psychiatric hospital, long-term recovery is the goal in a residential mental health treatment facility, which may start with stabilization services but then also focus on lifestyle adjustments and long-term solutions.

While both facilities offer inpatient mental health treatment, psychiatric hospitalization would be considered more of a first step. After completing hospitalization, a person may consider transferring to a residential mental health treatment, where they can learn skills to address their behavioral, emotional, physical, and/or psychological challenges.

Some residential mental health treatment centers serve as an alternative to a psychiatric hospital stay, offering the same crisis stabilization services to start. However, residential facilities may not be able to accommodate clients facing the most serious disorders or crises.

Residential mental health treatment often provides more of a home-like environment, as opposed to a hospital setting. Like psychiatric hospitals, residential treatment facilities may also have a staff of psychiatrists, psychiatric nurses, and other medical professionals available to provide supervision and care, along with therapists, counselors, dieticians, nutritionists, case managers, and more.

Length of stay is determined by the needs of the client. There is also a community aspect to residential facilities. Unlike psychiatric hospitals, where treatment is provided very much on an individual basis, clients in residential mental health centers undergo treatment side by side. As a result, they are able to experience an additional avenue of support and build healthy relationships that can help boost their confidence and self-esteem.

In residential treatment centers, clients are given the time and space to heal in a calm, comfortable, and supportive environment. Once stabilized, clients receive treatment to identify the root cause of their mental illness, heal from trauma, and learn tools to help with emotional processing and long-term symptom management. In many cases, being at a distance from one’s home environment can allow the space to learn and grow without pressure and distraction. Emphasis is placed on reintegration into the community.

More freedoms are also typically available to clients in residential mental health centers, such as access to phones; some of these inpatient mental health treatment centers allow clients to bring a cell phone. Clients may be permitted therapeutic “passes” to participate in experiential therapies and/or to spend time with loved ones. Clients may also have more opportunities to practice the skills they are learning in therapy, such as through helping with meal preparation or participating in prosocial activities like sports or game nights.

Different Types Of Residential Mental Health Treatment

Some residential mental health treatment centers are clinical and specialize in evidence-based treatment. Throughout the day, clients may participate in skill-building activities that include traditional therapy, as well as educational and vocational support.

Residential mental health treatment is also available as work- or farm-based programs. Residents receive treatment from clinicians for mental and/or behavioral conditions while also getting the opportunity to work and learn skills that can help them find employment afterward. Clients may reside in shared apartments with other people in treatment, as opposed to facilities.

What To Expect During Residential Mental Health Treatment

A stay at a residential mental health center also begins with an assessment to determine the client’s individual needs. If crisis stabilization services are required by the client and available, medical professionals on staff will provide supervision and care, such as medication management.

At these treatment centers, there is more variety in a typical day-to-day structure. Clients may participate in traditional individual and group therapies, such as CBT and DBT, as well as stress management. Clients are also exposed to a wider range of alternative and experiential therapies, such as adventure therapy, art therapy, music therapy, equine therapy, pet therapy, and/or yoga. Depending on religious beliefs, religious and spiritual therapies can also be provided.

The daily schedule is still highly structured, but with more room for flexibility. Specific times are designated for meals and therapy, as well as community meetings and outdoor activities. Clients are allowed snack times and some facilities, particularly those for juveniles, administer schooling.

Choosing Treatment That Works For You

When it comes to deciding whether psychiatric hospitalization, residential mental health treatment, or a combination of both may be helpful for you or your loved one, be sure to conduct your research.

Factor In Affordability

It may help to start your research by considering available funds and/or health insurance. If you have insurance, consider looking for inpatient mental health treatment facilities within your network. If you don’t have insurance, community hospitals may provide the best point of contact for questions and concerns. If direct pay is an option for you, you may want to consider both public and private facilities. Some treatment providers may offer scholarships, sliding fee scales, and payment plans for clients in need.

Consider Your Unique Needs

When choosing a facility, consider treatment centers that offer specialized care for your or your loved one’s specific mental health needs. For example, some inpatient mental health treatment centers have units dedicated to specific disorders, e.g., eating disorders, while others do not.

Determine Level Of Urgency

Level of urgency refers to whether you or your loved one is experiencing an active mental health crisis and/or if mental health issues are posing a danger.

Again, some residential mental health centers provide stabilization services, but not all do, and not all can accommodate clients who pose a danger to themselves or others.

Resources

For people looking for more information on psychiatric hospitals and residential mental health treatment centers and the differences between them, or other mental health help, the following links provide valuable information and guidance.

• 988 Lifeline: a free and confidential hotline available 24 hours a day, seven days a week, providing prevention and crisis resources for people in distress and their loved ones
• Crisis Text Line: a free and confidential texting line available 24 hours a day, seven days a week, connecting people with crisis counselors for mental health support
• National Institute Of Mental Health: the lead federal agency for research on mental disorders, providing up-to-date information about mental health
• Substance Abuse And Mental Health Services Administration (SAMHSA): an agency within the U.S. Department of Health and Human Services that spearheads the effort to improve mental health and awareness nationally, including by providing a search tool for mental health hospitals and residential centers nationwide
• U.S. Centers For Disease Control And Prevention – Mental Health: the leading science-based, data-driven service organization on national public health, offering information on adult and children’s mental health, stress management, and more
• Vets4Warriors: a nonprofit organization that facilitates peer support connections for veterans in need of confidential mental health support