Finding Answers to Complex Questions About Residential Mental Health Treatment

“Often people think that ‘residential treatment program’ just describes the facilities. But it actually indicates a level of care,” says Tonda Williams, Admission Director at Bridges to Recovery. “What it means is that we do not have locked doors or psych techs who can restrain clients.” While this is part of what makes residential treatment inviting for so many and helps dispel the damaging myth that residential care means a loss of agency, it also means that this type of treatment is not appropriate for everyone right off the bat. “Clients have to be appropriate clinically for a residential program, which means they cannot be a danger to themselves or others, psychotic, or anything that would prevent them from being able to participate in the program,” Williams tells me.

Not currently being stable enough to enter into residential treatment immediately shouldn’t deter you from contacting the residential facility you would like to go to, however. A high-quality program can guide you to create a plan of action to ensure you get the care you require in the short term, with a longer-term goal of transitioning to residential care. Often, this means stabilizing in a hospital environment prior to residential treatment. Williams explains, “If someone is experiencing a manic episode and is currently in the hospital but wants to come to our facility, we will work with the hospital to ensure that they are on a therapeutic dose of medication and are cognitively ready to participate in our program.”

Substance abuse and mental health disorders often go hand-in-hand. It is estimated that 50% of people with serious psychiatric illnesses also struggle with a substance use disorder, and 29% of people with any form of mental illness abuse drugs or alcohol. The reasons for this are multiple and complex, and range from genetic predisposition to deliberate self-medication. When the two conditions occur simultaneously, it can be hard to know where to start. “Making the determination of whether or not they are appropriate for a primarily psychiatric program or if they need a chemical dependency program first followed by a psychiatric program can be difficult for patients and their families,” Williams explains.

Although today’s sophisticated dual diagnosis programs offer highly effective treatment for both mental illness and substance abuse, programs still tend to be either more addiction-focused or psychiatric-focused. As such, which program best suits your situation depends on the nature of both of your conditions. Often, however, people in the midst of crisis are unable to accurately assess their own needs and, more importantly, may have limited knowledge of the exact services offered by each treatment facility. As such, seeking the guidance of experienced professionals who understand the unique needs of people with co-occurring disorders is often paramount to ensuring that you receive the care you need in the program that is right for you. “We work very closely with Alta Mira, [a renowned addiction treatment center in the Bay Area], in determining if the client is better suited to begin treatment there or with us.”

While residential mental health treatment can be truly transformative, your success following the program depends on the quality of the program itself and your ability to engage with that program in a productive way. Often, people who have been unsuccessful in previous residential settings or have relapsed following a period of stability following residential care become disheartened and start to lose hope that they will be able to heal.

There is a multitude of reasons someone may fail to improve in residential care or relapse following a residential stay, including misdiagnosis, inadequate therapies, unproductive therapeutic relationships, and simply not being ready to engage with the therapeutic process on a deep level. Many are also surprised to learn that most residential programs don’t provide daily individual psychotherapy, which serves as the cornerstone of treatment at Bridges to Recovery. “We see people who have been in and out of doctor’s offices and on all kinds of medications,” Williams tells me. “Often people come into treatment feeling that they are not being heard from clinicians. With daily individual therapy, people feel heard and they become more involved in their recovery.” And at Bridges, being heard doesn’t just extend to formal therapy; with a maximum of only 6 clients at a time, each person is assured that they will receive the time and attention they need throughout the course of treatment.

For people with chronic mental health disorders who have not been able to find relief in other types of treatment, Bridges to Recovery now offers a 90-day program that gives you the time, space, and support to make the meaningful changes you need to achieve healing. “A lot of the time a client will have stabilized over the course of treatment, but they struggle with basic life skills upon returning home, such as the inability to hold a job,” says Williams. To respond to the needs of these clients, the 90-day program includes an adaptive living program as well as a range of intensive workshops. Because family dynamics often play a vital role in the recovery process, we also offer personalized support for families to secure a smooth transition back into your everyday environment following treatment and optimize recovery. As family dynamics can be difficult to navigate and we must prioritize the well-being of our clients, “we are really careful about how we piece together the family component.”