Levels of Mental Health Care Compared: Outpatient, IOP, PHP, Residential and Inpatient
Short answer
Most mental health care is outpatient: scheduled visits you leave the same day. When weekly visits are not enough, an intensive outpatient program (IOP) or partial hospitalization program (PHP) adds more treatment while you live at home. Crisis residences, residential programs and inpatient hospital units provide 24-hour care. A clinician can help you judge which level fits how you are doing right now.
In crisis or thinking about suicide? Call or text 988 now (in New York City it reaches NYC 988). If you are in immediate danger, call 911.
This guide is not enough if
- You might act on thoughts of suicide right now: call 911 or go to the nearest emergency room.
- You need to talk with someone today: call or text 988.
- You are choosing care for a child or teen. A separate guide covers teen IOP and residential care.
- You need a ruling on whether your insurance will pay. Only your plan can answer that.
If you are not sure whether this is an emergency
If you or someone else is in danger now, call 911. If it is urgent but not life-threatening, call or text 988; in New York City, NYC 988 can also send a Mobile Crisis Team. The guide to crisis options in New York City explains those services.
This guide is for a calmer question: weekly therapy or medication visits do not seem like enough, or a clinician has mentioned a program, and you want to know what the options mean. It covers adults. For teens, see when a teen needs more than weekly therapy.
The levels, from least to most intensive
SAMHSA and New York's Office of Mental Health (OMH) describe these settings. Programs vary, so treat these as general descriptions, not rules.
- Outpatient care. SAMHSA describes it as an appointment you leave the same day, with how often you go depending on the care you need. It can be in person or by telehealth. This includes therapy, psychiatric evaluation and medication visits with a private practice or a licensed clinic.
- Intensive outpatient program (IOP). In New York, OMH lets licensed outpatient clinics add an IOP for people who may benefit from more intensive, time-limited treatment. OMH says a traditional IOP centers on group therapy, for example three days a week for two to three hours a day, alongside individual and family therapy and medication management, though programs can be designed differently.
- Partial hospitalization program (PHP). OMH defines it as a program for adults or adolescents that provides active treatment to stabilize acute symptoms in a person who would otherwise need hospitalization. You go home at night.
- Crisis residence. OMH describes a residence with 24-hour supervision, generally for up to 30 days, for people with acute symptoms or a temporary loss of support, designed to avoid hospitalization.
- Residential treatment. SAMHSA says you live at the treatment program, usually for a few weeks to a few months, and sometimes a year or more for more serious conditions.
- Inpatient hospital care. OMH defines it as a 24-hour hospital program with psychiatric, medical, nursing and social services for people who cannot be adequately served in the community. SAMHSA says stays are often a few days or weeks.
| Level | Where you sleep | How intensive | Often considered when |
|---|---|---|---|
| Outpatient | Home | Scheduled visits; how often depends on need | Most ongoing care |
| Intensive outpatient (IOP) | Home | Several hours a week; a traditional New York model is 6 to 9 hours | Weekly visits are not enough, or as a step down |
| Partial hospitalization (PHP) | Home | Active treatment to stabilize acute symptoms; you go home each day | A person would otherwise need a hospital stay |
| Crisis residence | At the residence | 24-hour supervision, generally up to 30 days | Acute symptoms or a loss of support at home |
| Residential | At the program | Live-in treatment, usually weeks to months | Longer, structured care away from home |
| Inpatient hospital | Hospital | 24-hour psychiatric, medical and nursing care | Care cannot be adequately provided in the community |
Signs it may be time to talk about more support
There is no single checklist, and only a clinician who knows your situation can recommend a level of care. These are common reasons to raise the question with your therapist or prescriber soon:
- Symptoms keep getting worse over several weeks, even with steady treatment.
- Getting through the day is hard: work, school, eating, sleeping or basic self-care.
- Thoughts of suicide or self-harm are new or stronger. If you are in danger, call 911; to talk now, call or text 988.
- You were recently in an emergency room or a hospital and need a step down before weekly visits.
- Alcohol or drug use is growing alongside mental health symptoms.
- The people around you can no longer keep you safe or supported at home.
Stepping up, stepping down
Levels of care are not a ladder you climb once. Many people move up for a while and then back down. OMH notes that an IOP can mean less disruption to daily life than a psychiatric emergency program, a partial hospital program or an inpatient stay. Its IOP guidance also asks programs to describe how they will connect with people leaving psychiatric emergency programs and inpatient units, so an IOP can serve as a step down after a hospital stay.
New York also licenses community programs that do not fit neatly on this list. OMH describes Assertive Community Treatment (ACT) as a mobile team that provides treatment and support mainly in a person's home or community, and continuing day treatment as a program that helps adults with serious mental illness build skills to stay in the community. A clinician can tell you whether one of these fits better than a short program.
Before stepping up, a clinician may first try changes within outpatient care, such as more frequent sessions, a different type of therapy, or a medication review. When you leave a program, ask early who will provide care afterward, how records will be shared, and when your next appointment is. Writing a safety plan before discharge gives you steps to follow if things get hard again.
How to find a program in New York
Start with your current clinician, who may already know local programs and can share records. Then call your insurer and ask which programs are in network and whether you need prior authorization. Two official search tools can help:
- OMH's Mental Health Program Directory (opens in a new tab) lists state-licensed programs by county and program type, including partial hospitalization, crisis residences and inpatient units.
- SAMHSA's FindTreatment.gov (opens in a new tab) lets you search for mental health and substance use treatment across the country.
- This site's residential treatment centers list includes programs in several states. Programs outside New York follow their own state's rules, so check each one yourself.
- If you would value support from someone with lived experience while you decide, the guide on peer support explains where to find it.
Questions to ask any program
Before you agree to a program, a short call can tell you a lot. Useful questions include: Is the program licensed, and by which state agency? How many hours and days a week does it run, and for about how long? Who prescribes medicine, and how often will I see them? How are family members or other supports involved? What happens if I am in crisis at night or on a weekend? Who arranges care when I leave, and will you send records to my outpatient clinicians?
Where outpatient care fits, and when it is not enough
Mind Body Seven is an outpatient practice. It offers psychiatry and therapy for adults, teens and children at its Brooklyn office and by telehealth across New York State, as described on the adult psychiatry and therapy page. Outpatient clinicians can help you think through whether a more intensive program makes sense, and can be part of your care before or after one.
Outpatient care is not the right level if you need daily treatment, 24-hour supervision or emergency care. The practice cannot respond to emergencies. If you are in danger now, call 911, and for urgent support at any hour, call or text 988.
Frequently asked questions
What is the difference between IOP and PHP?
Both let you live at home. An IOP adds several hours of treatment a week, often group therapy plus individual sessions and medication visits. OMH describes a PHP as active treatment to stabilize acute symptoms for someone who would otherwise need a hospital, so it is usually more intensive. Program schedules vary, so ask each one how many hours and days it runs.
Can I keep my therapist or psychiatrist while I am in a program?
Sometimes. Many programs use their own team while you attend, and some coordinate with your outpatient clinicians. Ask both the program and your current clinician how they will share information and who will manage medicines during the program. Signing a release lets them talk to each other. Do not stop or change a medicine without talking with your prescriber.
Can I do an intensive outpatient program by telehealth?
Some programs offer it. SAMHSA notes that outpatient programs can be in person or by telehealth. Whether a given IOP runs online depends on the program and your situation, so ask how sessions are delivered, what happens if you are in crisis during a session, and whether your plan covers it.
How do I know which level of care I need?
A clinician decides with you, based on how severe your symptoms are, how safe you are, how well you are managing daily life, and what support you have at home. Starting with the least intensive level that can keep you safe is a common approach. If you are unsure, ask your current clinician or schedule an evaluation, and use 988 or 911 if things become urgent.
Next: get ready to decide
The six parts of a written safety plan, how to make your space safer, and who can help you write one.
Sources
- SAMHSA: Treatment Types for Mental Health, Drugs and Alcohol
- NYS Office of Mental Health: Licensed Program Type Definitions
- NYS Office of Mental Health: MHOTRS-Based Intensive Outpatient Program Guidance
- NYS Office of Mental Health: Mental Health Program Directory
- SAMHSA: FindTreatment.gov
- Mind Body Seven: FAQs (outpatient and telehealth care)
Recent changes
- May 13, 2024: OMH updated its guidance for intensive outpatient programs run by licensed outpatient clinics. It describes the traditional group-based model and says programs should not be limited to it. NYS Office of Mental Health: MHOTRS-Based Intensive Outpatient Program Guidance (updated 13 May 2024)
Reviewed by Dr. Beata Lewis, MD, Founder and Clinical Director, board-certified in adult psychiatry, child and adolescent psychiatry, and integrative medicine on November 8, 2026. Facts checked against the sources above on November 8, 2026. This guide is general education, not medical advice, a diagnosis or a treatment plan, and reading it does not make you a patient of Mind Body Seven. For advice about your situation, talk with a licensed clinician.