Residential Treatment for Mental Illness

Residential treatment for mental illness has gone in and out of fashion over the years. Early residential treatment centers focused on containing the mentally ill rather than healing their conditions and have been likened to prisons. Modern facilities are patient-centered and focused on healing. Voluntary treatment is preferred, but those who are considered a danger to themselves or others may be involuntarily committed.

History

• Early residential treatment facilities in Europe were overcrowded, underfunded and often dangerous. In the United States, early facilities were humane private centers that focused on holistic care. As state-run centers replaced private facilities and institutionalization became the norm, the quality of care decreased while the number of patients increased. By the 1950s, the mental health system in the United States was in crisis. Public outcry and newer treatment methods led to deinstitutionalization. Within a decade, community-based outpatient mental health became the new norm.

Significance

• Today's modern mental health facilities are cheerful, welcoming campuses focused on patient care. Hospital stays are designed to facilitate the patient's return to society. Due to new medications and treatment methods, most mental health treatment can be performed on an outpatient basis.

  Residential facilities retain the stigma of the past. Many people are reluctant to seek hospitalization for fear of mistreatment. Those who are admitted involuntarily may worry that they will never be released.

Types

• Open campuses, from which residents are free to come and go, are the least restrictive residential centers. Most residents are transitioning back into the community from a more restrictive facility.

  Lock-down units, where patients must remain within the facility at all times, are the most restrictive. Children on lock-down units attend classes on the unit. Special passes may be granted for visits with family, and supervised field trips may occur away from the unit.

Features

• Residents in mental health facilities follow a regimented daily schedule. Schedules generally include personal hygiene tasks, light housekeeping chores, group and individual therapy sessions, classes, recreation and free time. Special activities may be offered as rewards.

  Each client also has an individualized treatment plan, which may include personal activities away from the group. The goal is to teach clients to live within a group setting while tackling their own illnesses.

Considerations

• Clients may be involuntarily committed for a brief stay if they are a danger to themselves or others, but strict laws govern how long they may be kept. The goal of hospitalization is to stabilize the client's condition and help her to return home as soon as possible. Residents are usually referred for continuing services in the community. Mental illnesses that used to require lengthy institutionalization are now commonly treated on an outpatient basis.