Five Things Families Should Look for In Treatment Centers (November 2022)
By Michelle McCorkle, MPH, CSSGB
This article is reprinted with permission by Michelle McCorkle, MPH, CSSGB and Lightfully’s permission.
Attempting to find a high-quality mental health treatment program for you or your loved one can be overwhelming. Countless programs describe themselves as offering “highly individualized” treatment, present themselves as “trusted” providers, and boast excellent outcomes. It can be difficult to look past the marketing and decide what program is right for you. Because I am a healthcare compliance and quality professional, often family members or friends will ask me about the quality of a particular healthcare facility they are considering. Aside from visiting the facility (which may not be practical depending on circumstances), there are a few key items that I recommend looking for to determine if a treatment program is right for you or your loved one.
- Verify a program’s licensure status on the state licensing website. For higher levels of care (such as residential, detoxification, or inpatient treatment), most states require facilities to be licensed. Most of these states also have publicly available databases where you can verify their license status, what type of treatment they are licensed to provide, and review their most recent on-site survey information. This data includes surveys that are conducted as a result of a patient or family member complaint. If you are having trouble finding your state’s licensing website, you can typically see this information in the lobby at most treatment centers, or you can ask the admissions team at the facility what agency issues their license. While almost every organization will have a few minor findings on a survey, findings that indicate serious safety problems or that staff are not appropriately licensed to provide care are a huge red flag.
- Check a program’s accreditation status. While mental health licensure is a good place to start, licensing requirements do vary dramatically across the nation. Some states do not offer licensure for lower levels of care (such as Intensive Outpatient treatment), requiring only a business license to open a mental health treatment facility.Just because a business has a license to operate does not mean that it is high-quality. Quality programs seek out increased oversight via optional accreditation through organizations like The Joint Commission (TJC) or Commission on Accreditation of Rehabilitation Facilities (CARF). These organizations are nationally recognized and set standards for fire safety, clinical quality of care, client safety, and ongoing process improvement. So,after checking an organization’s licensure status, I will look on their website to see whether they list any type of accreditation. If you can’t find this information on their website, you can always ask the facility’s admission team. You can then check their status by going directly to the accreditor’s website.The Joint Commission offers a website called “Quality Check” to the public: https://www.qualitycheck.org/ High quality organizations will show as “accredited.” If an organization’s accreditation status shows as “accredited with follow up survey,” “preliminary denial of accreditation,” or “denial of accreditation,” there are quality of care issues at the facility. CARF also offers a provider search at http://www.carf.org/providerSearch.aspx High quality organizations will display a “three year accreditation.” If the organization has a “one year accreditation,” “provisional accreditation,” “non accreditation,” or “accreditation with stipulations,” there are quality and compliance issues at the facility.
- Ask for specific information to support generic claims. After checking an organization’s licensure and accreditation status, the next thing I recommend is examining the organization’s claims about treatment provided and treatment outcomes. Virtually every program will state they offer “highly individualized” treatment. However, despite this claim, clients all attend the same group therapy sessions, the same activities, and essentially receive the same treatment. These types of claims are generally fairly innocuous, but some other programs will claim to guarantee recovery or offer “cutting edge” treatment. Good treatment must be evidence-based. While there may be some exceptions, “cutting edge” treatment programs are typically home grown, with little evidence to support their effectiveness. Ask what evidence-based treatment methodologies are used by the organization and how they are incorporated into the treatment program. If a program boasts excellent outcomes, ask about what data is collected to make that determination. If a program guarantees an outcome – run the other way! Mental health treatmentinvolves a dynamic interaction between clients and their treatment providers, and outcomes can never be guaranteed.
- 4. Confirm claims about treatment of special populations. If you are searching for a specialized type of treatment, such as trauma therapy or eating disorder treatment, ask detailed questions about how the facility specializes treatment for that population. Some treatment facilities advertise specialty treatment that occurs alongside general mental health or substance use disorder treatment. Organizations should be able to clearly articulate how their care is tailored to specific populations they say they treat. If a program states they provide residential treatment for eating disorders, ask about dietitian and physician involvement in treatment. If a program states that they provide treatment for trauma, ask if the staff providing that treatment receive evidence-based training or certification, such as EMDR. If a program claims to specialize in treatment for individuals in the LGBTQIA+ community, ask how they verify that their staff are competent to provide treatment to this population. Quality programs are able to articulate both what they can treat and the limitations of the care they can provide.
- Ask about the qualifications of and training for the individuals who provide therapy. If you have completed the steps above and think a program might be right for you, ask about qualifications for direct care treatment providers, such as primary therapists. Most treatment organizations have impressive websites that lists leaders with years of experience and a lot of “alphabet soup” after their names. While these individuals are important to the direction of the organization, they do not typically provide direct treatment services. With the demand of behavioral health services at an all-time high, programs are experiencing substantial turnover of clinical staff who provide direct treatment to clients. Ask the facility you are considering about the qualifications of the individuals who provide group therapy, individual therapy, and specialized therapy. Associate, intern, and even bachelor’s level licensed providers often provide the bulk of clinical services at residential treatment centers with limited to no oversight by an appropriately experienced and licensed staff person. It’s important to ask how those individuals are supported – e.g., how does the organization train or onboard staff, what type of regular supervision by a fully licensed individual is provided, and how does the organization evaluate competence?
Quality based programs will have a robust oversight and supervision process for their clinical staff. They will also invest time and resources into the orientation and ongoing training for that team. Their clinical leadership will be involved in the development of and oversight for evidence-based treatment programs, not just figureheads on a website.
Many programs exist that provide high quality treatment. Lightfully Behavioral Health’s commitment to its clarified clinical model, enlightened culture, and transparent compliance practices cements it as an industry leader in providing truly excellent treatment to the clients they serve.