Timme & Associates

Need Psychiatry NOW! “Urgent” vs “Emergent”

To help maintain the sanity of our patients and our staff, we share this concept with our patients for educational purposes only. Timme & Associates is NOT an emergency clinic. This blog is not medical advice nor does it list individual treatment options. Instead, the goal is to provide education about the levels of care inside the mental health system.

Life is a lot. There are bound to be times when you feel overwhelmed and need more help. As an outpatient practice, we have strengths and shortcomings; after all, we’re human too. One of our weaknesses is that we can’t be all things to all people all the time. This is where terms and definitions are super important.

“Outpatient” psychiatry generally means working with a patient that does not need psychiatric interventions (e.g., medication changes, therapy, coordination of care, etc.) from their clinician more than once a week. To distinguish between “urgent” and “emergent,” keep in mind the phrase “threat to self or others.” Anything that creates a threat to self or others (self harm, suicide, hallucinations) is considered emergent. If this is you or your loved one, call 911 or go to the nearest ER as they are staffed to give immediate interventions.

Outpatient psychiatry cannot typically service urgent or emergent concerns. Our clinicians work diligently to give each person in the office their undivided attention; urgent and emergent concerns would break that attention. Disruptions to a person’s treatment planning creates ripples that can affect other patients and staff.

Crisis Care Centers are also a great resource to consider in emergent mental health situations. These centers offer walk-in services for individuals experiencing a psychiatric crisis, often as an alternative to the emergency room. Staffed with mental health professionals, they can provide rapid assessment, crisis intervention, and short-term stabilization. Many are open 24/7 and serve as a compassionate and effective bridge to ongoing care when someone is in acute distress but may not need hospitalization.

Here are two local Crisis Stabilization Units:

“Urgent” situations generally need a response within 24-48 hours. Intensive Outpatient Programs (IOP) and Partial Hospitalization Programs (PHP) are designed to be the answer to the “urgent” need because they are staffed to perform “rolling evaluations,” typically from morning to evening.

As a step between “outpatient” and “emergency/inpatient” care, IOP and PHPs serve a vital and important function in the mental health ecosystem. IOPs are generally 3 hours a day of therapeutic work 1-5 days a week, whereas PHPs are 6 hours a day of therapeutic work for 5 days a week. With both programs, the person enrolled is allowed to return to their homes for the evening to try out the skills and processes they learned during the day and review them with their therapy team the next day.

Each level of care in the mental health ecosystem (outpatient, IOP, PHP, emergency, and inpatient) plays an important role; it is critical to get people to the right level of care as soon as possible. At Timme & Associates, we offer psychoeducation (like this blog) to make sure our patients know their options; our fear is that you would wait for care that is already accessible and appropriate.

The San Francisco North Bay is home to amazing IOP and PHP programs. We encourage you to contact them directly if you’re having urgent concerns and unable to see your psychiatrist within 1-2 weeks. Listed in alphabetical order:

We do not expect you to know if you or your loved one needs IOP or PHP. As part of the mental health ecosystem, each resource above – as well as Dr. Timme and her fellow clinicians and staff – are all trained to help you figure out which level of care you need. Give us a call, fill out an intake form, or send us a HIPAA-friendly email. We’re happy to help!

Categories: , ,
Tags: , , , , , , , , , ,