Impaired ability to make behavior changes without repeated, structured, clinically directed motivational interventions, delivered in a 24-hour milieu.
LEVEL III.5 – Dual Diagnosis Enhanced
Meets criteria for Level III.5 plus any of (a) through (d):
Reluctance to engage in activities necessary to address a co-occurring mental health problem; OR
Inconsistent follow-through with treatment for a mental problem; OR
Minimal awareness of co-occurring problem; OR
Requires active interventions with family, significant others, and other external systems to create leverage and align incentives.
LEVEL III.7 – MEDICALLY MONITORED INTENSIVE INPATIENT TREATMENT
Status characterized by (a) or (b) or (c):
Despite serious consequences, does not accept or relate the addictive disorder to the problem severity; OR
Needs intensive motivating strategies, activities and processes available only in 24-hour structured, medically monitored environment; OR
Need ongoing 24-hour psychiatric monitoring to follow through with the treatment regimen and to deal with issues regarding compliance with psychiatric medications.
LEVEL III.7 – Dual Diagnosis Enhanced
Meets criteria for Level III.7 plus (a):
a. Lack of commitment to engage in activities necessary to address a co-occurring mental disorder.
LEVEL IV – MEDICALLY MANAGED INPATIENT TREATMENT
Problems in Dimension 4 are not sufficient for placement into Level IV.