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Text Box 2Levels of care for addiction treatment (Mee-Lee et al., 2001)

Level I. Outpatient treatment

Treatment provided in regularly scheduled sessions at a treatment centre, designed to help the individual achieve changes in their alcohol use and physical, psychological and social functioning

Level II. Intensive outpatient treatment/partial hospitalisation

An organised outpatient service that delivers treatment services during the day, before or after work or school, in the evenings or on weekends. Such treatment may include medical and psychiatric assessment and treatment, medication, psychological interventions, and educational, housing and employment support.

Level III. Residential (medically-monitored) treatment

Organised services staffed by designated addiction treatment and mental health personnel who provide a planned regimen of care in a 24-hour live-in setting. Such services adhere to defined sets of policies and procedures. They are housed in, or affiliated with, permanent facilities where patients can reside safely. They are staffed 24 hours a day. They all serve individuals who need safe and stable living environments in order to develop their recovery skills. Such living environments may be housed in the same facility where treatment services are provided or they may be in a separate facility affiliated with the treatment provider

Level IV. Medically-managed intensive inpatient treatment

Provide a planned regimen of 24-hour medically directed evaluation, care and treatment of mental and substance-related disorders in an acute care inpatient setting. They are staffed by designated addiction specialist doctors, including psychiatrists, as well as other mental-health and specialist addiction clinicians. Such services are delivered under a defined set of policies and procedures and have permanent facilities that include inpatient beds. They provide care to patients whose mental and substance-related problems are so severe that they require primary biomedical, psychiatric and nursing care. Treatment is provided 24 hours a day, and the full resources of a general acute care hospital or psychiatric hospital are available. The treatment is specific to mental and substance-related disorders – however, the skills of the interdisciplinary team and the availability of support services allow the conjoint treatment of any co-occurring biomedical conditions that need to be addressed.

From: 5, ORGANISATION AND DELIVERY OF CARE

Cover of Alcohol-Use Disorders
Alcohol-Use Disorders: Diagnosis, Assessment and Management of Harmful Drinking and Alcohol Dependence.
NICE Clinical Guidelines, No. 115.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society; 2011.
Copyright © 2011, The British Psychological Society & The Royal College of Psychiatrists.

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