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When someone you love experiences a serious mental health crisis it may be difficult to know which treatment setting is right for their psychological needs. Family members want to ensure that their loved one receives the very best of care, although sometimes the lines are blurred as to which level of care is appropriate. To some, the idea of admitting their loved one into the psych ward of a hospital is simply unnerving.
Fortunately, in many cases the residential mental health treatment setting can be a more palatable option, as long as the loved one is not in danger of causing harm to themselves or others. The residential setting tends to be more intimate and less sterile than the hospital setting, which can improve the patient’s willingness to engage in treatment. Generally, the more comfortable the individual feels, the more they will trust the care staff and participate in therapeutic activities.
Of course, there are instances when the hospital setting is the right treatment choice, especially in a crisis event. Read on to learn more about these two levels of care—the residential treatment setting and the psychiatric hospital setting—to decide which is appropriate for your loved one’s needs.
When is a Mental Health Disorder a Psychiatric Crisis?
Someone who has been struggling with a mental health disorder may experience a dangerous spike in their symptoms, causing obvious signs of impairment, or impulsive actions such as a suicide attempt. However, sometimes the signs of an impending mental health crisis are a collection of less intense symptoms. Being able to recognize the warning signs of a potential psychiatric breakdown can help you get immediate help for your loved one. The warning signs might include:
- Emotionally detached, isolate themselves
- Becoming catatonic or uncommunicative
- Extreme mood swings
- Unable to perform basic daily tasks
- Exhibit symptoms of psychosis, such as hallucinations, delusions, paranoia
- Becoming cognitively impaired, mental confusion
- Neglecting personal hygiene
- Loss of interest in usual activities, avoiding social settings
- Extreme agitation or irritability
- Persistent feelings of despair or hopelessness
- Stop going to work or attending school
- Sleep disturbances, nightmares, insomnia, night terrors
- Noncompliant with psychotropic medication regimen
- Sudden weight loss or gain
- Increased substance use
- Strange or disorganized speech, oral or written
- Socially inappropriate behavior
- Violent outbursts
- Suicidal attempts or threats
When a cluster of the symptoms of a psychiatric crisis is evident the individual will need to be evaluated by a mental health provider. After assessing the mental state of the individual, the psychiatrist can recommend the most appropriate level of care best suited to their mental health needs.
What Triggers a Mental Health Crisis?
A mental breakdown is an unfortunate event that occurs when certain life events or experiences overwhelm the ability to manage the emotional stress, resulting in deep distress that impairs normal functioning. Everyone has a certain level of stress tolerance that is influenced by temperament, genetics, general health status, emotional maturity, and other coping skills. When chronic stress levels eclipse the ability to manage it, a mental health crisis might happen. Some examples of things that might trigger such an event include:
- High-stress occupations that lack proper supports
- Witnessing or experiencing a traumatic event
- Intense feelings of grief after loss of a loved one
- Ongoing physical or sexual abuse, or a history of abuse
- Professions that are associated with emotional burnout
- Severe interpersonal conflict
- Family history of mental health disorders
- Serious or chronic medical condition
- Serious financial issues, such as bankruptcy or foreclosure
In addition to these reasons that could spark a mental breakdown, an existing and worsening mental health disorder may also become so severe that the individual’s life is put at risk. This is considered a psychiatric emergency.
Examples of a Mental Health Crisis
Sometimes a mental break is so severe that it becomes a life-threatening event. As well, a psychotic break where someone loses touch with reality can be very disturbing for others to witness. In either of these types of mental health crises a choice between a residential program or a psychiatric hospital must be carefully weighed before deciding on the best setting. Examples of such psychiatric events include:
- Suicide attempt. When experiencing unrelenting depression, someone may become so hopeless and full of despair that they decide to end their life. When that attempt is unsuccessful there is great reason for loved ones to celebrate, but then the next step should be obtaining intensive mental health treatment for the individual.
- Psychotic break. A psychotic event occurs when there is a break from reality. Certain mental health disorders can present with psychotic features, such as hallucinations, delusions, catatonia, or paranoid thoughts. Some illicit substances can also cause psychosis, as can some health conditions. Depending on the severity of the psychosis, either a psych ward in a hospital or a residential mental health setting will be considered.
- Severe impairment. When the effects of a serious mental health disorder have eroded a person’s ability to perform daily tasks or to function normally they have become severely impaired. A comprehensive residential mental health program can help the individual through revisions in their medications, as well as through psychotherapy that can help them return to full functioning.
- Danger to others. If a severe mental health disorder has caused someone to act out with violent rage or acts of violence, they have become a threat to other people’s safety. The best treatment setting for these individuals is a psychiatric hospital where they will be isolated during acute stabilization.
Involuntary versus Voluntary Psychiatric Admission
Choosing residential treatment over a psych ward for a loved one with a serious mental health disorder can be a difficult call. In fact, this decision might rest on whether the individual would be willing to enter psychiatric treatment willingly or not. If they are open to voluntarily entering a residential treatment center, chances are that would be an appropriate choice for them. In the case where the individual is unable to make a sound decision about his or her own welfare, an involuntary admission to a psych ward might be the better option.
While both settings offer acute stabilization services, the psychiatric hospital will provide continual monitoring, and may have an isolation policy that involves the use of restraints. Generally, the psych ward of a hospital is set up to protect both the patient, the other patients, and the mental health providers from unpredictable or even violent behaviors. Someone whose symptoms, while also experiencing a serious mental heath event, do not rise to this level would be better suited to a voluntary admission to a residential mental health setting.
Treatment for Deteriorating Mental Health
Individual psychotherapy sessions: Psychotherapy is the core treatment element of mental healthcare. Depending on the particular diagnosis and its specific features, a therapy modality, or modalities, is selected as the vehicle to help a patient elicit foundational changes in their thoughts, attitudes, and behaviors. Some examples of these evidence-based therapies include psychodynamic therapy, cognitive-behavioral therapy, prolonged exposure therapy, and dialectical behavior therapy.
Medication. A broad list of medications are available that help manage the symptoms of a particular mental health disorder. Antidepressants, antipsychotics, antianxiety medications, and mood stabilizers are prescribed together with psychotherapy other treatment measures.
Group therapy. Group sessions provide opportunities for small groups to discuss and share their mental health issues while being facilitate by a therapist who guides the topics. These intimate group settings provide a safe environment for sharing and foster peer support in the process.
Psychosocial interventions. An important component of treatment is assisting the individual in improving their ability to get along with others. These interventions can offer new communication skills, conflict resolution techniques, and vocational rehabilitation.
Experiential or holistic therapies. To further augment the effects of the traditional therapies, experiential activities such as mindfulness meditation, yoga classes, art and music therapy, and deep-breathing techniques, are often included in the treatment plan.
Transitional Support Following Residential Treatment
Once someone has been discharged from a residential treatment program or psychiatric hospital there will be referrals made for aftercare services. Intensive case management programs can provide both community support and transitional housing to help individuals recovering from a psychiatric event to integrate back into the community after residential treatment. Fortunately, there are social work programs that are designed for just this purpose. Coordinated Specialty Care (CSC) is one type of treatment approach that has a team of mental health professionals and specialists that help the individual in a variety of ways. Another service available is called Assertive Community Treatment that also provides assistance for individuals with mental illness who are reentering the community. Services include:
- Case management
- Support groups
- Family focused support
- Help with education and employment
- Medication compliance support
- Counseling patients how to manage daily problems proactively
CSC can provide the individual with a well-rounded source of support services over and above medication and psychotherapy. These support services allow for the best possible outcome for individuals living with a serious mental health disorder.
Early detection and psychiatric intervention will result in an optimal clinical outcome. If your loved one is displaying the signs of a potentially serious breakdown or psychotic event, see a mental health provider sooner rather than later. From there, you will be able to decide on the right care approach for your loved one.
Mental Health Hope Offers Guidance for Mental Health Disorders
Mental Health Hope is a free online support source for individuals seeking information and guidance about treatment options. Our team of mental health experts can provide helpful solutions for a loved one who is experiencing declining mental health. The team is able to lead you to the resources best suited to the specific psychiatric issue at hand. Call Mental Health Hope today for a free confidential assessment at (877) 967-9274.