February 16, 2023

WISE-ROJAS | Hello From Outside Residential: What is Residential? What Now?

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Trigger warning: this piece contains discussion of suicidal ideation, depression and other mental health conditions.

Hello again. Yes, I’m still writing from California instead of my Ithaca dorm. Nevertheless, instead of writing from residential, I’m writing during my spare time on my iPad at an Intensive Outpatient Program facility. I’m in a better state of mind, but still in treatment. When I tell my friends/people in my life where I’m currently at, I’ve gotten so many questions: What is residential? What do you do when you get out? What’s IOP/PHP? How long will your process take? Honestly, it was quite shocking how much I’ve had to explain myself, despite the stigma around mental health slowly chipping. 

It’s not anyone’s fault that treatment paths are not well-known. To be honest, I used to have the same questions about myself. Cornell students should be educated on the varying paths of mental health treatment in today’s world. Previously, I discussed what happens when you disclose wanting to end your life to a counselor and how being inpatient at a hospital works. I also talked about taking a health leave to get additional help — specifically, going to residential. However, I didn’t explicitly describe what residential was nor the path to treatment as a whole. When the Cornell community is educated on these topics, it can work to destigmatize mental health and teach others that healing is a process, not instantaneous.

Before I dive in, I want to acknowledge how much of a privilege it is to have access to these mental health healing paths —  these resources cost time and money. Additionally, you need the support of people in your life. I have friends and (both biological and chosen) family, alongside mentors, on my side. This is not meant to force anyone to take the same path I did nor suggest that any other kind of path is wrong. This is just to describe my experience and bring awareness to long-term recovery when it comes to mental health.

Part of this conversation that needs to be brought to light is the debate over prevention vs. treatment. Many people advocate that mental health should be treated the same, from a medical perspective, as physical health. From that perspective, there needs to be more healthcare than just crisis care; there has to be a way to sustain treatment in the long-term. It’s similar to how you need to have your yearly physical appointments to screen for all kinds of problems and treatments before matters escalate. I once heard a metaphor that described mental health as a car that needs to be maintained by visits to the tire shop, except the tire shop is a therapist’s office. This is a form of prevention. 

If someone discloses that they’re in a crisis or a danger to themselves or others, they need to be treated. When you reach that point and start to improve, it’s often perceived that “you’re doing better, so you don’t need as much help.” Hearing this kind of response can lead to relapses because effort is only put toward treating someone in crisis, not someone recovering from crisis. 

I kept falling into this cycle — I didn’t take my problems seriously because I thought that it was normal to end up in the psych ward over and over again. Yes, crisis help is important, but simple checks here and there after that are not enough when your problems are chronic. I felt hopeless until I realized that hope is found in gradual progress; I just needed to take time to get there.

The most intensive level of recovery for mental health conditions and substance disorders is inpatient hospital care. This is for those in crisis. For some people, this alone is enough if they have a solid foundation of coping skills and resources. 

The next step below hospital care is a residential facility. You’re not in a hospital, but in a home-like setting with access to resources 24/7. They provide crisis support and overall support for restructuring your life: There’s a schedule. There are rules. You are reminded of how to care for yourself and how to cope with the day-to-day impacts of your condition. You are forced to cope with your history, trauma and other factors that contributed to your condition. My stay in residential was 90 days long, however, people stay varying lengths for a variety of reasons. I stayed 30 days because my insurance wouldn’t cover a longer stay in my situation. 

The step below is PHP, also known as Partial Hospitalization Program. It’s similar to residential in that there’s a schedule, mandated appointments and classes. However, you’re in charge of getting yourself to the facility, putting in the work, getting yourself together and learning how to adapt to the outside world again. It takes place during weekdays for a limited number of hours. The step below that is IOP, also known as Intensive Outpatient Program, which is the same as PHP, just for fewer hours. 

Some people skip over PHP and go straight to IOP depending on their situation; that’s what my case was. What’s next for me (after IOP) is regular outpatient treatment, which is what most people have (a once-weekly therapy session coupled with a once-monthly psychiatry appointment). I’m currently preparing for regular outpatient treatment and trying to find a therapist and psychiatrist that meet my needs in California until I go back to school in August. I’ll then be trying to secure the same support system in Ithaca.

The beauty of this process? There’s no requirement to be at a certain level. In the same way that you can work toward the next level, you can also go backwards if needed. If IOP isn’t enough for me, I’ll go to PHP. If that’s not enough, I might go back to residential — there is no shame in that. All that matters is the fact that you’re trying. 

Today in treatment, we discussed how nothing in life is instant. Treatment is the same way, and it’s not one-size-fits all. Today (as of writing) is day 42 since I’ve started my treatment journey; I’m not “cured” but I’m doing significantly better. For the first time, I feel equipped to handle whatever comes my way. I’m proud of my ability to get help. 

Daniela Wise-Rojas is a sophomore in the College of Arts and Sciences. She can be reached at [email protected]. She served as Dining Editor on the 140th Editorial Board. Anything But MunDANIties runs periodically this semester.

Suicide hotlines:

Cornell Health, speak with a counselor 24/7: 607-255-5155 (extension x4).

Ithaca Crisis Line: 607-272-1616 or 800-273-8325

Advocacy Center (for sexual or domestic violence): 607-277-5000

National Suicide & Crisis Lifeline: 988 

Trevor Project hotline (LGBTQ+): 866-488-7386

LGBT National Hotline: 888-843-4564

TransLifeline: 877-565-8860

RAINN National Sexual Assault Hotline: 800-656-4673

National Crisis Text Line: Text HELLO to 741741 

Steve Fund crisis text line: Text STEVE to 741741 (especially for students of color)

Trevor Project chat service & text line: Text START to 678678 (especially for LGBTQ+ students)