Is IOP the Right Fit? Here’s How Charlie Health Determines the Right Level of Care

When someone is struggling with their mental health, the last thing they need is more stress, like trying to figure out what level of care will actually help them feel better. Put simply, an IOP is a type of treatment consisting of multiple hours of structured therapeutic support per week, including both individual therapy and group sessions. 

An IOP offers an opportunity for people to heal from serious mental health conditions while still participating in their day-to-day lives, but it’s not always clear whether it’s the right treatment plan for them.

That’s why Charlie Health takes out the guesswork — because an IOP isn’t right for every client. Some people might need less intensive care, while others might need more. 

Read on to learn about how Charlie Health assesses prospective clients to determine whether IOP is the right fit — plus, what happens when it isn’t. 

Why assessment needs to come before treatment

Before starting treatment with Charlie Health, everyone must go through a comprehensive biopsychosocial assessment, or BPS. The BPS helps Clinical Admissions Team members get to know potential clients — in the biological, psychological, and social realms — to understand their history and the severity of their symptoms. 

“The BPS is critical because it ensures clients are receiving the right level of care from the start,” says Jackie LeBlanc, LICSW, LCSW, Director of Clinical Admissions at Charlie Health. “A thorough assessment helps us determine whether Charlie Health can safely and effectively meet a client’s needs and whether [virtual] IOP is the most appropriate treatment recommendation.”

This process helps answer a crucial question: What level of care will actually help this person the most, even if it isn’t our own program?

“Mental health treatment is not a one-size-fits-all. If we admit someone who requires a higher level of care, we risk delaying the intensive support they need,” LeBlanc says. “Conversely, if someone’s needs could be effectively addressed through a lower level of care, we want to avoid over-treating.”

This assessment ensures that:

• People in active crisis get urgent care ASAP
• People who need intensive support from an IOP receive it
• People who don’t need an intensive level of care avoid unnecessary overtreatment

What to expect from a biopsychosocial assessment

The biopsychosocial assessment is a chance for a clinical admissions team member to touch on a lot of aspects of a client’s needs and history, including: 

• Symptoms of anxiety, depression, self-harm, or suicidal ideation
• Current emotional and physical pain on a 1-10 scale
• Prior psychiatric diagnoses, if applicable
• Substance use history and severity, assessed against ASAM Criteria when present
• Family history of substance use, disordered eating, mental health conditions, and suicide attempts or deaths
• Physical and dental health, including recency of routine care

The BPS assessment then seeks to understand the client’s non-clinical life circumstances, such as:

• Past and present living situations
• Relationships with family and peers
• Hobbies and interests
• The role of spirituality or faith in their lives
• Relationship status and sexual orientation
• Formal accommodations at school or work (such as a 504 plan or IEP)
• Education and employment history
• Legal history, including probation status, upcoming court dates, prior charges, time in detention, and any court-ordered treatment

It also evaluates how a client is operating day-to-day, covering:

• Any history of aggression and its triggers
• Difficulty with school or work attendance
• Difficulties with hygiene or basic functioning
• Sleep patterns including trouble falling or staying asleep
• Eating habits

Ultimately, all of these questions determine how severe an individual’s symptoms are, how significantly they’re impacting functioning, and how much support they currently have.

So, who is a good fit for an IOP?

Someone who needs more support than weekly therapy but doesn’t require 24-hour supervision is a good fit for an IOP, LeBlanc says. They may experience significant mental health symptoms that impact their daily functioning, but they can still remain safe in their community, she says. The clinical admissions team member will be able to gauge this based on the BPS.

According to LeBlanc, some signs an IOP is a good fit include:

• Ability to participate in treatment several days per week for around 10-15 hours per week
• Motivation and willingness to engage in care
• Stable enough to remain in their home environment
• Presence of some level of support system or safety planning
• No imminent safety concerns requiring immediate intervention

Who needs a higher level of care than an IOP?

People with high-acuity needs or those in high-risk situations require a higher level of care than an IOP, since an IOP is not emergency care.

7 min read

What Does High Acuity Mental Health Mean?

IOP

LeBlanc says some red flags that someone may need a higher level of care include:

• Active suicidal intent with plan and inability to maintain safety
• Recent suicide attempts requiring ongoing acute stabilization
• Active psychosis that significantly impairs functioning or reality testing
• Severe substance withdrawal risk requiring medical monitoring
• Medical instability, particularly with eating disorders
• Homicidal intent or significant risk to others
• Cognitive or behavioral impairment that would prevent meaningful participation in group-based treatment
• Situations where a client cannot safely remain in their home despite safety planning and outpatient support

Higher levels of care include:

• Partial hospitalization program (PHP): An outpatient program that’s even more intensive than an IOP. The time commitment is typically 25-30 hours a week. 
• Inpatient/residential treatment: 24/7 monitoring at a general inpatient psychiatric unit, psychiatric hospital, or substance abuse and addiction treatment units.
• Emergency department care: If someone is in imminent danger, they may need to go to the emergency room for stabilization before they continue onto other care (whether that’s an IOP, PHP, or residential treatment.

Who needs a lower level of care than an IOP?

People who have mild to moderate mental health symptoms may not need 10+ hours of care a week. Many people with mental health conditions see great results from traditional once-weekly therapy, especially if they are working with a clinician who’s the right fit for them.

“If the [admissions] clinician determines that the individual’s symptoms are mild, stable, and manageable through outpatient services, they may recommend a lower level of care such as weekly individual therapy, psychiatry, family therapy, or community-based supports rather than IOP,” says LeBlanc.

However, if a Charlie Health Admissions team member decides someone doesn’t need an IOP, they won’t be left on their own — the clinician will offer to connect them with our Care Navigation team who can provide more appropriate recommendations and make warm handoffs to the right resources, LeBlanc adds. 

The bottom line

Whether or not Charlie Health’s IOP is the right fit, a biopsychosocial assessment with a Clinical Admissions team member will help point in the right direction, determining which level of care will be the most helpful. 

“The ultimate goal is to place each client in the level of care that gives them the best opportunity for safety, engagement, and long-term recovery,” says LeBlanc.