Guide
When someone keeps getting hurt, or wants to die.
Residential care can help when outpatient therapy has not been enough. The first step is almost never a residential bed. Here is the order that usually works, and what a good program does differently.
If there is danger now
Call or text 988, the Suicide & Crisis Lifeline, or call 911. 988 can connect to a mobile crisis team in many counties.
Tonight
- Stay with the person, or make sure someone does.
- Lock up or remove things that could cause serious harm, if you can do it safely.
- Call 988 together if you are unsure what to do.
This week
- A psychiatric evaluation decides the level of care: outpatient, a day program, crisis residential, residential, or a hospital.
- Ask for a written safety plan before leaving any emergency room or hospital.
- Book a first follow-up within 7 days of discharge.
What a good program does
- Full DBT, the treatment with the strongest evidence for repeated self-harm: weekly individual therapy, a skills group, between-session coaching and a therapist consultation team. “DBT-informed” is not the same.
- A stated plan that keeps treatment going after self-harm, rather than ending it.
- Family involvement, especially for teens.
- A step-down to a day program and outpatient DBT near home.
Checked 1 October 2026
California residential programs built on DBT.
Programs whose own websites describe a full DBT model. Many others mention DBT; ask each the four questions above.
Clearview Treatment Programs
DBT residential with a dedicated BPD pathway. In-network with Anthem Blue Cross.
Optimum Performance Institute
DBT-based residential, then day treatment with housing; an intensive track for BPD.
Questions people ask
Self-harm and suicidal thoughts, answered.
Is residential treatment the right first step after self-harm?
Usually not the first step. Start with safety and a psychiatric evaluation, which decides the level of care: outpatient, a day program, crisis residential, residential, or a hospital.
What is DBT, and why does it matter?
Dialectical behavior therapy is the treatment with the strongest evidence for repeated self-harm. Full DBT has four parts: weekly individual therapy, a skills group, coaching between sessions, and a team that supports the therapists.
What should a residential program do if self-harm happens during the stay?
A good program has a stated plan that keeps treatment going, rather than discharging the person. Ask about it before admission.
What should I do tonight if I am worried?
If there is danger now, call or text 988 or call 911. Stay with the person, or make sure someone does.
Also on this site
Related kinds of care.
Residential care ends. Someone still has to be there every week.
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See the directory promise →Where every row comes from.
State records
- DHCS certified residential mental health programs, FY 2025–26 Q4
- DHCS MHRC and PHF licensing list, September 2026
- CDSS community care licensing file, May 2025 (latest posted)
- DHCS substance use facility list, downloaded 1 Oct 2026
- CDPH healthcare facility listing, 1 Oct 2026
How crisis, transitional and long-term are told apart. The DHCS list labels all three as social rehabilitation programs. We group them by the type letter in each certificate number: S for short-term crisis, T for transitional, L for long-term. DHCS does not publish this key; we checked it against programs whose own descriptions are known. Treat the grouping as our reading of the file, not a state label.
Private teen homes. The CDSS file lists 342 children's group homes but does not say which are treatment programs. We kept the ones run by youth treatment operators we could identify by name, from the file dated May 2025, the latest the state has posted. That list can miss an operator; if a teen treatment home is missing, tell us. A licence record does not establish age range, fit, quality, safety or an open bed.
STRTPs. A DHCS mental health program approval is not the separate CDSS facility licence. Neither proves age, fit, admission or an open bed. For a named program, use the exact-record check.
Mental health houses without a DHCS row. 33 houses hold a Social Services social rehabilitation licence that we could not match to a DHCS certification, by name and city. Their programme type is not stated in either file.
Developmental disability homes. From the Social Services licensing file (May 2025). Children's home addresses are withheld by the state.
Substance use hospitals. Chemical dependency recovery hospitals from the CDPH facility listing, 1 October 2026.
License dates. 62 substance use rows show an expiration before 1 October 2026 in the state file. They are tagged, not removed, because renewals can lag.
Eating disorders. Licensed by CDPH as congregate living health facilities. The state file does not say which homes treat eating disorders, so we matched names and street addresses to operators' published residential sites, checked 1 October 2026. One operator-listed site was not found in the CDPH file and is flagged.
What a row can prove. That the state listed a named program, its operator, city and capacity in a dated file. It cannot prove quality, safety, fit, payment, admission or an open bed. Inclusion is computed from those files and is never purchased.
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