Understanding the Pediatric Mental Health System

What is in-home mental health care?

Intensive in-home services give kids and families time with someone from their therapeutic team right inside the home — where a lot of struggles often occur. During this time, your in-home therapist or behavior analyst may work with the entire family, including parents, caregivers and siblings. They usually spend between two and 10 hours per week with you, depending on what kind of support your family needs. Typically, in-home care lasts for two to three months. During visits, your care team has the opportunity to see situations happening in real-time, so they can provide advice, care and guidance in the moment. They can sometimes also provide respite care, during which they may give parents and caregivers a break. This is often helpful for families who are considering residential care, who have children on the autism spectrum, or whose children often have conflicts or significant behavior concerns in the home.

Does insurance cover in-home care?

Different insurance companies cover different services, but in-home services are not often covered by private insurance plans. You and your care team will need to work with your insurance company to find out whether or not they cover these services. However, for families on Medicaid, in-home mental health care is often covered.

There are other options for covering the cost of in-home mental health care. Work with your care team and your chosen in-home agency’s team to find out what’s possible.

In-home care and education

Your in-home care visits will depend on your family’s availability, needs and schedule. This means you can often schedule around school so that children don’t miss valuable education time.

In-home mental health providers can help with topics related to education in many ways. If your child is homeschooled, for example, your care team may be able to provide support during their schooltime. Additionally, because some mental health concerns are related to school, such as school refusal, in-home clinicians can see these moments firsthand and give immediate support. 

As with any level of mental health care, it is very helpful to have a release of information (ROI) form signed, so that your child’s care team can coordinate and collaborate on your child’s needs and help them have the best chance of success. An ROI allows your doctor to communicate directly with your child’s school to arrange any accommodations that will benefit their mental health care.

What is my primary care physician’s role during in-home care?

Your child’s primary care physician (PCP) is a constant throughout any type of mental or physical care they receive. It is great to keep them informed about the goals of your child’s care, but they are usually not directly involved with in-home mental health care, unless they are helping with your child’s medication management.

What can you do at home to support your family?

Mental health care can present challenges for everyone in your family. This is especially true for in-home care, as it can feel uncomfortable to have a person in your home experiencing private moments alongside your family. This type of therapy works best when the whole family is committed to engaging, but it’s also important to advocate for your family and maintain your sense of safety at home.

Mental health providers often recommend that family members find mental health care for themselves if they need it, connect with the people in their life who can provide support and to find time for self-care.

What is the next step in care?

While your child is getting in-home care, they may also continue seeing their outpatient therapist or other mental health clinicians. Your doctor may recommend continuing outpatient care, or they could suggest a different type of care, such as residential treatment, intensive outpatient care or partial hospitalization. Your doctor will make these decisions with care and with the individual needs of your child in mind. Your team is there to work with your family to help you toward the best next step.