What psychiatric pharmacy is, what we do, and how we treat patients
Psychiatric pharmacy. What thoughts does the phrase bring to mind? Apprehension? Curiosity? Many student pharmacists have not considered the possibility of a career as a pharmacist serving patients with psychiatric illnesses. To a student, psychiatric pharmacy might be a less visible type of pharmacy practice than cardiovascular pharmacy or antibiotic stewardship. Those of us in the field have found it an enormously satisfying profession. In all ways, psychiatric pharmacy offers a career rich with the opportunities that we are looking for as health care providers.
Collaboration a hallmark
First of all, psychiatric pharmacy is a field that supports the desire to care for and to care about patients. We are able to interact directly—sometimes with a scheduled caseload and sometimes by consultations—with patients who share captivating stories and experiences. The patients are intelligent and engaging, and we quickly learn that they deserve respect and care. It is a rewarding, but not rare, experience to be told that our contributions to their care made a difference in the life of an individual with a serious mental illness.
Collaboration is a hallmark of psychiatric pharmacy. The medications used to help manage the symptoms of psychiatric illnesses are varied, and the drug regimens can be complex. Other health care providers can find the rational use of psychiatric medications confusing and challenging. To understand and clarify the responses of these patients to pharmacotherapy choices, pharmacists often need to seek the opinions of others on the health care team, such as psychologists and social workers. Primary care providers, including physicians, are immensely grateful for a pharmacist’s advice. More than pharmacists in many other types of pharmacy practices, psychiatric pharmacists have opportunities to interact with families and with local and national support organizations such as the National Alliance on Mental Illness.
Just as other pharmacists do, each day we apply the principles of evidenced-base pharmacotherapy and the knowledge of biopsychosocial, administrative, regulatory, and clinical sciences, and we serve as an interface helping to move translational research to clinical practice. According to the College of Psychiatric and Neurologic Pharmacists (CPNP), patient care and safety are the priorities, and in addition, the core responsibilities include:
- Working collaboratively with interprofessional teams to optimize drug therapy.
- Providing direct patient care, including treatment assessment and medication management activities.
- Monitoring for potential adverse drug reactions and interactions.
- Evaluating and educating others on the medical literature.
- Conducting medication education groups for patients.
- Educating patients and families on psychiatric medications as well as psychiatric disorders and other related conditions.
- Engaging in patient advocacy efforts both independently and with consumer groups.
- Teaching other health care students, residents, and practitioners.
- Conducting original research and/or publishing in peer-reviewed journals and texts.
Psychiatric illnesses tend to be chronic and challenge patients throughout their lifetimes. Consequently, psychiatric pharmacists serve populations from youths to older adults. Psychiatric pharmacists often find themselves serving people in areas such as chemical dependency, developmental disabilities, long-term care facilities, adherence clinics, mental health clinics, and within the prison systems.
Board of Pharmacy Specialties (BPS) Training Preparation for entry into the field is commonly through a specialized residency (PGY2) in psychiatric pharmacy. Several residency slots exist throughout the United States (http://cpnp.org/career/residencies). As with other types of pharmacy practice, continual professional development is essential. It is common to earn board certification in psychiatric pharmacy through BPS. Board certification recognizes unique knowledge and skills for managing patients with psychiatric illnesses. Networking and professional support are critical for maintaining professional competence, and we are fortunate to be a member of an active, member-driven professional organization such as CPNP.
For thousands of pharmacists, psychiatric pharmacy has provided a fulfilling career in which to both prosper and grow. It might for you as well.