10 Questions to Ask Mental Health Residential Treatment Programs

1.What type of accreditation or licensing does the program have?

Mental health residential treatment programs may qualify for a number of different types of accreditation or licensure. 

Skyland Trail has received The Joint Commission Gold Seal of Approval since 1998. Accreditation from the Joint Commission indicates excellence in ensuring patient safety and quality of care. Skyland Trail adult facilities are also licensed by the state of Georgia Department of Community Health as personal care homes.

2. Is the mental health treatment center using evidence-based, or science-based, treatment methods?

Some treatment approaches may sound good on paper or on a website. They may even seem relaxing or enjoyable. New, untested approaches may appear to be an easy fix. 

If your doctor recommended treatment for a serious infection, she would share the results of that treatment in clinical trials. Did it work? After breaking a leg, you’d want to know that the treatment program would help your leg heal and help you get stronger.

You can apply these same standards to psychiatric care. Ensure that the program is offering evidence-based care and that clinical staff has received training in these specific methodologies. Many therapeutic approaches like Cognitive Behavioral Therapy, Dialectical Behavior Therapy, Acceptance and Commitment Therapy, 12-step approaches, etc. have been studied extensively and have been shown to be effective when used as indicated. Also be sure that the mental health center assigns a specific therapeutic approach to each client based on diagnoses, symptoms and goals. An evidence-based therapy used to treat a diagnosis that is not indicated may not produce the intended outcomes.

And remember, a serious mental health diagnosis is a chronic illness. Intensive psychiatric programs are hard work. There should be an expectation for clients to engage fully in therapy and work hard to examine and change current thought patterns and behaviors. After completing a psychiatric residential mental health program, clients should have reduced symptoms and improved skills for maintaining their health. Ongoing therapeutic work and self-care strategies will likely be required to maintain recovery. Be wary of treatment programs that promise an easy fix.

3. Is the program effective? What measurements or studies are available to demonstrate effectiveness?

Beyond client demographics, ask mental health programs you are considering to provide before treatment and after treatment evaluations. Did their psychiatric patients improve and to what extent? Where improvements similar across all diagnoses or did clients with specific diagnoses improve more than others?

Outcomes research is an integral part of the evidence-based psychiatric treatment program at Skyland Trail. We use highly respected mental health evaluations to measure the effectiveness of our mental health treatment programs. 

Clients complete a series of evaluations at admission to measure their symptom severity, attitude toward medication adherence, hope for the future, level of functioning, senses of self efficacy and relationships with others, and physical health. Clients are tested on those indicators again when they graduate from the program. Skyland Trail also uses specialized evaluations of our specific treatment programs for bipolar illness, major depression, schizophrenia, and anxiety.

4. Is the program a good fit for your loved one?

No psychiatric treatment program is exactly the right fit for everyone. A working farm community may be just the ticket for one person, but may not offer enough structure for someone else. Or maybe you just have terrible seasonal allergies. Some clients may be more comfortable in a female-only or male-only program. Be sure the program is welcoming to gay, lesbian, transgender, or gender queer individuals. Some clients have specific needs based on their diagnosis. Check out the programs available for a history of trauma, eating disorders or substance abuse. If spirituality is important to you, understand how the program includes or excludes a client’s faith or spirituality in treatment.

5. How will the program help the client pursue stated personal or professional goals?

To what extent is the mental health treatment program tailored to the individual client? Is it more of a one-size-fits-all approach where all clients participate in the same curriculum? Or are therapeutic approaches and supporting activities individualized based on current symptoms and challenges?

To what extent is the patient a partner in the treatment process? Are most treatment objectives defined by the clinician, or does the client have an opportunity to describe goals he or she would like to achieve as a result of working hard in treatment. 

Clients engage more fully in treatment when they feel valued as a person instead of as a diagnosis. When they are able to see the impact of unhealthy thought and behavior patterns on their self-defined goals – relationships, professional achievements, personal happiness- they may be more likely to re-examine long-established beliefs and unhealthy coping mechanisms. New skills can either be offered as tools to build a future clients have envisioned for themselves, or as required fixes to what others have defined as defects. 

6. How can families participate in treatment?

Family involvement can be a crucial part of the recovery process. During the admission and assessment process, input from family members can give the clinical team a more robust picture of a client’s history of symptoms and treatment, challenges and strengths. Be sure to ask how much input families have in the assessment process.

During treatment, families can encourage clients to fully engage in treatment. Treatment is hard work. The more people encouraging the client to stick to it, go to group, and practice using their skills, the better. Ask the treatment program what kind of communication families can expect during treatment. Are families assigned a primary point of contact on the clinical team? 

As part of treatment the client is making important changes in how he or she views himself or herself, relates to others, and manages independent living skills. He or she is trying to stop unhealthy thought and behavior patterns. If the client returns home to an environment that reinforces the old patterns, it can be hard for the client to solidify new strategies and skills and all too easy to revert to old habits. Family therapy can help the family system make important adjustments to help support the health and growth of all family members. Find out if the mental health treatment program offers family therapy or other family education.

Finally, self care and peer support is important for family members as well. Ask if the treatment program offers any support groups or education opportunities for families as part of its psychiatric treatment programs.

7. What is the average length of stay?

Make sure you understand the recommended length of stay for the entire continuum of care at the mental health treatment program. What is the recommended length of stay for residential treatment program? What happens after residential treatment? What is the expected length of stay for day treatment? For the intensive outpatient program? 

Make sure your loved on and your family can commit to the entire length of stay and the full program in terms of time away from school and/or work and in terms of the financial commitment. Separate from a minimum length of stay, find out the what the program’s clinical team recommends as full participation in a complete continuum of care to experience the best possible outcomes.

At Skyland Trail, the typical length of stay for our adult program is 2 to 4 months when admitting to the psychiatric residential treatment program. Most clients spend 1 to 2 months in residential treatment and an additional 1 to 3 months in nonresidential day treatment and intensive outpatient programs. Some clients admit directly to our mental health day treatment program and have an average total length of stay of 2 to 3 months. 

Our longer length of stay gives clients with serious mental illnesses like bipolar disorder, major depression, schizophrenia and anxiety, the time and support they need to learn to manage their illness and learn and practice healthy coping strategies and independent living skills.

8. What does a typical day look like?

Different types of mental health treatment programs offer different kinds of activities and varying degrees of structure. Ask to see a sample daily or weekly schedule. Evaluate the schedule based on your understanding of your loved one’s needs for structure, supervision, physical activity and social interaction. 

• Does every day look about the same, or do daily activities vary? 
• Consider the mix of talk therapy, hands-on or expressive therapies, and physical activity. 
• How much one-on-one time with dedicated therapists or psychiatrists is offered? 
• Are most groups generalized for the whole patient population, or are clients offered opportunities for specialized therapy and learning? 
• Outside of traditional therapeutic treatment hours, how are clients encouraged to socialize on evenings and weekends? 
• Are off-campus activities in the community offered?

9. How does the treatment program work with insurance companies? Is financial aid available?

Psychiatric residential treatment is a significant investment. Make sure you understand the full costs of treatment before enrolling. 

Insurance coverage of mental health services is confusing terrain. Just because your plan offers benefits does not mean that the insurance company will authorize those benefits for you or your loved one. The insurance companies often use a different definition of “medical necessity” than what families or even treatment programs would expect. 

Many treatment programs will connect you with a financial counselor to help you understand how your insurance benefits may be applied toward portions of the treatment program. Many treatment programs offer connections to third party insurance advocates that can help you use out-of-network benefits. 

If the treatment program is a nonprofit, you may be eligible for financial aid awards that can offset program fees. 

When you are trying to get your loved one in a good treatment program, it can be hard to weigh the costs and benefits of a long term mental health treatment program. Take time to consider the financial implications for your family and be sure you have the financial resources needed for your loved one to complete the full recommended continuum of care.

10. Can you tour the facilities? Can you talk to alumni families?

Seeing is believing. Do not rely on websites and marketing materials as your only window into the program. Ask to tour the facilities. Many programs also offer opportunities to speak to former clients and client families about their experiences. Ask for an inside perspective on the best aspects of the mental health treatment program as well as any areas for recommended improvement.