Community-Based Outpatient Mental Health Therapy
Outpatient psychiatric treatment is an intensive therapy intended to help people who are dealing with serious mental distress and complex mental conditions. Treatment is designed to help stabilize the mental state, promote recovery and prevent the need for psychiatric hospitalization in a hospital.
Outpatient treatment offers various individual and group therapies by a multidisciplinary staff that includes psychiatrists, psychologists, nurses, social workers and other practitioners. The therapy is provided in a special complex that creates a therapeutic environment for people who arrive between 3 and 5 times a week, for 6 hours each time. The program provides at least one hot meal per day of therapy. Most outpatient programs operate in the morning, but some operate in the afternoon and evening to allow patients to maintain employment or academic continuity, even if part-time.
Important to know
Important to know
In recent years, there has been a growing trend of developing specialized day treatment programs that focus on specific mental health conditions, such as eating disorders, complex post-traumatic stress disorder (PTSD), postpartum depression, and more.
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Who is suitable for outpatient treatment?
Psychiatric day treatment is intended for:
- People experiencing a severe mental health crisis that cannot be stabilized in an outpatient clinic, and for whom there is concern that without intensive mental health care, psychiatric hospitalization may be required.
- People coping with various mental health conditions, such as a first psychotic episode, schizophrenia and other psychotic disorders, bipolar disorder, major depressive disorder, anxiety disorders, post-trauma, eating disorders, personality disorders, and more.
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Who is not suitable for outpatient treatment
This service is not suitable for situations that require continuous medical supervision, care, and support around the clock:
- Individuals in a life-threatening mental health condition that requires ongoing inpatient supervision and treatment, such as an immediate risk of suicide or severe self-harm.
- Individuals with an uncontrolled physical illness that requires continuous monitoring and medical care in a hospital setting.
- Individuals displaying antisocial, violent, sexual, or severely aggressive behavior that could disrupt the program’s activities.
- Individuals diagnosed with an active addiction that requires detoxification.
Outpatient Services
As part of psychiatric day treatment, individuals can receive a wide range of therapies included in the mental health services basket. Treatment is provided by a multidisciplinary team that includes professionals from various fields, such as psychiatry, nursing, social work, psychology, nutrition, occupational therapy, and creative arts therapies.
These services include:
- Developing a treatment plan: At the start of care, each patient receives a personalized, multidisciplinary treatment plan tailored to their specific needs.
- Treatment coordination: Each patient is assigned a professional staff member who manages and coordinates their care.
- Psychiatric medical care and follow-up: Psychiatric evaluation, management, and ongoing monitoring of symptoms and coping, adjustment of medications, and follow-up on side effects.
- Individual psychotherapy: Provided by specialists in psychology or psychotherapy using various approaches, such as cognitive behavioral therapy (CBT), psychodynamic therapy, or integrative approaches that combine several methods.
- Occupational therapy: Focused on developing and maintaining functional, cognitive, and physical abilities.
- Creative arts therapies: Including visual art, bibliotherapy, drama, music, psychodrama, movement, and dance therapy.
- Group therapy: In addition to individual therapy, group sessions are facilitated by professionals from different disciplines, often working together. These groups may focus on psychotherapy, illness management and recovery, health promotion, or arts-based activities such as movement or photography.
- Nutritional therapy: In day treatment for eating disorders, nutritional therapy is a central part of the overall program, while in other day treatment programs it is provided as needed.
- Family guidance: The current therapeutic approach views the patient as part of their surrounding systems—primarily the immediate family. Therefore, therapy often includes addressing family conflicts and dynamics, as well as involving the family in the therapeutic and rehabilitative process.
- Promoting daily functioning: This service helps patients improve daily living skills, as well as social and occupational abilities. In later stages of treatment, it may also support gradual reintegration into community life, work, or studies.
- Rehabilitation continuity: Support in coordinating ongoing therapeutic frameworks and accessing entitlements through the National Insurance Institute, including eligibility for rehabilitation benefits and services tailored to the individual.
In addition to these services, patients participate in various workshops and activities offered as part of the day treatment program, such as life skills workshops, therapeutic gardening, discussions on current events, and movement activities.
Day treatment services also include coordination with external entities such as health maintenance organizations (HMOs)—for prescriptions, specialist consultations, and medical tests—as well as with rehabilitation, education, and social welfare services when needed.
The activities
- Outpatient care takes place 5 days a week, in the morning or afternoon, for 6–8 hours per day - with all patients attending at least 3 times a week.
- As part of the treatment, 2 meals a day are served, one of which is a hot meal.
- The daily schedule is fixed and structured, encompassing all the services, therapies, workshops, and activities mentioned above.
- Since therapy requires presence and active participation in the therapeutic process, it is important to know that if a person is unable to attend treatment days and participate due to their mental condition, the therapeutic staff will consider referring them to an alternative therapeutic setting, such as a partial hospitalization program (outpatient hospitals or home hospitalization) or inpatient hospitalization in a hospital.
Where Outpatient Services Are Available
Psychiatric day treatment is provided in specialized community programs by health maintenance organizations (HMOs), the outpatient (clinical) departments of psychiatric and general hospitals, and by nonprofit organizations and private providers that operate community mental health services.
List of Psychiatric Day Treatment Centers Across Israel (Hebrew)
Choosing a Day Treatment Program
The choice of a day treatment program is based on the medical recommendation of the therapeutic team according to clinical needs. There are separate psychiatric day treatment programs for adults and for children and adolescents. Additionally, some programs specialize in specific mental health conditions, such as eating disorders, complex trauma, and dual diagnosis.
Another important factor is the geographical proximity of the day treatment program to the patient’s home, as participants are expected to return home each day after treatment.
Application and Admission to Outpatient Treatment: Step by Step
Before starting treatment at the center, the patient must undergo an intake process that includes:
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1Contacting a care provider
To receive the service, you must contact a care provider, psychiatrist or mental health professional and request a detailed letter of referral for outpatient treatment.
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2HMO authorization and financing
If the outpatient treatment is not provided by the HMO, you must obtain prior authorization (Form 17) from the HMO. Admission to outpatient treatment is subject to HMO authorization in advance.
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3Outpatient treatment review and update
Upon receipt of the letter of referral, the outpatient program will issue an update regarding the admission process, the date of the assessment (intake) appointment and the estimated waiting time.
Important to know
Important to know
There is a similar service known as psychiatric outpatient treatment, intensive therapy that is provided in an outpatient framework with no overnight stay. The purpose of psychiatric outpatient treatment is to maintain continuity of care after being discharged from the department while gradually reducing its intensity and assisting the patient to return to their lives in the community.
Thanks to the nursing staff of the "Lev HaSharon" Medical Center for their assistance in writing this article.