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MENTAL HEALTH Program: INPATIENT TREATMENT EXTENSION REQUEST Please note complete form in BLOCK CAPITALS Please return this form to nurses cigna.com Hospital name Telephone numberPATIENT DETAILS Name
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How to fill out mental health programme inpatient

01
To fill out a mental health programme inpatient, follow these steps:
02
Gather all necessary personal information, such as name, date of birth, and contact information.
03
Obtain a referral or recommendation from a mental health professional, such as a psychiatrist or therapist.
04
Contact the desired mental health programme inpatient facility and inquire about their admission process.
05
Complete any required intake forms or questionnaires provided by the facility.
06
Provide any additional medical or psychiatric documentation that may be required.
07
Schedule an intake assessment or evaluation with the facility's staff.
08
Attend the scheduled intake assessment, where your mental health and treatment needs will be assessed.
09
Receive an admission decision from the facility based on the assessment results.
10
If accepted, review and sign any necessary consent forms or treatment agreements.
11
Prepare for admission by packing necessary personal items and arranging any necessary logistics, such as transportation.
12
Follow the facility's instructions for check-in and arrival on the designated admission date.
13
Engage actively in the mental health programme inpatient as recommended by the facility's staff.
14
Attend therapy sessions, participate in group activities, and follow any prescribed treatment plans.
15
Communicate openly with the facility's staff about your progress and any concerns throughout your stay.
16
Prepare for discharge by working with the facility's staff to create an aftercare plan and ensuring a smooth transition back to the community.
17
Follow any recommended follow-up appointments or mental health support upon discharge.

Who needs mental health programme inpatient?

01
Mental health programme inpatient is typically recommended for individuals who:
02
- Have severe mental health conditions that require intensive treatment and supervision.
03
- Are at risk of self-harm or harm to others due to their mental health condition.
04
- Have attempted self-harm or suicide in the past.
05
- Require a structured and supportive environment to manage their mental health symptoms effectively.
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- Have not responded adequately to outpatient mental health treatment.
07
- Are experiencing a mental health crisis or acute psychiatric symptoms that necessitate immediate intervention and monitoring.
08
- Need a safe and controlled environment for detoxification from substances while addressing co-occurring mental health issues.
09
- Are unable to safely manage their mental health symptoms and daily functioning in their home or community setting.
10
The decision to seek mental health programme inpatient should be made in consultation with a mental health professional who can assess the individual's specific needs and recommend the appropriate level of care.
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A mental health programme inpatient refers to a structured treatment plan provided to individuals who require intensive support for mental health issues while being admitted to a healthcare facility.
Mental health professionals, healthcare institutions, or facilities that provide inpatient care for individuals with mental health disorders are typically required to file reports on their mental health programme inpatient activities.
To fill out a mental health programme inpatient form, individuals or institutions need to provide patient information, treatment details, diagnoses, duration of stay, and outcomes as required by the reporting guidelines.
The purpose of a mental health programme inpatient is to provide comprehensive care and treatment for individuals experiencing severe mental health issues, ensuring their safety and facilitating recovery in a controlled environment.
Reports on mental health programme inpatient should include patient demographics, diagnosis, treatment plan, duration of stay, discharge information, and any follow-up care recommended.
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