All individuals receiving pharmacotherapy for a mental illness should fully understand their disorder(s) and their drug therapy, and have appropriate expectations of their treatment. These individuals should have therapeutic outcomes maximized and adverse effects effectively managed. For nearly 50 years, there have been pharmacists who have specialized in providing pharmaceutical care to individuals receiving psychotherapeutic medication. As a member of an interprofessional treatment team, the psychiatric pharmacist focuses on optimizing drug treatment by monitoring clinical response, recognizing and managing drug-induced problems, recommending appropriate treatment plans, ensuring that baseline and follow-up laboratory tests and physical assessments pertinent to drug therapy are ordered and utilized, and counseling the patient and family members about their medication.
As an organization, the College of Psychiatric and Neurologic Pharmacists (CPNP) is committed to developing and promoting pharmacists who practice in the specialty areas of psychiatry and neurology. In 1992, the Board of Pharmacy Specialties recognized Psychiatric Pharmacy as a specialty of pharmacy; as of the close of 2014, there are 804 board-certified psychiatric pharmacists (designated by the credentials BCPP). In 1998, CPNP was founded, growing to a current membership of over 1750 individuals.
Psychiatry continues to be a rapidly evolving discipline within medicine. Its scientific foundation is neuroscience, and novel pharmacologic treatments for psychiatric disorders continue to become available along with improved clinical practice guidelines. Psychiatric pharmacists are directly involved in psychiatric treatment teams, providing direct patient care and providing active medication education to patients and their families. Yet the public and many health care providers still view pharmacists as someone who primarily dispenses medication. For these reasons, CPNP proposes that a psychiatric pharmacy manifesto be created that promulgates the basic tenets of psychiatric pharmacy practice and make it a permanent, living document on the CPNP website.
CPNP is committed to securing the future of psychiatric pharmacy by developing and strengthening the number of psychiatric pharmacy practitioners, developing psychiatric pharmacy services, and supporting legislation and regulations that promote increased pharmacist roles in providing direct patient care. CPNP envisions a world where every individual with a psychiatric disorder has a care team that includes a psychiatric pharmacist accountable for optimal medication therapy.
CPNP is committed to continually providing patients and families with education about their diseases and treatment. CPNP has a close relationship with the National Alliance on Mental Illness (NAMI), with several continuing initiatives that provide medication education to consumers. CPNP members author a number of medication information sheets, and also answer patient medication questions in a series called “Ask the Psychiatric Pharmacist,” both published on the NAMI website (www.nami.org).
The public mental health care system is challenged to meet the needs of the mentally ill. Seriously mentally ill individuals are stigmatized and impoverished, lack primary medical care, die decades earlier than the life expectancy of the general population, often abuse alcohol and illicit drugs, and are incarcerated in such huge numbers that jails and prisons have become the new mental “institutions.” Stigma seriously limits health care delivery for seriously mentally ill individuals while stigma is so much less of an impediment for neurologic and medical disorders that garner much more community support.
Psychiatric pharmacists can provide needed patient care services in an over-burdened mental health care system. Psychiatric pharmacists:
Psychiatric pharmacists’ capabilities are not well recognized and are underutilized
The public needs to understand the value of what psychiatric pharmacists do
More psychiatric pharmacists are needed to care for individuals with mental illness
Psychiatric pharmacists should be specifically included in future mental health initiatives by federal, state, local and commercial interests
Psychiatric pharmacists deserve recognition and payment for the clinical services that they provide
Psychiatric pharmacists must contribute to the development of the next generation of psychiatric pharmacists via increased psychiatric pharmacy residencies and activities aimed at exciting pharmacy students about opportunities as a psychiatric pharmacy specialist
Psychiatric pharmacists, whether academic or practice-based, must contribute to increased understanding of mental illness and psychotherapeutic medication by all pharmacy students and residents
It is imperative that psychiatric pharmacists work with community pharmacists to assure appropriate care for people with mental illness in their community
In keeping with the scientific and health care tradition of communicating new ideas, psychiatric pharmacists should share their successful practice models with the larger healthcare community
Psychiatric pharmacists are and should continue to be actively involved in conducting research to advance the evidence for appropriate use of psychotherapeutic medication
Mental health care initiatives are needed to extend the reach of psychiatric pharmacists to the millions of individuals taking medication for mental illness
Psychiatric pharmacists must continue to transform their practices as healthcare integration unfolds
Compiled and written by Glen L. Stimmel, PharmD and the CPNP Past Presidents Council, 2015