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Partial Hospitalization Program (PHP) for Mood and Anxiety Disorders

Patients with mood and anxiety disorders sometimes need extra support. The Partial Hospitalization Program (PHP) is a day program for those who need some assistance managing feelings of anxiety, overwhelm or depression.

Lisa Madden, Associate Vice President of Behavioral Health, discusses who benefits most from PHP, how a typical treatment day works, and the goals of the program.
Partial Hospitalization Program (PHP) for Mood and Anxiety Disorders
Featured Speaker:
Lisa Madden
Lisa Madden is an Associate Vice President of Behavioral Health, Administration.
Transcription:

Bill Klaproth (Host): So what is the Partial Hospitalization Program? Here to explain the program, also known as PHP, is Lisa Madden, Associate Vice President of Behavioral Health Administration at Southern New Hampshire Health. Lisa, thank you for your time today. So what is the Partial Hospitalization Program?

Lisa Madden (Guest): The Partial Hospitalization Program is a day program, an outpatient program that is designed for individuals from the ages of eighteen to seventy with mood and/or anxiety disorders. These are folks that are really having sort of an acute episode of symptoms and maybe feeling the need to be in a structured environment. They may have come recently from the hospital and they are stepping down to the day program, or they may be coming to this program so that they can not have to have a hospital experience, but would benefit from the support on a daily basis. It is open seven days a week, and it's something that we do even have available on holiday.

Bill: So what are the goals then of PHP?

Lisa: The goals are broken down into eight different categories, and I'll just give a quick review of what those are. The real first thing is to really understand the psychiatric diagnosis that the person is living with. There's a lot of education that's offered, there's a lot of information that's offered so that people know how to be able to manage their psychiatric condition in a way that will allow them to stay in the community and feel that they are enjoying their world.

There's also the ability to identify stressors and triggers that may prompt some of their symptoms. We offer psychiatric evaluation for medication management and treatment. There's also a chemical dependency evaluation and treatment recommendation. This program is not geared towards serving people whose primary issue is substance use disorder. That would be more appropriate for our other program called Intensive Outpatient for Substance Misuse. This is for mental illness, so we try to make sure that we're treating the right primary issue here and have people in the right program.

We also offer the opportunity for learning coping strategies, and how to do stress management, and mindfulness. There is educational support for families. We work a lot with the National Association for Mental Illness, NAMI, and we have family meetings and encourage the support of family members. So for folks that are dealing with these symptoms and issues, there may need to be a plan for if things deteriorate and they need a crisis plan.

And finally, we work with folks to coordinate their outpatient appointments and aftercare to make sure they have what they need when they're finished with that program.

Bill: So Lisa, how long is the treatment?

Lisa: The treatment ranges between five and ten days, and we do look for folks to come continuously throughout that time. That's where they can gain the most from the educational component and from the treatment component is if they come on a daily basis.

Bill: So Lisa, what type of person would benefit from the PHP?

Lisa: Well the people that would benefit from this program are those who are experiencing an acute increase in some of their symptoms of depression, or anxiety, maybe they're stress has really increased over the past several weeks and they're looking to not necessarily have to be in the hospital, but to be in a place where they can receive some structured daily support to work through those issues.

Bill: And then who would not be appropriate for the program?

Lisa: People who are not appropriate for this program, it is an outpatient program, a day program, are those who are extremely volatile, have a real heightened sense of suicidality, or at risk of hurting anybody else. Those are folks that we're not prepared to manage in this program.

Bill: So can you describe a typical day? What would patients expect to experience at the Partial Hospitalization Program?

Lisa: Sure, new patients arrive at the program at about 9:00 AM, and they are registered and complete some assessment paperwork, and have an idea of what they're looking for within the program, and then the groups start at 9:30. And there's a variety of groups that run through the day. We do have a break for lunch and then there's an afternoon group. And a lot of these groups are focusing, again, on strategy to be able to manage their stressors, manage their- enhance their coping strategies, and become more mindful of their illness so that they can feel that they can manage themselves in the community in a productive manner.

Bill: And Lisa, what happens after the program has been completed? Is there subsequent follow-up care or support available?

Lisa: Sure. A significant part of the work that occurs when they're in the Partial Hospitalization Program is to coordinate with all of their community supports. So there may be appointments made with their physician, with psychiatrists, or with clinicians that are offering them ongoing treatment in the community to make sure all of those connections are solid and are available to the patient prior to them finishing the program.

This is really a program that only has five to ten days of duration, and we want to make sure that we have the right supports in place for their aftercare.

Bill: So how do you know if someone is ready for the program?

Lisa: Well this is a program in which people- it's a voluntary program. People contact us, and tell us that they're interested in learning more about their mental illness, and what they can do to be able to manage it. And they're ready for it is if they can engage in a conversation that says, "I am willing to participate in the groups, to learn more, to share what's happening with me," and that they're able to manage their behaviors in a way that does not put anybody else at risk.

Bill: So how does someone get into the program? Can someone just come in and be admitted? Or does a patient have to be referred? How does that work?

Lisa: Sure. Well the patient or primary care provider or a treatment provider can make a referral to the Partial Hospital Program on behalf of one of their patients, and I have a phone number there that I can offer you. That number is (603) 577-5740, and there is an initial phone screening and some questions that are asked in addition to having a conversation with the patient who wants to be involved in the program. And then they're asked to come in to the program the following morning, or whenever they can make the arrangement to come in for that 9:00 AM time, to finish completing paperwork and then enter into the group process. So we accept the referrals by phone, and then we make a connection for them to come in the following day.

Bill: And lastly, is there anything else we should know about the PHP Program, Lisa?

Lisa: I think the PHP Program is a wonderful opportunity for folks to be able to get the support that they need to learn more about mental illness and be able to find options for managing their mental illness so that they can live comfortably in the community. I also think it's a great way to be able to re-enter the community if they've been in a hospital setting, and they want to be able to have some support as they return home. And we think that it offers people the guidance and structure that hopefully will keep people from having to have a long-term hospital stay.

Bill: A really important program. Lisa, thank you so much for your time today, and sharing that information with us. To learn more about the PHP Program, please visit www.SNHHealth.org. That's www.SNHHealth.org. This is Simply Healthy, a podcast by Southern New Hampshire Health. I'm Bill Klaproth, thanks for listening.