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Referral Form: Psychiatric *Please include Written Order or Psych Evil with this form, per IHS requirement* *1. Referring Professional 2. Agency 3. Contact Info *Youth First Name Youth Phone Number
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How to fill out intensive behavioral health services

01
Contact your local mental health agency to inquire about availability of intensive behavioral health services.
02
Schedule an initial assessment with a mental health professional to determine if intensive services are necessary.
03
Complete any required paperwork and provide necessary information about your mental health history and current concerns.
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Work with a treatment team to create a personalized treatment plan that includes goals and objectives for the intensive services.
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Attend all scheduled appointments and actively participate in therapy and other therapeutic activities.
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Regularly evaluate progress and adjust treatment plan as needed.

Who needs intensive behavioral health services?

01
Individuals who are experiencing severe mental health symptoms that interfere with daily functioning may benefit from intensive behavioral health services.
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People with a history of trauma or abuse may require intensive therapeutic support to address underlying issues.
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Those with a dual diagnosis of mental health and substance abuse disorders may benefit from integrated treatment in a intensive program.
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Individuals who have not responded to traditional outpatient therapy may need more intensive and focused treatment.
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Intensive behavioral health services involve specialized treatment and support for individuals with significant behavioral health needs.
Providers or facilities offering intensive behavioral health services are required to file for these services.
Providers must fill out the necessary forms and documentation required by the governing body overseeing intensive behavioral health services.
The purpose of intensive behavioral health services is to provide comprehensive care and support for individuals with complex behavioral health issues.
Providers must report detailed information about the individual receiving services, the treatment provided, and the outcomes of the interventions.
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