Levels of care

Standard outpatient care

Standard outpatient care is the level most people start with: scheduled appointments with a therapist, a prescriber, or both, while continuing to live at home and keep up with work, school, and family.

What this level of care is

• Individual therapy, usually weekly or every other week, in 45 to 60 minute sessions.
• Psychiatric medication management with a psychiatrist, psychiatric nurse practitioner, or in some cases a primary care physician.
• Optional group therapy, family sessions, or specialty modalities depending on the practice.
• Delivered in person, by telehealth, or a mix of both.

Who is typically referred

• People experiencing symptoms that interfere with quality of life but not with basic functioning or safety.
• People stepping down from a higher level of care who now need maintenance support.
• People who want to address a specific issue such as grief, a life transition, or a relationship problem.

What a typical schedule looks like

• One therapy appointment per week is the most common starting point.
• Medication appointments are typically monthly at first, then every one to three months once a regimen is stable.
• Between appointments, care is self-directed — practicing skills, tracking symptoms, taking medication as prescribed.

Insurance and cost considerations

• Outpatient therapy and psychiatry are the most widely covered mental-health benefits under commercial plans, Medicaid, and Medicare.
• Copays, deductibles, and session limits vary; ask whether the clinician is in network before the first visit.
• Many practices offer sliding-scale rates. Community mental health centers are required to serve people regardless of ability to pay in many programs.

What this level is not

• It is not a crisis service. Most outpatient clinicians are not available between sessions.
• It is not intensive enough for someone who is unsafe, unable to function day to day, or deteriorating despite regular treatment.
• It is not supervised care — nobody monitors medication adherence or daily safety.

Questions worth asking

1. What is your training and license type, and what conditions do you most often treat?
2. How do you decide whether a different level of care is needed?
3. What happens if I have a crisis between sessions?
4. Do you coordinate with my prescriber or primary care doctor?
5. What is the expected cost per session after insurance?