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Difference Between Inpatient and Residential Mental Health Treatment

November 02, 2020

Written by Tom Gettelman, PhD, Chief Clinical Officer & Director of Admissions

What is the difference between inpatient and residential treatment?

Acute Inpatient Hospitalization

  • A person is actively suicidal or homicidal or their psychiatric symptoms are so extreme that they are unsafe in their daily lives

  • Units are locked to allow for closer observation and can thus serve clients who are under involuntary status

  • Typically not a long term treatment program (3-7 days)

Residential Treatment

  • A person is struggling with mental health issues that have affected their ability to be successful in school, work, and life.

  • A voluntary, unlocked facility. Clients are not forced to enter treatment and can choose to leave at any time once in treatment.

  • Usually a longer treatment program (average 30 days)

  • Treatment is intensive, community-based, and geared towards therapeutic skill building and coping mechanisms to practice during and after treatment

HopeWay is a residential treatment program. Clients often enter our residential program either as a step down from acute, inpatient hospitalization or as a way to prevent a hospitalization. It is similar to the following analogy:

If you were to break your hip, you would go to the hospital for immediate attention and possible surgery. You may then step down to a rehabilitation facility to give your hip time to heal and to work with a physical therapist.

HopeWay was created to essentially provide a place for you to rehabilitate your brain. The residential program allows clients to receive 24/7 care while participating in intensive group and individual therapy.


Benefits of Residential Treatment


Residential treatment facilities offers more intensive and longer term treatment than what is possible in a hospital. Individuals are typically in an acute hospital for 3-7 days, while clients are our residential facility for an average of 30 days. The extended time allows medications to be leveled and adjusted, if needed. Clients have the opportunity to participate in extensive therapy which can often facilitate the healing process. Time allows clients to break pre-existing bad habits and learn new, healthy habits. Also, time provides more information which helps clarify complicated diagnostic pictures. HopeWay’s team of experts have the ability to work with clients in various settings which can be instrumental in understanding specific diagnoses.


Residential clients meet with their primary therapist on a weekly basis for individual or family therapy, meet with their psychiatrist weekly for an individual session, and attend many hours of group therapy each week. Due to the length of stay and structure of the program, clients have the ability to build strong rapport with their therapists and other healthcare providers while also building beneficial relationships with other clients. This allows for deeper connections, honest conversations and shared healing. It is very common for individuals suffering from a mental health condition to isolate. They may not have the energy to be in social situations or it feels safer to be alone.

Residential treatment provides a safe environment to start engaging in social interaction again. The social aspects of treatment at HopeWay are some of the most beneficial and are frequently cited as such by clients. This can be seen during group therapy when clients hold each other accountable and push each other outside of their comfort zone to initiate the recovery process.


While in the Residential Program, clients are expected to follow a structured weekly schedule and participate in all therapeutic programming. The schedule includes meal times, group therapy, individual therapy, exercise and individualized down time. This gives clients the opportunity to establish a consistent routine, while also focusing on self-care, which is often lost when someone is suffering with a mental illness. This practice provides a good foundation that clients can apply to their life when they transition out of treatment. Maintaining a healthy routine is extremely important to maintain gains made in treatment.


Clients entering the residential program pack their belongings from home like they would if they were going on a trip. Each client has their own individual room and bathroom with common areas within the residential unit. There are nurses on staff 24/7 in case a client needs help or support at any hour. The residential unit was designed to feel like a home, with a comfortable, inviting and safe environment and décor which supports the healing process.


Both residential treatment and acute inpatient hospitalization are vital parts of the mental health continuum of care.

Often times professionals in each setting collaborate to make sure people are receiving the appropriate level of care, at the appropriate time. Residential clients will often say:

The first few days can be uncomfortable due to the new environment and new faces. However, it gets better! You just have to trust the process.

While treatment is hard work, for many it is life changing.


Tom Gettelman, PhD

Dr. Tom Gettelman, Chief Clinical Officer, has over 25 years of experience in residential, PHP, and IOP facilities for children, adolescents, teens, and adults. He has held positions such as Vice-President of the Mindy Ellen Levine Behavioral Center and Mecklenburg County’s representative on the North Carolina Commission for Mental Health, Substance Abuse, and Developmental Disability. In addition to serving as HopeWay’s Chief Clinical Officer, Dr. Gettelman serves on the board of Davidson Lifeline, as well as the Governance Committee for the Teen Health Connection. Dr. Gettelman received his bachelor’s degree in psychology from the University of Wisconsin-Milwaukee and his Doctorate degree in clinical psychology from the University of South Florida.


Learn More About Residential Treatment


Editor’s note: This blog post is presented for informational purposes only and is not meant to diagnose or treat any illness. If you have any health concern, see a licensed healthcare professional in person.