Help! My spouse/partner/child/parent/friend needs mental health or addictions treatment! Where can they go? How do I know if a program is right for them?
For family and friends of a person experiencing a mental health crisis (and for the person themselves), finding one’s way through the health care system can be incredibly difficult. It is hard to know what is available and how to access it. Once you have found a program, here are some questions to ask:
1. What are the real costs of the program?
Costs vary widely! Some programs are free while others cost thousands of dollars a day. Ask if insurance will pay for all or part of the costs. Also ask about costs that may be incurred in addition to daily fees. Are prescription drugs covered? Does the program provide personal items such as toothpaste or laundry detergent? Is there travel assistance available? If the person drops out of treatment, will fees be refunded?
2. What model does the program follow?
Popular models for addiction and mental health treatment include group therapy, cognitive behavioural therapy, and motivational interviewing among others. See https://www.treatmentsolutions.com/therapies/ for concise descriptions of several models.
Be sure to ask if the program will address both an addiction and a mental illness, as these issues often occur together. Some programs will only treat one or the other.
3. What is the goal?
I.e. for addictions, is the goal sobriety or harm reduction? For mental illness, is it medication adherence or quality of life?
4. How do they measure success?
Hospitals measure success in length-of-stay numbers, but is that how you would define success? A treatment program might say 80% of clients are sober a year after completing the program, but what does that mean? Does that statistic include all clients, or only the ones that responded to a survey? How do they gather their data? Who measures this – is there independent data on their success rates?
5. How much of the time is spent on intensive work for their addiction or mental health concern?
Ask how much of the schedule consists of recreation, rest time, or other activities not directly related to working on the issues. The majority of time should be spent on therapy.
6. What is the level and degree of follow-up?
Do they arrange follow-up or do you need to do this? Who does the follow-up? Ask about the method of follow-up – phone calls, office visits, after-care groups, etc.
7. How does the program involve family/significant others?
When one person has an addiction or mental illness, the whole family is affected. Family and friends also affect the addiction or illness. Therefore, treatment is most effective when it includes the family. Relapse rates in mental illness are reduced up to 20% when family is involved!
Here are some specific questions that families can ask the psychiatrist or other health professionals: http://www.bcss.org/resources/topics-by-audience/family-friends/2005/06/questions-to-ask-the-psychiatrist/
8.Does the program meet professional standards?
Look for programs where therapy is provided by professionally educated and experienced therapists. Are they educated in both addictions and mental health treatment? Also ask about the program’s accreditation and oversight – who monitors it?
9.If the program is a residential one, what rules do they have around visiting and contact with friends and family?
Some programs enforce a visiting ban for the first week or so. Find out exactly what this means.
10.If it is a day program, what provision do they make for after-hours support?
Are program workers on call? What crisis services are available after hours? Asking these questions will help you identify the program that is the best fit for your situation.
My thanks to Patrick Griffith, RN, RPN, BN, MPA, for suggesting several of these questions and reading recommendations.
Dodes, L. & Does, Z. (2014) The sober truth: Debunking the bad science behind 12-step programs and the rehab industry. Massachusetts: Beacon Press.
Ottawa Public Health; Canadian Mental Health Association; Canadian Public Health Association; Mental Illness Caregivers Association; Military Family Services (2016). Mental Health Caregiver Guide: A guide for caregivers of persons living with mental illness or experiencing mental health challenges. Ottawa, ON: Ottawa Public Health.