Differences Between PHP and Residential Inpatient Treatment

As you research the different treatment options available for mental healthcare and substance abuse treatment, you’ll find several options – what we call levels of care. The level at which a patient will be admitted to our facility will be based on many variables discussed during the admissions process. For example, patients with mental illnesses that interfere with their ability to conduct their day-to-day life responsibilities may need residential or inpatient care. In contrast, higher-functioning patients may be admitted to partial hospitalization, intensive outpatient (IOP), or outpatient care.

Parsing the Meaning of These Terms

While the differences between levels of care can sometimes be nuanced, and treatment protocols may be similar, the differences can dramatically affect the therapeutic process and ultimate outcomes. This article will discuss the difference between residential treatment and partial hospitalization. Let’s start by defining them:

• In a Residential program, patients remain in the medical facility overnight – the same facility where therapy occurs. The intensity of therapy can vary, but ultimately a multidisciplinary team will be available to patients 24/7, on call.
• A partial hospitalization program or PHP like ours offers the same intensity in treatment, but patients spend their extra time in a more home-like environment.

We, too, offer a multidisciplinary group of clinicians that render therapeutic services, including group therapy and individual therapy, medical and psychiatric consultations as appropriate, medication-assisted therapies, and more.

How Do We Decide on the Level of Care

Our admissions specialists and clinicians work together to understand what each patient needs. While we can’t make a comprehensive diagnosis at the first meeting, we can get a feel for the level of care that suits the patient best by looking at past therapy and engaging the family. Upon admission, we offer a thorough intake and assessment continuum that includes clinical, medical, and psychological evaluations, at which point patients are assigned a case manager.

Who We Can and Can’t Accept into PHP

We have ‘rule-outs,’ or patients we cannot accept before they have completed a residential level of care. The criteria are relatively narrow and include the following:

• Is the patient stable enough to sit through a 1-hour group? This is important in ensuring the patient can get the most from our PHP program. If they can’t participate, no treatment is effective.
• If the patient is not medication compliant or in active psychosis, we will often refer them to a residential facility first. One example could be a patient with schizoaffective disorder who is non-compliant with their medication plan. Under those circumstances, a clinician might determine that this patient requires 24-hour supervision until stabilized.
• Is the patient suffering from serious health concerns requiring around-the-clock care? In these cases, an inpatient medical care facility may be best until the patient is stabilized.

With the above said, patients who don’t present severe symptoms and don’t require 24-hour medical supervision are often appropriate for our PHP program. Our solid clinical and medical backbone allows us to handle even challenging cases.

Many Patients Prefer Mental Health PHP to Other Forms of Care Because

• PHP for mental health allows patients to return to home-like surroundings at the end of each day. In doing so, they are immediately thrust into surroundings that require adaptation and collaboration with supervision
• Partial Hospitalization Programs offer circumstances that more closely resemble “real life” and lessen the sense of being institutionalized
• Mental health PHP is usually more cost-effective than inpatient or residential mental health treatment
• Clinical research has shown Partial Hospitalization Programs to be an effective alternative to inpatient treatment for many patients

Why Proper Placement Matters

Our focus on mental health and wellness, first and foremost, means that we diagnose the disorders that other programs miss. We correct the diagnosis and follow it up by providing the most effective, evidence-based treatment. Patients in our Partial Hospitalization Program aren’t simply evaluated once and treated the same for weeks. We pay careful attention to both symptoms and progress, constantly reevaluating with a critical eye and ensuring high communication among staff during our daily meetings. Listening to patient feedback, we also determine the efficacy of our treatment and watch for signs of any tertiary conditions.

While we are a mental health primary facility, we specialize in dual diagnosis treatment – treating co-occurring addiction issues. This allows us to tailor our program to virtually any behavioral health need.

It is critical to measure the success of treatment, which provides a benchmark for recovery and holds us accountable. We measure success not so much by how the patient does in treatment but by how the family and patient recover progressively throughout and post-treatment. Some of the factors we emphasize include whether the family is operating as a unit (Is the marriage better? Are the siblings talking?), the patient is sticking to the post-treatment plan, the internal “chatter” starts to become more muted, there is a renewed hope and vision of a path forward in life, and the patient begins to give off different energy to those around them.

To learn more about the levels of care at The Sylvia Brafman Mental Health Center, we encourage you to contact us.