Mental health PHP for Palm Beach Gardens — inpatient density, home at night.

RECO Health's mental health PHP runs 30-plus clinical hours weekly Monday through Friday, with weekly psychiatry, a dedicated primary therapist, and in-house access to rTMS and ketamine for treatment-resistant presentations. For PGA National, Mirasol, BallenIsles, Old Palm, and Frenchman's Reserve residents, that's a 35-minute drive south to a level of clinical density outpatient practices in northern Palm Beach County don't match. The therapist who begins with you in PHP continues with you into IOP — the same clinical relationship, at reduced frequency.

Palm Beach Gardens sits roughly 25 miles north of Delray Beach — a 35-minute I-95 run that puts residents of PGA National, BallenIsles, Mirasol, Old Palm, and Frenchman’s Reserve inside RECO Health’s clinical catchment. Northern Palm Beach County has capable outpatient psychiatry, but the density that a partial hospitalization program provides — 30-plus structured clinical hours weekly, integrated psychiatry, in-house interventional access — isn’t replicable in a private-practice office.

PHP versus IOP versus inpatient: how placement is decided

Partial hospitalization is the level of care between inpatient psychiatric hospitalization and intensive outpatient. It is clinically appropriate when acute inpatient risk has passed but the picture is too active for weekly outpatient work — active suicidal ideation without imminent intent or plan, severe functional impairment across work and household roles, an unstable medication regimen requiring frequent titration, or a documented step-down from a recent inpatient admission.

Placement decisions are structured by LOCUS for adults and CALOCUS-CASII for adolescents, which score risk of harm, functional status, comorbidity, recovery environment, treatment engagement, and treatment history. Clients who score above the PHP threshold on the risk or functional dimensions — but below the inpatient threshold — are the population PHP was designed for.

Clients who don’t meet PHP criteria step directly into IOP at roughly nine clinical hours per week across three days. Clients who screen into acute inpatient criteria — imminent self-harm intent, psychotic disorganization with impaired reality testing, or medical instability from withdrawal — are stabilized inpatient first and admitted to PHP as a step-down.

What 30 clinical hours a week actually covers

The PHP week runs Monday through Friday, six clinical hours per day, and combines three components: psychiatric medication management, a weekly individual therapy hour with an assigned primary therapist, and daily group programming across evidence-based tracks. Groups are not open-format check-ins — every group carries a written curriculum, a clinical goal, and a documented modality.

Core tracks include CBT for depression and anxiety, DBT skills across mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, trauma-focused work using CPT and EMDR for indicated clients, ACT for values clarification, and MI for ambivalence about treatment or substance use.

Dual-diagnosis programming is embedded — clients with co-occurring substance use disorders are not siloed into a separate track and forced to lose the psychiatric care they came for. Disorder-specific psychoeducation covers bipolar illness, PTSD, OCD (with YBOCS-anchored progress tracking), and adult ADHD (assessed with the ASRS at intake). Experiential modalities — trauma-informed yoga, art therapy, somatic work — supplement the cognitive-behavioral core rather than replacing it.

Integrated psychiatry, TMS, and ketamine within the same program

PHP clients see psychiatry at least weekly, and more frequently when medication changes require monitoring. Assessment uses measurement-based care — PHQ-9 for depression, GAD-7 for anxiety, YBOCS for obsessive-compulsive severity, ASRS for adult ADHD — with scores tracked across the episode of care. Medication decisions are not made in isolation from the therapy team; group and individual clinicians document response and side effects into the same chart the prescribing psychiatrist reads.

Typical regimens include SSRIs (sertraline, escitalopram) or SNRIs for unipolar depression and anxiety, second-generation antipsychotics (quetiapine, aripiprazole, olanzapine) for bipolar spectrum illness and psychotic features, lithium where history and renal function support it, buspirone for generalized anxiety when SSRI monotherapy is insufficient, and buprenorphine or naltrexone for co-occurring opioid or alcohol use disorder.

Because rTMS and ketamine services are in-house, PHP clients who become candidates for interventional treatment — typically after documented failure of two adequate antidepressant trials — access rTMS (standard 3,000-pulse sessions at 120% of resting motor threshold over the left DLPFC) or IV ketamine and intranasal esketamine without leaving the program. The psychiatry team stages treatment around the group schedule and adjusts based on serial measurement-based response.

Step-down to IOP with the same primary therapist

PHP is not designed as an indefinite level of care. Most clients step down to intensive outpatient after three to six weeks, depending on symptom trajectory, medication stability, and functional recovery. The decision is anchored to serial PHQ-9, GAD-7, and functional measures rather than to a fixed calendar.

The clinically load-bearing feature of the transition is therapist continuity. The primary therapist assigned in PHP follows the client into IOP rather than handing off to a new clinician. The same individual sessions continue at reduced frequency; the therapeutic alliance built during the intensive weeks carries into the step-down. Continuity of relationship is not an administrative convenience — the literature on outpatient dropout after PHP or inpatient discharge points squarely at fractured handoffs as a driver.

What to expect on the first day

Admission begins with a two-to-three-hour intake: a biopsychosocial assessment covering psychiatric history, substance use history scored against DSM-5 criteria and ASAM Criteria dimensions, medical history and current medications, family and social history, and a structured risk assessment. Standardized instruments are administered at intake and repeated throughout the episode — PHQ-9, GAD-7, PCL-5 for PTSD screening, AUDIT and DAST for substance use severity, and diagnosis-specific scales where indicated.

Clients meet with a psychiatric provider within the first 24 to 48 hours for medication reconciliation and initial orders. A primary therapist is assigned within 72 hours and completes the individualized treatment plan with the client — problem list, measurable goals, modality selection, and target discharge criteria. Family contact, with written consent, is initiated in the first week; confidentiality is governed by HIPAA for mental health records and by 42 CFR Part 2 for substance use disorder records.

Insurance and admissions from Palm Beach Gardens

RECO Health is in-network with Florida Blue, Aetna, Cigna, UnitedHealthcare, Humana, and BlueCross BlueShield plans commonly held in Palm Beach County, and works with additional commercial payers on a single-case basis. PHP typically requires prior authorization; benefits are verified and authorization secured before your first clinical day, with deductible, coinsurance, and per-diem structure quoted in writing.

From Palm Beach Gardens the drive to Delray Beach is roughly 25 miles down I-95, generally 35 minutes outside PGA-tournament rush windows. Clients in PGA National, Mirasol, BallenIsles, Old Palm, and Frenchman’s Reserve who elect to commute daily receive a schedule that avoids the worst southbound congestion. Clients who prefer not to commute during the intensive PHP phase can be placed in RECO’s supportive housing for those weeks and return home to Palm Beach Gardens once they step down to IOP.

Serving residents of: BallenIsles, Frenchman's Reserve, Mirasol, Old Palm, PGA National.