Why step down from a PHP or IOP to Concierge Psychiatry?
The most vulnerable period in psychiatric treatment is the transition from intensive care back to outpatient management. Research shows a 20.9% readmission rate within 30 days of psychiatric hospitalization.
The primary cause? Inadequate discharge planning and insufficient follow-up support during the critical post-discharge period.
Traditional outpatient psychiatry cannot provide the intensive management these transitions require. Our concierge psychiatric practice fills this gap.
Step-Down from PHP and IOP Programs
Partial Hospitalization Programs (PHP) provide 5-6 hours of daily treatment, while Intensive Outpatient Programs (IOP) offer 2-3 hours of treatment several days per week. When patients complete these programs, they typically transition to monthly psychiatric appointments; a dramatic reduction in support that often leads to decompensation.
Case Example: Emergency Step-Down from PHP
In a fictional example, a 28-year-old executive stepped down from a partial hospitalization program after severe depression with suicidal ideation. They try to access psychiatry through their insurance, and were able to make one appointment every three weeks.
On the contrary, we provided daily appointments for the first week, then appointments every other day for two weeks, gradually transitioning to twice-weekly sessions as they stabilized. We coordinated closely with their therapist from our vetted network, ensuring seamless communication and rapid therapeutic engagement.
Within six weeks, they had transitioned to weekly appointments without crisis or hospitalization, a trajectory that would have been impossible with insurance based follow-ups.
Multiple Appointments Per Week—Even Daily
For high-acuity patients, we provide appointments as frequently as needed. Twice weekly during medication titration. Every other day during acute crises. Daily appointments when stepping down from inpatient or PHP care. This intensive outpatient management prevents hospitalizations and residential placements that would otherwise be inevitable with inadequate support.
We build comprehensive outpatient teams, leveraging our network of therapists who can accommodate urgent referrals. Where traditional psychiatry might tell a patient "we'll see you in a month," we create a coordinated care structure with multiple touchpoints per week across psychiatry and therapy.
Ready to step down from a hospitalization?
Dr. Caroline Fu offers concierge psychiatric care in Boston, Mass and via telehealth.
