Just as no two individuals are the same, so too are everyone’s behavioral health needs unique. Even when two people suffer from the same mental illness—such as depression, anxiety or schizophrenia—the severity of their condition can vary greatly. Depending on the individual, a mental health issue could be a minor inconvenience in their life or a debilitating condition that impairs their day-to-day functioning.
When a person seeks treatment to help manage a mental illness, the level of care they receive should match the severity of their needs. For consumers with lesser needs, standard outpatient therapy (which typically consists of 30-minute to one-hour sessions no more than once or twice a week) is often sufficient to help them with their challenges. On the other hand, consumers who are experiencing a period of extreme need may be admitted to a psychiatric hospital for inpatient care. But what if a person’s needs are somewhere in between—too great for outpatient care to fully address, but not severe enough to warrant hospitalization?
Consumers who struggle with substance use disorder have the option of Intensive Outpatient Treatment (or IOT) if they fall within this category. However, consumers with other mental health challenges have not traditionally had access to this level of care, which is a gap that Sarah Gunther of KEY Consumer Organization has been passionate about filling. Gunther explains,
“I am on the Cummins Consumer Advisory Board, where I’m able to give some direction on ways that Cummins can improve. Every time we’ve had a conversation about substance use IOT, I’ve advocated for general mental health IOT as well. I thought it could help a lot of people as a step between purely outpatient and inpatient treatment. Not everyone benefits from hospitalization, which can actually be harmful for some people, but they might benefit from more intensive help than they get with regular outpatient care.”
At the suggestions of Gunther and other advocates, Cummins Behavioral Health has begun providing Intensive Outpatient Treatment for consumers with challenges not related to substance use disorder. We believe this program will help more people get the right kind of help for their behavioral health challenges, right when they need it. In this blog post, IOT group facilitator Christina Kerns explains who the program benefits, how it works, and exactly what it does help individuals with greater mental health struggles.
MHIOT: How It Works and Who It Can Help
Mental health IOT (or MHIOT) is a relatively simple program in practice, though it does require a large time commitment from consumers. Therapy is administered in a group setting, with group members meeting three days a week for three hours each day. During sessions, group members discuss whatever mental health difficulties they’re experiencing, provide input and communal support for each other, and learn life skills that can help them through their struggles.
As the group facilitator, Christina’s primary job is to ensure that the session runs smoothly. “I help keep the discussion moving,” she says. “I’m there to give feedback on any issues, help group members reach their treatment goals, and assist them in identifying common themes with one another so they can work together and help each other heal and grow. It’s so important because group members learn how to problem solve and cope with their challenges together.”
As mentioned above, the program is ideal for people whose needs are too great for standard outpatient treatment but not severe enough for inpatient treatment. In practice, many consumers are referred to MHIOT as a means of preventing hospitalization or as follow-up care after a stay in the hospital. “Our hope is to provide consumers with additional services so that we can help prevent crisis situations and hospitalizations from occurring,” Christina explains. “And if anyone has been hospitalized within the last month, we like to check and see if our group would be appropriate as a step-down for them.”
Although it has only been running since the end of June, Christina reports that many consumers of MHIOT have responded favorably to the program. It’s her opinion that the group format has been especially beneficial for helping members achieve their mental health goals. “The mental health IOT group is extremely important to Cummins, because so many individuals within our communities who are trying to manage a mental illness do not have access to support groups,” Christina says. “Since we’ve started this group, many of our consumers have found it helpful for their recovery to share their experiences in a safe and confidential setting, which allows them to gain hope and develop supportive relationships with one another.”
What Happens During a Typical MHIOT Session
We’ve explained the underlying principles of mental health IOT, but what exactly do these principles look like in practice? How do group members work toward their mental health goals, and what does Christina do to guide each session? What should someone expect the first time they attend a group?
Like many group therapy sessions, every MHIOT meeting begins with introductions. “We have five basic questions that everyone answers,” Christina explains. “They tell us their name, how they’re feeling that day, any court issues they’re willing to discuss, what skills they’ve used since the last session, and whether they’re having any suicidal ideation, homicidal ideation, or thoughts of self-harm.” The group works through each member’s answers one by one, providing emotional support and guidance as needed.
After introductions, Christina leads the group in a discussion of their recovery values, including a daily reading to help members understand and apply each value. Once this is done, the group typically moves on to a lesson on mindfulness. “We teach the ‘wise mind,’ which is about not getting stuck in our emotional mind or our rational mind, but mixing the two together,” Christina says. “A lot of our members had no idea whether they tended to react with their emotional mind or their rational mind, nor did they know how to identify what feelings they’re feeling in the moment. It’s really a process that we have to teach ourselves.”
Finally, each session ends with training and discussion on a life skill that can help group members achieve their mental health goals. These skills are taken from dialectical behavior therapy (or DBT), a type of psychological therapy that emphasizes validation and acceptance. According to Christina,
“We chose dialectical behavior therapy because it’s the basis for skills training, and it’s been shown to help an array of diagnoses—especially serious mental illnesses like depression, anxiety, and personality disorders. There are three bases that I teach from: on Monday, we focus on distress tolerance skills; on Wednesday, we focus on interpersonal effectiveness skills; and on Friday, we focus on emotional regulation skills. So the group is learning how to recognize and identify their emotions, how to interact with other people, and how to use these skills to improve their mental health and wellness.”