12
Treatment
Table 2. Ambulatory (Level 1-WM and Level 2-WM) and
Inpatient Placement Considerations
Level 1-WM
Appropriate Neutral/Uncertain Inappropriate
Emotional,
behavioral,
or cognitive
conditions and
complications
Mild/stable
psychiatric
symptoms.
Active psychiatric
symptoms.
Mild cognitive
impairment.
Moderate or
severe psychiatric
symptoms.
Moderate or
severe cognitive
impairment.
Symptom
monitoring
Absence of reliable
caregiver.
Communication
barrier (e.g.,
language, hearing,
speech).
Recovery/living
environment
Absence of reliable
support network.
Unable to come to
treatment setting
daily.
Unable to obtain
transportation or
housing.
Family/friends
not supportive of
WM process.
Risk of harm Commitment not
high, cooperation
and reliability
questionable.
Imminent risk
of harm—not
cooperative or
reliable.
Significant risk of
imminent relapse.
e Guideline Committee rated each placement consideration on a benefit-to-harm ratio,
comparing the potential harm that might result from the factor being considered to the
expected benefit to the patient of being managed in a less restrictive setting. e rating
was made in terms of the average patient in an average setting for both Level 1-WM and
Level 2-WM. A consideration is Inappropriate for a given setting when the potential harm
outweighs the expected benefit. A consideration is Appropriate for a given setting if the
expected benefit outweighs the potential harm. Neutral/Uncertain considerations are ones
where the harms and benefits are about equal or cannot be determined or where the Guideline
Committee disagreed. If a consideration that is inappropriate for Level-2-WM is present, the
patient should be managed in an inpatient setting.
(cont'd)
