Choosing the Right Mental Health Facility
Professional guidance for comparing residential treatment programs.
1. Introduction: Making the Best Match
You seek a residential treatment community that will give an adult with mental illness a brighter future. But the task you face is a complex endeavor – with high stakes. How do you use our Directory to find the best fit between person and program, a fit that can turn a life around?
The ARTA Directory of Residential Treatment Programs lists more than 30 long-term mental health facilities and links you to each treatment program’s web site for detailed information. All ARTA residential programs meet specific criteria for membership, and each one has been operating for a minimum of two years.
To help you make the best choice of residential treatment program, we’ve created this guide to the program selection process. The guide has been created for people who are not mental health professionals, and who need help understanding the differences between programs and how those differences will affect the course of psychiatric treatment.
On this page the mental health professionals of ARTA walk you through the process. You will find answers to the following questions and more:
- What is the goal of the treatment facility selection process?
- When is the “right” time to consider a mental health treatment facility?
- How long should someone keep trying on their own to improve their mental health?
- What type of residential treatment community should I choose?
- How important is a residential treatment center’s geographic location?
- What physical attributes and psychiatric services should I be looking for?
- I’ve heard that a certain residential treatment community is “the best.” Should I put that treatment center at the top of my list?
- How important is the composition of the treatment center’s peer community?
- To what extent should the person with mental illness be involved in the search and the decision?
Just follow the steps on this page, and you’ll be on your way to choosing a residential mental health facility.
2. Before Starting Your Search
Health Insurance and Finances
Before you begin your search through ARTA’s directory of residential mental health facilities, it’s important that you know that most – though not all — of the residential treatment programs listed in our directory are not covered by private or public health insurance, including Medicare and Medicaid. As a result, most facilities are self-pay.
Some inpatient mental health treatment centers do accept public and/or private health insurance. Some residential and psychiatric rehabilitation services may even be offered for free. For information on such programs, explore these resources:
- The National Alliance on Mental Illness (NAMI) offers a rich array of resources for people with mental illness and their families. For information about more local mental health services and other resources, you can contact the branch of NAMI in your state.
- Mental Health America’s Finding Therapy Page provides a rich directory of affordable treatment services for people with mental illnesses such as clinical depression, bipolar disorder, schizophrenia, and anxiety disorder.
- Your community mental health center offers a variety of resources for people looking for affordable facilities for mentally ill adults.
The mental health treatment centers in our directory share some common characteristics, but each has a physical layout, a range of mental health resources and services, and an ambience all its own. Before you start comparing residential psychiatric facilities, you need to consider a number of factors that play a role in selection of an appropriate care facility.
Understand Your Goal
In order to make the best match between an adult with mental illness and a residential treatment facility, you need to consider the treatment needed and the ways in which the physical layout, psychiatric services, and other characteristics of a care facility meet those needs.
ARTA residential programs offer four different styles of residential treatment community.
Within those four broad categories, programs differ in a number of critical ways:
- The physical layout and ambience of the facility.
- The nature and intensity of mental health treatment offered.
- The degree of independence and community integration.
- The activities offered in treatment.
- The proximity to other treatment resources.
The goal here is find the right combination of mental health treatment and services in a setting that offers the person participating in the program a subjective feeling of rightness, or being “at home.” You will get a feeling for the atmosphere of a place from its web site, from speaking with staff, and of course, from a personal visit.
Readiness for Mental Health Treatment
Is there a “right” time for a person to enter residential psychiatric treatment? For many families, the choice to pursue residential treatment is difficult from both an emotional and a financial standpoint. It can awaken feelings of guilt if the family is ready for placement yet the individual is resisting. There are several points to keep in mind regarding readiness.
Recognizing the Need
Often, the family is the first to recognize the need for mental health treatment. The family sees the need to set limits on an adult family member’s behavior and lifestyle, and may express their realization as, “This can’t go on.”
Role of the Individual
Sometimes a mentally ill individual also recognizes that their own efforts haven’t worked and that they can’t seem to improve their mental health on their own. But sometimes the individual does not see or admit this, and the family needs to take action anyway. In some cases, the family may make further support contingent on the person’s agreeing to get treatment for his or her mental illness. All of these scenarios can be the driving force for positive change.
Feelings About Residential Care
Spending time in a mental health treatment facility is never part of a person’s vision of their own future. Even when an adult with mental illness recognizes the need for psychiatric help, they often have mixed feelings about entering a residential treatment community.
People in need of care often experience ambivalence, which can express itself as push-pull behavior: the person agrees to go to a residential treatment program, then pulls back from the decision. However, mixed feelings should not be a reason to avoid residential placement. Though it may seem, at the time, insensitive to overrule their ambivalence, it is often in the person’s best interests, and can result in the restoration of their mental health.
Matching Treatment to Psychiatric Condition
As you read the descriptions of programs in our Directory, you will see that most accept people with the same range of psychiatric diagnoses, from schizophrenia and anxiety disorders to bipolar disorder, major depressive disorder, and more. However, often a treatment community has a concentration of adults with the same psychiatric condition. This concentration may change over time, or it may remain constant.
A high ratio of residents struggling with the same mental health condition as the person needing care may be a positive — or it may not be. If this ratio reflects a facility’s area of specialization, it is a positive. But if it does not represent a specialization, this concentration of mental health conditions can overburden the facility, in which case it may not be a growth-enhancing situation for someone who is mentally ill.
Our advice for you is to openly discuss your concerns about the composition of the community with people from the residential program. Keeping in mind the person’s specific psychiatric needs, initiate a discussion as to whether the current or foreseeable composition of people at the residence will work positively over time — or not.
Four Main Styles of Residential Treatment Community
ARTA programs offer four different styles of residential treatment community:
- Clinical residential treatment programs.
- Group residential communities.
- Farm-Based and Work-based residential programs.
- Apartment-based communities.
Please keep in mind that there is a lot of overlap among the four categories. This means that nearly every program in our directory, whatever its dominant style, has features of other styles. It is a question of emphasis.
For example, in farm-based or work-based residential treatment programs, collective and purposeful work sustaining the farm or other operations is at the core of the therapeutic experience. At the same time, farm-based programs can offer levels of independent apartment living off the farm. Likewise, an apartment-based program can revolve around a strong community that offers the benefits of a group environment, much like in a group home.
What’s more, some ARTA facilities offer a sequence of care consisting of three or four completely different program styles, each fully developed. In addition, programs of any style may offer opportunities to continue your education or to work at jobs in the community.
This overlapping of styles – and in some cases, the availability of several distinct types of program under the umbrella of one facility — will be helpful to the person who needs help. It means facilities offer a richness of options within their own programs, which a resident can take advantage of as their needs change or as they grow more independent.
For more information, see Program Types.
Location of Mental Health Facility
Should you choose a residential treatment facility that is close to your own or a family member’s home? Surprisingly, the answer is often “no.” Limiting the geographic location of your residential treatment search means limiting mental health care options. Remember that your goal is to find the best mental health care possible. Limiting your selection to a particular geographic area limits your options before you even begin the search.
We understand and support your wish for close contact among friends and family members. However, we recommend that you set no geographical limits on the choice of residential treatment program. Instead, let the nature of the program guide your choice. How a facility approaches the healing process is what affects a person’s growth and recovery – not whether it is close to or far from home.
More important, there are some advantages to seeking residential treatment farther from home:
- Adults with mental illness may feel freer to explore themselves and their mental health issues when they are farther away from the family.
- Living far from home can force a person to leave behind friends who are poor influences.
Getting away means leaving guilt behind, too. For a person with psychiatric issues, watching friends achieve success and independence can create feelings of abandonment and low self-esteem. Moving away and developing new relationships free of negative feelings can open the door to growth and recovery.
3. Finding a Residential Community
Patient Needs and Treatment Options
As you make your way through our Directory of Residential Treatment Programs, you will discover many differences among communities. How do you know which psychiatric treatment approach is best? Which residential structure will work best? For example, how do you know if a same-sex community is best – or not a good idea? How do you know whether more independence is a good idea – or a recipe for back-sliding?
To find the answer, you can take the following approach:
- Carefully consider psychiatric needs and the facility’s offerings.
- For the person going to the program, experience is the best guide. They should outline the conditions in which their psychiatric condition has improved.
- Family members might reflect on their experience as well. Under what circumstances has the person done better?
- Discuss all of these issues with facility administration and staff.
Questions to Ask
Besides the style of a program, what other key aspects should you research and compare? Here is a checklist of questions to use as you learn about the mental health care offered by ARTA’s resident long term mental health treatment centers:
Demographics of Residents
- What is the age range of residents?
- What is the gender make-up?
- What is their range of psychiatric disorders?
Psychiatric Rehabilitation Staff
- What is the ratio of staff members to residents?
- What are the qualifications of the staff?
- What is the level of supervision and client independence?
- How much interaction is there between staff and residents?
- What kind of relationships do staff form with residents?
- What do administrators look for in staff?
- What qualities are valued?
Therapeutic Treatment Approaches
- Is inpatient psychiatric care offered on-premises?
- What kind of mental health treatment (for example, individual or group psychotherapy, vocational development, treatment for co-occurring addictions) offered?
- How often is treatment offered?
- What clinical treatment if any, takes place off-premises?
- Is psychiatric treatment mandatory or optional?
For some people, this might mean a more intensive approach, including frequent treatment sessions using a variety of techniques, conducted both on and off site. However, for a person who cannot benefit from intensive mental health care, it may make sense to attend a program that works vigorously to connect residents with mental health resources in the surrounding community, to the extent that the person can benefit from them.
Expectations for Residents
- On a daily basis, how much participation in the program is expected of a resident?
- Are residents required to take part in structured activities for a certain number of hours a week, or, can they choose to not participate in much?
- What are the behavior guidelines regarding such things as expression of anger, relationships with peers, and smoking?
- How does the facility respond to violations of these guidelines?
- What is the level of supervision regarding psychiatric and other medications?
- Is there a procedure by which residents move (at their own pace) toward independent taking of medications?
- Do mental health caregivers provide clients with information they are taking for their mental health condition?
- What kind of activities are in the residential treatment facility? Artistic? Vocational? Educational? Nutritional support? Exercise?
- What activities are mandatory, and what are optional?
- Are residents made aware of special interest activities in the general community?
- Are they given practical help (such as transportation) in taking advantage of community resources?
- To what extent are residents helped to find volunteer positions or paying jobs in the community?
Family Support Services
- How easy are family meetings to arrange?
- Are treatment decisions made in collaboration with the family?
- Is there ongoing communication between the residential facility and the family?
- What is the balance between respect for the confidentiality of the adult participating in the program and respect for the need for mental health progress updates on the part of the family who is paying?
We advise you to ask directly about these communication issues, in particular, pinpointing the process of communication among facility, resident and family.
4. Ensuring Family Support
Family members of a person needing treatment for mental illness can contribute something to this search no one else can: they have had the longest and most intimate contact with the person in psychiatric distress. This gives them a unique and valid perspective on their loved one’s ups and downs over the long haul. Here are some ways in which they can make their knowledge pay off.
Share Patient History
It is important that you share your observations and insight with people from the residential programs you are considering. It is also important that you share your perspective with the person who will participate in the program.
Don’t Push Too Hard
Resist the temptation to “sell” your family member to a program you have decided is the right one. Instead, let one place’s rightness emerge over time, as you offer forthright information.
In the same vein, we want to caution you against forcing a fit into a program you’ve heard is “the best.” No residential treatment community is best in absolute terms. The best mental health facility is the one that best meets the needs of the person who needs help.
If, after conversations with people at a treatment residence, it turns out the place is not right for your family member, they will probably suggest other residential communities. You can rest assured that recommendations from ARTA members come from real knowledge of other ARTA residential programs.
Collaborate with the Patient
Residential treatment works best when the adult with mental illness participated voluntarily in selection of the program and the treatment that follows. Inviting the person needing treatment to participate in the discussion is a generally a good place to start.
Collaboration should start with the selection process. We encourage family members to support each other as you research and compare residential treatment communities. For the person in need, this can be that all-important first, concrete step in pulling their life together.
How does this partnership work? After you have narrowed the choice down to two or three likely facilities, review those web sites. Jot down questions or concerns about any aspect of the programs. Participating in the selection process means the person needing care is already buying into making a positive change in his or her life.
5. Conclusion: Choosing from Many Possible Paths
There is no one right path to finding a good match between a person with mental illness and a residential program. There are infinite paths. What you have read here are suggestions from people who hold key positions in residential treatment communities and who have been dealing with families and prospective residents for many years.
You are now ready to use ARTA’s Directory of Residential Treatment Programs for mental illness. We wish you good luck in finding a residential treatment solution that serves you well. And we are confident that if you use the resources we have provided as you do your search, you will experience a better outcome