Learn About Different Levels of Mental Health and Substance Use Treatment

Would you know what to do if a friend or family member needed help with a mental health or substance use issue? What kind of help would they need? Who could help?

Not knowing what to do can be scary and confusing. But there are many things you can do to support your loved one.

Where to Start?

First, take steps to learn about what you are seeing. Ask questions to learn:

• Are they having thoughts of harming themselves or others?
• Can they stay safe?
• Are they struggling with work or school?
• Are they feeling less connected to family and friends?

Next Steps

If you’ve found that your loved one needs help, learn about levels of care for mental health or substance use issues.

Levels of Care are the types of health care offered based on the patient’s symptoms. Usually a health care provider recommends a particular level of care based on a person’s specific needs.

An acute inpatient hospital is for someone who:

• Has thoughts of hurting themselves or others
• Has challenges with drug or alcohol use and/or difficulty stopping using substances on their own.
• Can’t function due to an underlying mental health or substance use disorder.
• Needs urgent help

Hospitals are the most intensive and restrictive level of care. They provide 24-hour treatment and offer medication management, psychotherapy (talk therapy) and withdrawal management.

What if a person is not in crisis but needs around-the-clock supervision and structure?
They could seek care at a Residential Treatment Center (RTC).

RTCs offer mental health and substance use treatment in a residential setting. RTCs have 24-hour nursing help and doctors on call. They help people with long-term or severe mental health issues. They also help people with alcohol and other substance use disorders. RTCs offer a high degree of safety, supervision and structure. They promote healthy habits as well as successful stabilization, withdrawal management and rehabilitation.

Some people may go to a Partial Hospitalization Program (PHP). It is not a residential program with 24-hour supervision. PHP provides intensive mental health and substance use treatment in an outpatient setting.

Often, these programs are every day for at least five hours a day. People usually go home in the evenings. These programs are highly structured to and offer help in a safe setting. This level of care also gives in-home support or access by phone for after-hours help.

What if the person is working or in school full time?
Intensive Outpatient Programs (IOP) are less restrictive than PHPs. They take place three days each week for at least two hours a day, allowing allows people to get care without neglecting daily duties. These programs offer individual and group therapy to help people learn skills to manage their mental health and substance use needs.

Can less frequent care still be helpful?
Outpatient (OP) care can take place in an office setting. OP may offer one-on-one, family or group care. It can involve psychotherapy and medication management. The frequency and duration of treatment varies depending on each person’s needs.

Which Health Care Providers Can Help?

Your loved one may see different types of caregivers in any of these levels of care.

Psychiatrist

• Psychiatrists have a medical degree and can manage medicines in all levels of care.
• They can provide psychotherapy.
• They can also admit and treat people in hospital settings.   

Psychologist

• They have a doctoral degree in psychology.
• They can provide psychotherapy.
• They can give and interpret psychological tests.
• They can prescribe medicine if licensed in New Mexico, Illinois, Iowa and Idaho.

Advanced Psychiatric Nurse (APRN)/Advanced Nurse Practitioner (ANP)

• APRNs and ANPs provide assessment, diagnosis and therapy for mental health conditions or substance use disorders.
• In some states, they also prescribe and monitor medications.

Physician Assistant (PA)

• Physician assistants practice medicine on a team under the supervision of physicians or psychiatrists.
• They examine patients and provide care.

Master's Level Behavioral Health Care Provider

• They have master’s degrees and a professional license to conduct psychotherapy.
• They cannot prescribe medicine.

Common titles:

• Licensed Marriage Family Therapist (LMFT)
• Licensed Professional Counselor (LPC)
• Licensed Clinical Professional Counselor (LCPC)
• Licensed Social Worker (LSW)
• Licensed Clinical Social Worker (LCSW)
• Board Certified Behavior Analyst (BCBA). They provide applied behavioral analysis (ABA) for people with an autism diagnosis.

Source: Types of Mental Health Professionals,  National Alliance on Mental Illness, 2020

Originally published January 2, 2019; Revised 2020, 2024