To help maintain the sanity of our patients and our staff, we share this concept with our Mindful patients for educational purposes only. This blog is not medical advice nor does it list individual treatment options. Instead, the goal is to provide education about the levels of care inside the mental health system.

Life is a lot right now. Between the pandemic, finances, work fatigue and the coming school stress, there are bound to be times when you feel overwhelmed and need more help. As an outpatient practice, we have strengths and shortcomings; after all, we’re human too. One of our weaknesses is that we can’t be all things to all people all the time. This is where terms and definitions are super important. “Outpatient” psychiatry generally means working with a patient that does not need psychiatric interventions (e.g. medication changes, therapy, coordination of care, etc) from their clinician more than once a week. To distinguish between “urgent” and “emergent”, keep in mind the phrase “threat to self or others.” Anything that creates a threat to self or others (self harm, suicide, hallucinations) is considered emergent. If this is you or your loved one, call 911 or go to the nearest ER as they are staffed to give immediate interventions.

Outpatient psychiatry cannot typically service urgent or emergent concerns. Our clinicians work diligently to give each person in the office their undivided attention; urgent and emergent concerns would break that attention. Disruptions to a person’s treatment planning creates ripple that can affect other patients and staff.

“Urgent” situations generally need a response within 24-48 hours. Intensive Outpatient Programs (IOP) and Partial Hospitalization Programs (PHP) are designed to be the answer to the “urgent” need because they are staffed to perform “rolling evaluations” typically from morning to evening. As a step between “outpatient” and “emergency/inpatient” care, IOP and PHPs serve a vital and important function in the mental health ecosystem. IOPs are generally 3 hours a day of therapeutic work 1-5 days a week whereas PHPs are 6 hours a day of therapeutic work for 5 days a week. With both programs, the person enrolled is allowed to return to their homes for the evening, to try out the skills and processes they learned during the day and review them with their therapy team the next day.

Each level of care in the ecosystem (outpatient, IOP, PHP, emergency, and inpatient) plays an important role; it is critical to get people to the right level of care as soon as possible. At Mindful, we offer psychoeducation (like this blog) to make sure our patients know their options; our fear is that you wait for care that is accessible and appropriate.

Fort Worth & Dallas are home to amazing IOP and PHP programs. We encourage you to contact them directly if you’re having urgent concerns and unable to see your psychiatrist within 1-2 weeks. Listed in alphabetical order:

Charis Behavioral Health (children): 817-997-4525 https://charisbh.com/
Cook Children’s (children): 682-885-3917 https://cookchildrens.org/behavioral-health/specialty-programs/Pages/Partial-Hospitalization-Program.aspx
John Peter Smith (adults and children): 817-927-3636 https://www.jpshealthnet.org/get-care/services/behavioral-health
Mesa Springs (adult and children): 817-484-0406. https://mesasprings.com/
Millwood & The Excel Centers (adult and children): 817-261-3121 https://millwoodhospital.com/
Mind Above Matter (adult and children): 817-447-3001 https://mindabovematter.com/
Reflections Lifestyle (children): 469-777-4688 https://reflectionslifestyle.com/
Texas Health Resources (adult and children): 682-236-6023. https://www.texashealth.org/Health-and-Wellness/Behavioral-Health

We do not expect you to know if you or your loved one needs IOP or PHP. As part of the mental health ecosystem, Mindful clinicians and staff are trained to help: give us a call, login through OnPatient, or send us a HIPAA-friendly email. We’re happy to help.