Outpatient vs. inpatient treatment for the chronically mentally ill with substance use disorders

Treatment decisions about complex patients with both substance use disorders and chronic mental illness cannot be reduced to an inpatient vs. outpatient dichotomy. Treatment progresses through a series of stages, in each of which we must make decisions about treatment settings and approaches. I discuss treatment decisions within the framework of a staged treatment model, reviewing decisions to be made during stabilization, engagement, persuasion, active (or primary) treatment, and relapse prevention (or aftercare).