According to the American Psychiatric Association (APA) the Substance Abuse and Mental Health Services Administration (SAMHSA), and the National Institute of Mental Health (NIMH), mental disorders or mental illnesses are psychological conditions that result in a disorganization of an individual’s personality functions, cognitive functions, emotions, and relationships that result in significant impairment or distress for the individual. Mental illnesses are identified by changes in the person’s thoughts, mood, and/or behavior.
Organizations like APA have standard diagnostic criteria and definitions of various different types of mental illnesses that include but certainly are not limited to disorders classified as:
- Anxiety disorders
- Developmental disorders
- Depressive disorders
- Bipolar disorders
- Psychotic disorders
- Personality disorders
- Eating disorders
- Substance use disorders
The actual diagnosis and treatment of a mental disorder or mental illness in any individual is dependent on numerous factors, including the individual’s physical health; some physical conditions can result in changes in mood, behavior, and thinking that mimic mental disorders. In order for an individual to be diagnosed with a mental illness, the behavior typically should not reflect complications associated with a medical condition like hypothyroidism, cardiovascular disease, a urinary tract infection, etc. In addition, the diagnosis and treatment should take into consideration the individual’s cultural background; certain types of behaviors that would be classified as a mental disorder in one culture would be acceptable as normal in other cultures. Finally, both should consider the social situation of the individual; individuals suffering from normal bereavement as a result of the loss of a loved one are typically not diagnosed with a depressive disorder unless the bereavement is extremely or abnormally prolonged. Residential treatment facilities offer 24-hour access to treatment as well as a safe haven for individuals with mental illnesses to stay in while they recover. They differ from inpatient psychiatric units in hospitals in that they are more “homey” in their environment and typically are not designed to deal with acute manifestations of mental illness. Instead, after an individual has left an inpatient psychiatric unit, these facilities are designed to continue to deliver intensive treatment in a controlled living environment for a specific period of time to allow the individual to continue their recovery.
Residential treatment has some specific advantages over outpatient treatment that can apply to individuals who have severe issues that need more intensive interventions. Of course, residential programs provide significantly more organization and efficacy than an individual attempting to deal with their mental illness without professional intervention.
Advantages of Residential Treatment for Mental Illness
According to APA, SAMHSA, the American Psychological Association, the National Institute on Drug Abuse, and numerous clinical references, there are several important principles to consider when initiating effective treatment for any form of mental illness. Residential treatment facilities can offer these advantages, and because of their structure, they can enhance the effectiveness of these principles.
These principles include:
- Availability: One important principle that helps to make treatment more effective is that the treatment intervention should be readily available for the person with the mental disorder. This means that when the individual needs treatment, they can receive it. Having individuals put on waitlists for specific types of treatments reduces the effectiveness of interventions for any type of mental disorder. In addition, individuals with severe issues or who have recently transitioned from an acute inpatient unit are often still unstable and may need access to specific types of interventions around the clock.Residential programs house clients in them, and this leads to the treatment interventions being available for these individuals at any time. As individuals become more involved in treatment and become more stable, they can transition to outpatient treatment when they do not need this level of management. Another important associated factor is that it should be relatively easy for the individual to get into the treatment program. Typically, residential treatment facilities have intake personnel that make the process for admission into the program quick and efficient.
- Assessing the person’s needs: Residential treatment typically begins with a thorough assessment of the individual’s physical, psychological, and social functioning that is performed by qualified mental health workers. As the individual progresses through treatment, they are continually reassessed regarding their progress, any new treatment needs, and any adjustments that need to be made to existing treatments. Continual assessment of the individual’s progress, needs, and alterations to existing treatment is easily accomplished in a residential treatment program where the individual is under some form of observation/supervision 24 hours a day.
- The use of evidence-based treatment approaches: An evidence-based treatment approach is a form of treatment that has sufficient research evidence and documentation to support its utility in the treatment of the specific mental disorder in question. Using the treatment approaches that do not have evidence-based support (research support) is considered to be unethical by organizations like APA. Residential treatment facilities most often utilize only evidence-based treatment approaches for their clients, which can include different types of medications, psychotherapies, support interventions, etc.
- Personalized interventions: Even though effective treatment programs should use evidence-based treatment approaches, there really is no one specific approach that is effective and appropriate for every person. Residential treatment facilities have an advantage over outpatient treatment facilities and self-care in that they can continue to assess the individual’s needs and observe their reaction to treatment around the clock. This allows treatment providers in residential programs to make adjustments to the treatment plan to suit the individual’s specific needs.For instance, some individuals will have reactions to certain types of antidepressant medications, and when these occur in a residential treatment program, they can be addressed immediately and a more appropriate medication can be administered. Other individuals may have specific cognitive difficulties that interfere with their ability to consolidate much of the information that is typically given to individuals in therapy. Residential treatment programs can immediately slow the pace down for the person, monitor their progress, and adjust the therapy to suit the capacity of the individual more efficiently.
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Ongoing care for the person: Obviously, residential treatment programs are able to provide ongoing care for the individual as long the person remains in an established treatment facility. This means that there are typically no significant gaps in between treatments, such that clients get consistent interventions for the entirety of their stay in the facility. Most often, these facilities put individuals on rather strict schedules of therapy, assessment, free time, chores, etc., in order to keep them occupied and keep treatment continuous. Clients cannot skip treatments.
Psychoeducation: Research indicates that the use of educational alone is not sufficient to create change; however, psychoeducation is an important component of a program to address issues with mental illness. Residential treatment programs typically offer numerous levels of psychoeducation regarding the specifics of the individual’s particular disorder, making lifestyle changes, understanding how to monitor behavior, the development of social skills, etc.
The use of mutual help or peer support: Individuals who are being treated for any form of mental illness will have a smoother recovery process if they have some form of family or social support. Residential programs offer strong forms of peer support as a result of clients living with others in treatment for similar issues. They may also include community support groups or social support groups (e.g., 12-Step groups) in their overall program. In addition, the majority of these programs offer family members a chance to interact with the person and have scheduled visiting times for family members.
Motivation-building efforts: Individuals in treatment for mental disorders often have self-doubt or may be anxious regarding their ability to recover. Residential programs offer these individuals a chance to see others in recovery who have improved themselves in addition to directly helping individuals improve their motivation through therapeutic interventions.
The use of the therapeutic alliance: The therapeutic alliance is a principal that is often used specifically for psychotherapy; however, it is an important principle for all forms of treatment, including the administration of medications. The therapeutic alliance refers to the sense of trust and mutual respect that both the client and the treatment provider have for one another. It is a sort of bond between the client and their treatment providers, and it allows for the person to participate in treatment with confidence and not to be hesitant or afraid to discuss their issues with their therapist. In addition, it allows the therapist to be frank and open with the client. Residential treatment programs allow for the development of these alliances between treatment providers and clients due to the frequency of interactions, honesty between individuals, and the ongoing commitment between therapists and clients targeted at helping clients improve their situations.
- Sufficient time in treatment: Individuals with all forms of mental disorders will demonstrate greater improvement and overall successful outcomes with more active and longer involvement in organized treatment protocols. It is a fact that the longer a person stays in treatment, the better their overall outcome is. Residential programs allow individuals to stay in treatment as long as necessary in order to move them to the next level, which is typically some form of outpatient treatment and a supportive living environment.
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Concerted efforts at improvement by treatment providers: Residential treatment programs are often very focused on their successes, client satisfaction with the program, and continually upgrading their approaches. The individuals in these facilities are professional treatment providers who take pride in assisting others and using the most efficient means possible to help their clients. This means that these individuals are constantly learning how to improve their approach and upgrading their skills. Program administrators constantly review the goals of the program and specific outcome variables in order to continually improve the overall program.
- Because residential treatment programs have access to clients throughout the day, and clients receive far more intensive treatment than in most outpatient treatment facilities (except perhaps intensive outpatient treatment), they offer specific advantages for individuals who are transitioning out of acute inpatient psychiatric treatment into longer-term interventions. Because these facilities also offer stable living conditions, the individuals who are making this transition need not worry about the everyday issues associated with living and are able to focus on their recovery and on stabilization. This makes these programs advantageous for many individuals and certainly far better than attempting to address one’s issues without professional help.