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Eating Disorder Professional Treatment - Inpatient and Residential

Bridget Engel, Psy.D., edited by Kathryn Patricelli, MA Updated: Feb 23rd 2017

Inpatient and Partial Hospitalization

If you (the patient) are in serious physical danger and cannot be treated or maintained safely without immediate medical interventions, the professional who is examining you may arrange for intensive treatment. Treatment in a more intense structured setting may also be required if your symptoms are out of control and danger appears to be an immediate possibility. Inpatient treatment involves around the clock care in a medical or hospital setting. It is designed to treat medical complications and restore weight, as well as provide limited therapy.

iv bag If you are not following treatment recommendations and doctors feel that your life is in jeopardy unless you receive treatment immediately, you may be admitted to the hospital against your will. This is known as "involuntary commitment". If you continue to refuse food and nutritional supplements while in the hospital, you may need intravenous (I.V.) feedings to save your life. Involuntary hospitalization does not typically last for long periods of time. The goal is to physically stabilize you, and prevent serious medical complications and death. Insurance companies cover the cost of brief admissions to the hospital only when medically necessary and thoroughly documented by qualified professionals.

If you need more support than can be given through outpatient therapy but need less supervision than an inpatient program, you may be asked to attend a partial hospitalization or day treatment program. These programs are becoming more popular as an alternative to the very high cost of inpatient programs. You will attend treatment at a hospital or clinic several days per week for a few hours each day. You will not sleep at the hospital, but instead return to your home in the evening.

Residential Treatment

Residential facilities offer 24-hour care to people who may not be in serious medical danger but who continue to do eating disordered behaviors. These patients need intensive support to help them with daily functioning. This might include people who use binging, self-induced vomiting, laxative abuse, compulsive exercise, and restricted eating. They might not have serious medical problems yet, but can't stop these behaviors without intensive supervision. These programs generally offer specialized treatment, including supervision of behaviors and daily living activities. However, they still provide people with opportunities for increasing responsibility for their own recovery. These programs are often located in medical hospitals or exist in estates or renovated houses. It is not very common for insurance companies to pay for this type of program. Generally, the patient or their family must pay "out-of-pocket" (without insurance benefits) for residential care.

Another option is a stay in a halfway or recovery house. These options provide support and relapse prevention within a less structured setting than a typical residential program. These programs offer care in between hospital and regular home environments where residents can live with others who are also in recovery. Residents attend group therapy and recovery meetings. They go to individual therapy, either as part of the house program or with an outside therapist. Residents are typically generally free from the worst behavioral, physical and medical eating disorder symptoms already. They are working toward living in the community again.

Typically, care progresses along a path. It begins with immediate, life-saving treatments in a hospital setting. Then the person moves to partial or residential programs and intensive therapy and then to less frequent outpatient therapy sessions. As people gain physical and emotional health (or if treatment started at a less severe stage), they will transition to a recovery program or to outpatient services while living at home again. As needed, they may return to a more intense level of care if symptoms come back or they feel out of control again.

 

    Reader Comments
    Discuss this issue below or in our forums.

    insurance ? What insurance - linda - Nov 29th 2010

    Maybe if we got all our kids with anorexia together befor the media and named our insurance co.'s we might get someones attention.

    HELP IF YOU CAN!!! - tara - May 24th 2010

    I have a ten year old that has Anorexia..I understand all of your comments..I am completely frustrated..I am a single working mom with medical..and can't get the help my daughter needs..she has been admitted into the hospital..discharged..we go from one therapist to the next..physc to the next..etc...on and on..all saying she needs higher care..she needs an inpatient eating disorder program which the insurance will not pay..meanwhile they give us the run around and pay for things that aren't helping..wsting time and money when in all reality is not doing a thing for my daughter..it has been 4 months now she hasn't eaten 1 bite of food..she lives on ensure plus..they just keep uping her meds..but hey guess what if you are a drug addict they will pay foor inpatient!! I could go on and on for hours about what we have been through..but why..I'm sure you already know..IF YOU KNOW ANYONE ANYWHERE THAT CAN HELP MY DAUGHTER GET INTO AN INPATIENT EATING DISORDER PROGRAM ...PLEASE..LET ME KNOW!!THANK YOU..AND GOD BLESS ALL OF YOU..

    RN - - Jun 29th 2009

    I work for Medicaid and we can only enroll facilities if they agree to our rate which is about 400 or 500 per day.  Many do not want to as they make more money from private pay.  There is a site I found called River Centre Clinic that will let you pay a flat fee for 3 months of care.

    Insurance Is Horrible for Eating Disorders - - May 20th 2008

    I totally agree with all of you and I know we are not alone. I too want to get my daughter in Residential but insurance refuses to pay or even help. They will pay for a hospital inpatient which is only for a short time. How can patients recover from this if insurance does not care. I have tried and I am exhausted and like all of you am not rich. I feel so frustrated and angry and very sad about this. I wish you all the best.

     

    insurance - - May 14th 2008

    I think insurance needs to reevaluate covering eating disorders.  Its horrible when we have sick children and can't get them care unless we are really rich!  I am soo disgusted with the system and feel that something must be done to save our children's lives.  Any ideas?

     

    Insurance ???? - - May 3rd 2008

    I am in a similar situation, I can't get insurance to cover my daughter for inpatient only for hospital!! I am so frustrated.

    i relate - Patti - Apr 21st 2008

    rachael i get what you mean. i'm in a similar boat too. i'm in the process of trying to apply for medicair and disability. try looking into things like "charity care" with hospital programs and grants and scholarships. there are a couple groups that give scholarships like Anna Westin Foundation @ 952-361-3051 or 651-645-5323 and the Freed Foundation @ 908-756-9260. Also there's team braeden (http://www.teambraeden.org/teambraeden/index.php). Anyways i'm in the same mess and i wanted to reach out. best wishes to you. i hope we both can recover.

    Getting Your Insurer to Pay for Treatment - - May 1st 2007
    Many insurance companies either don't cover treatment for eating disorders at all or routinely employ a number of trickes to avoid paying for treatment.  There's some good information on the Mirasol web site about what you can do to get the most out of your insurance.  One thing for sure:  YOU need to be the expert!  See http://www.mirasol.net/nview.php?r=25

    I agree - - Apr 28th 2007
    Since becoming more aware because of a family member's diagnosis of anorexia, I have found that there isn't much help from insurance. But that same insurance will have to pay when you are hospitalized near death and that cost could be even greater, so I don't understand them at all. If your condition is anorexia, talk to your doctor about medication, there is one that is supposed to help you gain weight, zyprexa. And like the doc told my family member....at some point you have to decide seriously to become a part of your own recovery.  I wish you the best.

    ?? - Rachael - Mar 11th 2007

    I think its actually pretty bad. I believe that atleast some residential programs should accept medicaid or have free treatment or scholarships because people, such as me, i have used up all of my insurance benefits for my LIFETIME and i am recommended to residential by my treatment team but i have no money for it and no one accepts what i have and i know many others have this problem and i think it is really sad. Thats just opinion.

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