Mental illness is common in the United States, affecting tens of millions of people annually, but overall, only about half of those affected receive treatment. For those with mental illness, there are many barriers to accessing optimal care, including lack of access to care, lack of accurate disease state information, limited financial resources, inadequate transportation, and stigma.
Persons with mental illness so frequently experience stigma that they often accept outdated notions and misconceptions as fact. They are treated differently from patients without these disorders, even by health-care professionals. This prevents patients with mental illness from receiving optimal care.
One effect is that people with serious mental illness have an up-to-25-year reduction in lifespan. This gap in care leads to significantly disproportionate health-care costs, but it is an opportunity for pharmacists with expertise in working in mental health.
Appropriately trained pharmacists are essential for bridging care gaps, improving outcomes, and reducing overall health-care costs. As such, this population represents a huge opportunity for board-certified psychiatric pharmacists (BCPPs).
Board certification is one way pharmacists can demonstrate that they have the knowledge and experience for leading teams around complex medication-management issues. The Board of Pharmacy Specialties (BPS) board certification is the gold standard for determining a pharmacist’s qualifications and capabilities within a specialty. Being recognized as a BCPP brings professional recognition and credibility as an expert in psychopharmacology and behavioral health matters among clinical colleagues and peers.
To sit for the BCPP examination, an applicant must be a graduate of an ACPE accredited pharmacy program, have a current active license to practice pharmacy, and meet experience and training standards. There are three ways to qualify for the experience and training requirement. One is completion of four years of postlicensure practice with at least 50% of time spent in psychiatric pharmacy activities. Second, applicants may complete a PGY1 residency plus two years of postlicensure practice with at least 50% of time spent in psychiatric pharmacy activities. Third, completion of a PGY2 residency in psychiatric pharmacy.
The College of Psychiatric and Neurologic Pharmacists (CPNP) is a pharmacy association whose members, many of whom are BCPPs, work to promote the value of pharmacists in working with mental illness. Members work directly with patients and caregivers to apply clinical knowledge and skills, educate other health-care professionals, work to reduce stigma, and develop knowledge about psychiatric disorders, including substance use and neurologic disorders.
Offering clinical educational experiences in psychiatry to students should be a priority in pharmacy schools. The pervasive nature of mental illness requires that pharmacists be comfortable and confident in working with patients with mental illness. Pharmacy students who had experience with persons with mental illness showed far less stigma about mental illness than other students. Most patients receive treatment for their depression and anxiety from primary care providers. BCPPs must collaborate with their ambulatory care and community pharmacist colleagues to assure they have the skills and confidence to effectively manage these patients.
With the support of BPS, pharmacy education leadership, and CPNP, the ground work and infrastructure is being enhanced to be successful. With ongoing and sustained efforts, we can be engaged in better supporting people with mental illness in all our health-care communities.