When to Refer to a Higher Level of Care

MENTAL HEALTH

  • Stabilization for
    • Self-harm
    • Bipolar Disorder
    • MDD
    • Trauma
    • PTSD
  • Plateau in treatment with talk therapy or medication management
  • Symptoms disrupting everyday activities
  • Problems with school, work, DUIs
  • Absenteeism/presenteeism at work
  • Unable to maintain healthy relationships with family or friends
  • Requires more support than can be provided in an outpatient setting

EATING DISORDERS

  • Large weight fluctuations
  • Abuse of diet pills, diuretics, or laxatives
  • Compulsive or excessive exercise
  • Avoidance of food or food groups
  • Bingeing and/or purging with regularity
  • Food refusal

SUBSTANCE USE

  • Have experienced relapses after medical detox
  • Previous treatments haven’t been successful
  • Substance use is negatively impacting work/school
  • Absenteeism/Presenteeism
  • Fights with peers/teachers/colleagues
  • Legal troubles (e.g., DUI)
  • “Non compliance” with legal entities
  • Needs additional support for co-occurring mental health conditions
  • Multiple positive urinalysis tests.
  • Court order due to relapses.
  • Continued consequences connected to relapses with little to no understanding on how to cope with cravings and triggers.
  • Continued use despite being given ultimatums.
  • Relapsing and having little to no motivation to disconnect from unhealthy environments.
  • Exacerbation of mental health symptoms that make recovery in an outpatient setting unlikely due to having a need for stabilization in a co occurring setting to address issues concurrently.

TMS/KETAMINE

  • Major Depressive Disorder (MDD), Persistent Depressive Disorder, Postpartum depression, Seasonal Affective Disorder (SAD)
  • Persistent despite talk therapy, medication management or other traditional interventions
  • Have tried one or more than one medication without success
  • Do not want medication
  • Because of issues with addiction recovery/sobriety
  • Do not want the side effects associated with certain medications
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