Understanding the Pediatric Mental Health System

What is a partial hospitalization program for mental health care?

Partial hospitalization programs (PHPs) — sometimes called mental health day programs — help kids with mental and behavioral health challenges that cause difficulties for them at school, home and in the community. These kids usually need more intensive care than they can get through outpatient treatment but can remain stable without the support of an inpatient unit or residential treatment. Mental health experts often recommend partial hospitalization for kids who are leaving more intensive treatment.

Instead of staying in a hospital or residential facility 24 hours a day, kids who are in a PHP spend much of each day getting treatment, but go home in the evenings. This is usually somewhere between 6 and 8 hours. Each PHP has a different length of stay, but they aren’t designed to be a long-term solution. You can expect them to last at least 1 week, and up to 4 weeks, depending on your child’s needs.

What’s the difference between partial hospitalization and intensive outpatient care? 

While each of these provide several hours of mental health care each week, they have different structures and help children in different ways.

Intensive outpatient care (IOP): Generally, kids in this level of care see a doctor for 9 to 12 hours a week after school. Their symptoms are often less severe than kids in a partial hospitalization program, and kids in IOP care can usually attend school.

PHP/mental health day program: Partial hospitalization programs can be either a step down from inpatient care or a standalone level of care to stabilize a patient and prevent hospitalization. Services often include individual and group counseling, nursing, psychiatric evaluation, medication management, education services, and family education and support.

Does insurance pay for partial hospitalization?

Insurance companies often ask that patients and families get an authorization for partial hospitalization programs. Most of the time, the doctor who refers your child to a PHP will help get that authorization.

Whether your insurance company covers PHP will depend on the plan you have and the specifics of your child’s condition. Sometimes getting coverage for these types of services can be difficult, so be ready to collaborate with your child’s doctors, the PHP you choose and your insurance provider.

PHPs and education

Most PHPs run during the day, so your child will likely miss some school time while participating in the program. To account for this, many PHPs build a short amount of time into their schedules for kids to do schoolwork. The goal isn’t necessarily to make sure kids stay up to date on assignments, but rather to work through possible challenges related to school.

To make the transition back to school easier, it is useful to have a release of information, or ROI, in place. This gives your PHP doctors permission to work directly with your child’s school to ensure they have the best chance of succeeding.

PHPs can also help with getting assignments and absences excused, creating plans alongside the family to make school more valuable for kids and more.

What is my primary care physician’s role during a PHP?

It is a good idea to make sure your primary care physician is updated on your child’s mental health care. Let them know that your child is participating in a partial hospitalization program and find out if they have any advice or resources for your family. During a PHP, your primary care doctor is probably not going to interact with your child beyond regular annual visits, but they may help with medication management.

Once your child is discharged from a PHP, it’s helpful to schedule a follow-up appointment with their primary care doctor within 30 days to check in.

What can I do at home to support my family?

When your child is in a PHP, it is important to remember that they will need plenty of support at home, as their condition is usually considered serious at this stage. Work with your child’s doctors to make sure you have a safety plan in place and to restrict access to any weapons in the home. Beyond this, you should plan to be there for your child, helping with any assignments from their doctors, practicing skills together and asking about their experience with PHP. Family engagement is critical to the success of PHPs. At the same time, it is very valuable for parents and caregivers to consider their own mental health and seek support through therapy, community or even parent support groups.

What is the next step in care?

Partial hospitalization programs are designed to last for a short period of time. When that time ends, your child’s doctors will help determine what the next best step is. For some, this may be transitioning to outpatient care or intensive outpatient care. Clinicians always make these decisions alongside kids and families to make sure they are getting the best care possible.