Levels of care & kinds of help

In guided self-help, you work through a workbook or online course with support from a therapist. It is based on CBT and is often the first step in NHS talking therapies for anxiety and low mood. If it doesn’t help enough, a different therapy can be offered.

Internet-based CBT, a structured online course based on CBT, has been found as effective as face-to-face CBT for several conditions.

Types NIMH describes

• Self-management: tools for stress, sleep or worry that give feedback
• Skill-building: game-like apps that teach coping and thinking skills
• Supported care: apps that connect you with peers or trained providers
• Symptom tracking: logging mood, sleep and activity, or phone sensors that notice changes
• Thinking-skills training

• A gentle first step for people unsure about seeking help
• Available anytime and anywhere, including remote areas
• Often cheaper than in-person care
• Support between therapy sessions

• Apps may overpromise and put people off care that would help more
• It’s unclear whether apps work equally well for everyone
• Many apps have no research showing they work
• Your personal data may not be well protected

Outpatient care can be with one person, a couple, a family or a group. See the CBT, DBT & other talk therapies and Couples, family & group therapy guides for the options.

In 2024, 12.8% of U.S. adults got mental health treatment by telehealth. Many VA trials found PTSD therapy by video works as well as in person in most cases.

NIMH suggests a physical check-up to rule out physical causes of how you feel. Your primary care provider can also refer you to mental health care.

An IOP gives you therapy several times a week, often a mix of group and one-to-one sessions. U.S. Medicare guidance describes IOP as at least 9 hours of therapy services a week.

When people use it

• As a step down after a hospital or day program
• When someone wants to keep working, studying or caring for family while getting more support
• When weekly therapy isn’t enough

Partial hospitalization programs (PHP) are more intensive than IOP. Medicare guidance describes at least 20 hours of therapy services a week, designed as an alternative to staying in hospital. A professional must confirm that the person would otherwise need inpatient care.

Days usually include group therapy, skills classes, one-to-one sessions and time with the care team. People sleep at home, which keeps them connected to family and community.

• What happens in a typical day?
• How long does it last, and what does it cost?
• Can family be involved?
• What happens when it ends? Is there a step down?

In 2024, 1.3% of U.S. adults had inpatient mental health treatment. The focus is on safety, getting steady and planning what comes next.

Many people step down to a day program or IOP, then to weekly outpatient care. Peer support, routines and relapse plans help people stay well afterwards.

You can call or text 988, or chat online. It is free, confidential and available 24/7. Veterans can dial 988 and press 1.

• Come to a home, school or public place
• Connect the person to follow-up care
• Help calm a crisis on the spot

You can ask 988 whether a mobile crisis team serves your area.

Anyone in the U.S. can text HOME to 741741 for free, confidential support, 24/7.

Assertive Community Treatment is a community-based team of professionals, such as health care providers, social workers and peer support workers, each with a small caseload. It supports people with serious mental illness who struggle to use regular outpatient services.

Intensive case management is a lighter version: a case manager coordinates care and helps with practical needs. A U.S. federal report lists both among the most effective approaches for people with mental health conditions who are homeless or at risk.

Coordinated specialty care is a team offering therapy, family support and education, help returning to work or school, and case management. In NIMH’s RAISE research, this team approach worked better than typical care.

The World Health Organization says prevention programmes have been shown to reduce depression. Examples include school programmes that build coping skills in children and teens, support for parents of children with behaviour problems, and exercise programmes for older adults.

Early intervention means acting when problems first appear. People generally do better when effective help starts as early as possible, as NIMH’s RAISE research on first-episode psychosis showed.

Treatment includes therapies and medical treatment options, which you can talk about with your clinical provider. Recovery support, like peer support, routines and relapse plans, helps people stay well afterwards.

The World Health Organization says physical activity reduces symptoms of depression and anxiety and supports brain health, sleep and thinking. The adult guideline is at least 150 minutes of moderate activity a week, but any amount helps.

The World Health Organization describes social prescribing as connecting patients to a range of non-clinical services in the community. Often a “link worker” finds out what matters to the person and helps them take the first step.

What it can connect people to

• Advice on money, benefits or housing
• Arts, music and creative groups
• Exercise and walking groups
• Gardening and nature groups
• Volunteering and befriending

Housing First offers permanent housing without requiring treatment first, with voluntary support. A U.S. federal report says research has consistently found it leads to greater long-term housing stability and better behavioural health outcomes.

Supported employment and education services give people a coach who helps them return to work or study. They are a core part of team-based early psychosis care in NIMH research.

If your current support isn’t enough, it’s OK to ask your therapist or provider, “Is there a more intensive option?” If you’ve been in therapy a reasonable time without improving, NIMH suggests talking about another approach or professional.

Your primary care provider, insurance company, EAP or FindTreatment.gov (SAMHSA’s locator for mental health services) can help you find the right level of care.

Find A Helpline lists free, confidential helplines in many countries. In an emergency, contact your local emergency number.