Continuum of Mental Health Care
No. 42; Updated September 2008
Communities provide different types of treatment programs and services for children and adolescents with mental illnesses. The complete range of programs and services is referred to as the continuum of care. Not every community has every type of service or program on the continuum. Some psychiatric hospitals and other organized systems of care now provide many of the services on the continuum. When several of the services are provided, the organization may be called a health care system.
The beginning point for parents concerned about their child's behavior or emotions should be an evaluation by a qualified mental health professional such as a child and adolescent psychiatrist. At the conclusion of the evaluation, the professional will recommend a certain type of service(s) or program(s) from the continuum available locally. The professional then usually is required to obtain approval from the insurance company or organization managing mental health benefits (e.g. managed care organization). In the case of programs funded publicly, a specific state agency must authorize the recommended program(s) or service(s). If the program or service is not authorized, it will not be paid. Many of the programs on the continuum offer a variety of different treatments, such as individual psychotherapy, family therapy, group therapy, and medications.
A brief description of the different services or programs in a continuum of care follows:
Office or outpatient clinic
Visits are usually 30-60 minutes. The number of visits per month depends on the youngster's needs.
Intensive case management
Specially trained individuals coordinate or provide psychiatric, financial, legal, and medical services to help the child or adolescent live successfully at home and in the community.
Home-based treatment services
A team of specially trained staff go into a home and develop a treatment program to help the child and family.
Family support services
Services to help families care for their child such as parent training, parent support group, etc.
Day treatment program
This intensive treatment program provides psychiatric treatment with special education. The child usually attends five days per week.
Partial hospitalization (day hospital)
This provides all the treatment services of a psychiatric hospital, but the patients go home each evening.
24-hour-per-day services for emergencies (for example, hospital emergency room, mobile crisis team).
Respite care services
A patient stays briefly away from home with specially trained individuals.
Therapeutic group home or community residence
This therapeutic program usually includes 6 to 10 children or adolescents per home, and may be linked with a day treatment program or specialized educational program.
This setting provides short-term (usually fewer than 15 days) crisis intervention and treatment. Patients receive 24-hour-per-day supervision.
Residential treatment facility
Seriously disturbed patients receive intensive and comprehensive psychiatric treatment in a campus-like setting on a longer-term basis.
Patients receive comprehensive psychiatric treatment in a hospital. Treatment programs should be specifically designed for either children or adolescents. Length of treatment depends on different variables.
Parents should always ask questions when a professional recommends psychiatric treatment for their child or adolescent. For instance, which types of treatment are provided, and by whom? Over what length of time? What is the cost? How much of the cost is covered by insurance or public funding? What are the advantages and disadvantages of the recommended service or program? Parents should always feel free to obtain a second opinion about the best type of program for their child or adolescent.