Inpatient vs Outpatient Treatment

Last Updated: Sep 21st 2020

Reviewed by Brittany Polansky

Inpatient vs Outpatient Treatment

Drug addiction and mental health is a struggle for us ALL! You don’t have to be an addict to struggle with addiction and all that comes with it. It affects everyone; from the addict, a family member, friend, co-worker; even a worried neighbor. Addiction is hard and finding the right treatment option is key to everyones’ mental health recovery. 

When researching drug treatment programs, there’s a lot of information out there about different options. This can be overwhelming, confusing and scary. Understanding what information you’re looking at can make this important decision a little easier. One of the primary concerns of anyone entering treatment is whether inpatient vs outpatient treatment programs are right for them; Which will work best for me? Many places offer both, but you should know which one is going to make the most sense for YOU and YOUR mental health. 

Getting an Assessment for Inpatient vs Outpatient

One of the initial steps you can take before entering treatment is getting an assessment by the treatment center. The treatment center has professionals who can help you narrow down your decision. The decision of going to inpatient or outpatient treatment is crucial because the wrong one may hurt your recovery. Many addiction professionals use the ASAM Criteria or something similar, which assesses your addiction severity.

Some of the aspects of your addiction that may be in the assessment include:

  • History of relapse
  • Physical and mental dependence
  • Readiness to change
  • Living situation
  • History of mental health issues

Who Inpatient Treatment is For

Inpatient is typically where most people need to go when they’re entering into a treatment program, especially those that are entering treatment for the first time and/or have found their lives no longer functionable and need more intense mental health treatment to assist in true and permanent recovery. Some people want to go to outpatient because they’re afraid to commit to an inpatient level of care.. The reality is that residential treatment is the best place for anyone beginning treatment because it removes them from triggers. Additionally, another benefit is that patients are finally able to give themselves the care and attention that they need and deserve in order to overcome addiction.

The inpatient level of care is extremely beneficial for anyone whose living situation triggers them. The outpatient level of care can sometimes subject you to additional stress from work, family, friends, spouses or unfortunately, even children and can keep people feeling forced to continue to live in their active addiction. In addition, many people in early recovery aren’t safe from their own thoughts or actions and this is why it is equally as important to remove the triggers AND focus on the improvement of ones’ mental health, which is exactly what inpatient treatment provides. Inpatient programs give people more structure and restriction so they don’t relapse on an impulsive craving rather instead focusing on the modification of behaviors and self love through mental health giving hope and a real chance at long term sobriety.

Outpatient is Often for Transition

There are some people who may benefit from going to outpatient treatment. Typically, these individuals have a less severe addiction. Someone who is in the early stages of addiction may benefit more from maintaining a normal life. This level of care is for those who have a very strong readiness to change and don’t have a long history of relapse. Most of the time, outpatient programs are for those who are transitioning from the inpatient level of care.

After inpatient treatment, the best thing patients can do for themselves is to continue drug treatment programming and mental health through outpatient. This gives them a way to test their recovery and have some freedom while also staying accountable. Aside from accountability, they also know that they still have a strong level of support to turn to. Sometimes returning to dealing with friends, family, work and other stresses and triggers too soon can be highly overwhelming and often lead to relapse and the cycle could continue. This is why it is so important to really consider whether inpatient or outpatient treatment is right for you.

Addiction Treatment – The Pro’s & Con’s: Inpatient vs. Outpatient Addiction & Mental Health Care

  1. Lives in facility                                  1. Lives outside facility
  2. No work release offered                   2. Ability to maintain work
  3. Daily treatment                                 3. Daily treatment
  4. Individual & group counseling       4. Individual & group counseling
  5. Guaranteed group attendance        5. Less success rate, group attendance
  6.  24-7 Facility support .                      6. Facility staff support system limited
  7. Higher success rate                           7. Lower success rate
  8. More expensive                                 8. More affordable
  9. 28 days – 6 mos care                        9. 3 mos – life care
  10. No “life” trigger exposure              10. Limited “life” trigger exposure

Co-Occurring Disorders (Dual Diagnosis) & What it Means for your Mental Health Treatment Decision

Mood, anxiety, schizophrenia and personality disorders often overlap with drug and/or alcohol addiction. These conditions affect the way you feel, behave and importantly, interact with others and how we perceive the world. Drugs, alcohol and addictive behaviors like compulsive gambling,  or even sex are often used as dysfunctional coping skills to help the addict attempt to function with the painful symptoms of mental illness. 

According to a report in the Journal of the American Medical Association:

  • Roughly 50 percent of individuals with severe mental health disorders struggle with alcohol and/or substance abuse.
  • 37 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.
  • 29 percent of people diagnosed with mental illness abuse alcohol and/or drugs.

Understanding the interactions between mental health and drug and/or alcohol addiction and the most common types of co-occurring disorders, can help you or your loved one get simultaneous treatment and begin your recovery and then, maintain your sobriety and new found mental health. Once a dual diagnosis has been determined, an inpatient treatment option is usually always recommended since these types of diagnoses often have the highest rates of relapse and unfortunately, the more severe consequences for the affected and their loved ones. These disorders require a more intense therapy plan which is more easily offered through inpatient treatment. Outpatient treatment is still available for dual diagnosis but usually only recommended for those who are transitioning from inpatient to outpatient programs. 

Common Co-Occuring Disorders (Dual Diagnosis)

The combination of mental illness and drug addiction comes in many forms, however, there are certain combinations that happen more frequently in those who are struggling with mental health and addiction. Some of the most common and frequent types of co-occurring (dual diagnosis) disorders include:

  • Major depression and cocaine abuse/addiction
  • Alcohol abuse/addiction and panic disorder
  • Alcoholism and poly-drug abuse/addiction with schizophrenia
  • Borderline personality disorder with episodic poly-drug abuse/addiction (the addict is in an intoxicated state without any preference to a particular drug and/or substance)

In a lot of cases, addiction and substance abuse appears to actually be the cause of mental illness, while in other cases, the opposite can occur. Several mental health disorders come from similar factors such as addictive disorders; family history, brain chemistry and trauma in ones’ life. When it comes to recovery from co-occurring disorders and dual diagnosis, treatment must target both the mental illness AND the addictive disorder in order to produce effective, lasting and long term sobriety and this is why so often, inpatient treatment is recommended by highly trained mental health professionals. 

Outpatient Treatment: You do Have Options!

Inpatient treatment isn’t always accessible or affordable for everyone; thankfully there are several outpatient options that can offer the same level of care without the financial or physical restriction of inpatient care. Let’s explore the options:

  1. Partial Hospitalization Program (PHP)

 PHP is a type of mental health outpatient program used to treat mental illness and substance abuse. When someone opts for partial hospitalization treatment, you may continue to reside at home, but commutes to a treatment center up to seven days a week for inpatient style addiction and mental health treatment . Partial hospitalization programs focus primarily on the overall treatment of the individual, and is intended to avert or reduce inpatient hospitalization stay.

  1. Intensive Outpatient Program (IOP)

IOP is a kind of mental health treatment service and support program used to treat eating disorders, bipolar disorder (including mania I and II), unipolar depression, self harm and/or alcohol and chemical dependency that does not rely on detoxification; typically required for a stay in an inpatient program. This program usually operates on a smaller scale and does not require the intensive inpatient treatment programs typically offered by the larger, more comprehensive treatment facilities which a lot of people tend to prefer. 

The typical IOP program offers group therapy and generally facilitates that average between 6-30 hours a week of programming for addiction treatment. IOP also allows the individual to be able to participate in their normal daily activities, such as work and/or school, and then allows them to be able to participate in treatment at a treatment facility in the morning or at the end of each day. With an IOP, classes, sessions, meetings, and workshops are scheduled throughout the day, and individuals are expected to attend the program fully.

The typical IOP program requires active participation in a 12-step program in addition to IOP participation as determined by the chosen treatment facility.

  1. Traditional Outpatient Treatment Program

Outpatient addiction and mental health treatment programs share many similarities with inpatient treatment programs, but in a differently structured environment. Outpatient treatment programs provide patients with more freedom of movement which allows them to maintain family, work, educational and other responsibilities all while obtaining the mental health and addiction treatment that they so desperately want and/or need. Because of the ability to go home after a daily outpatient program, patients are able to have a greater level of privacy and anonymity while seeking mental health/addiction treatment. This gives a sense of relief to those that know an extended absence would require an explanation to people they associate with on a daily basis; employers, co-workers, friends, associates, loved ones, etc..

Differing from inpatient treatment programs, patients are not provided with the safe, secure environment that isolates them from negatively influencing factors, “triggers”. Patients return to their own environments after outpatient treatment programs, and must voluntarily abstain from drug and/or alcohol use, as well as the continuation of mental health treatment which can be very hard for anyone since triggers are everywhere. However, the benefit of outpatient treatment does provide a support network for patients in the form of official support groups, individual and group counseling, and family counseling so that patients are never alone in their mental health recovery. Patients are provided with a strong support network of “sober” peers and sponsors to assist during and after treatment. Outpatient drug and/or alcohol treatment requires a component of group therapy and support groups like NA and AA, which provide a new, positive element of social change in a patient’s life and facilitates long-term sobriety and assists in overall mental health recovery.

Outpatient programs also focus on family support and involvement, which can assist with the accountability that is required in order to remain sober and healthy.

What is most important to understand is that regardless of statistics, each persons road to addiction and/or mental health recovery is their own; that is why after making the important decision to get help, that you make the next best decision; which treatment is right for YOU.

Don’t wait any longer!

Now that you know more about inpatient vs outpatient treatment, it’s time to seek real help. To schedule a mental health and/or addiction assessment and learn more about our drug treatment programs, call 1st Step Behavioral Health today at (866) 319-6126  or contact us here, and let us help you pave the road to long lasting recovery!

Reviewed for Medical & Clinical Accuracy by Brittany Polansky

Brittany PolanskyBrittany has been working in behavioral health since 2012 and is a Primary Clinician at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.