How Partial Hospitalization Programs Can Fill The Gaps in Access to Mental Health for Teenagers

Apr 10

By Cassandra Gibson, MD

Parents and schools know that America’s teens are struggling. They also know how hard it is to access any kind of mental health care, no matter how dire your situation. Though providers and parents desperately want to help, for most families there are only two options:

Calling dozens of therapists until you find one accepting new patients, knowing that waitlists, particularly for therapists who take insurance, and psychiatrists, can be 4-6 months. And here’s the kicker: make sure to maintain a goldilocks level of sickness that does not make you too well to warrant a coveted weekly therapy spot, but also isn’t so dangerous that you are sent out of the office to the emergency room.
Show up in an emergency room or urgent care setting, often waiting up to 10 days in a medical hospital for a short inpatient stay (3-7 days) focused just on safety. Then return to the stressors of home and school and option 1 of calling therapists.

Understanding the gaps in access to mental health for teenagers.

Not many teenagers can be expected to improve within these limitations. There are few cases where a single component of treatment – a specific medication, a school accommodation, an excellent therapist, or resolution/improvement in family challenges – is the answer.

My experience as a child and adolescent psychiatrist in communities across the U.S. has shown that we need a level of care in-between these two options. For many, a partial hospitalization program (PHP) provides this.

What are partial hospitalization programs?

These PHPs (daily over 3-4 weeks) make it possible to treat teens in their primary environment – the home. Being at home is an integral part of making lasting change, surrounded by the stressors and supports of daily life. The intensity of the treatment prepares teens for the realities and limitations of managing their mental health long-term in the community.

You can think of partial hospitalization as a surgery. Some will need it after a major crisis or accident, others may have an ongoing injury that just isn’t getting any better. Either way, a directed and intensive intervention is necessary. And physical therapy, follow-up visits and ongoing management are likely going to be needed afterwards.

In a surgery, you would not expect the anesthesiologist, surgeon and operating room nurse to be in different rooms with a parent coordinating their intensive efforts. In the same way, the fact that PHPs are provided by a consistent multidisciplinary care team means that the treatment is greater than the sum of its parts: not only can it stabilize an immediate crisis, it can also bring about positive, strengths-based growth for the long-term by drawing on a range of expertise.

Finally, facilitated group sessions can help teens to establish a sense of belonging that may have been missing for years.

Access to mental health care for teens and adolescents.

Not all communities have access to programs such as Bradley REACH’s partial hospitalization program, but where it exists it can be the connective tissue that our broken mental health system so badly needs.

Currently, Bradley REACH provides intensive mental health support for teens and virtual mental health services in Rhode Island, Florida, Massachusetts and Connecticut.

To find out more about partnering with Bradley REACH or to make a referral, please contact us here.

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