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Steven C. Stoner, Pharm.D., BCPP

Historical Information and Editing:  R. Lee Evans, Pharm.D., BCPP; Roger W. Sommi, Pharm.D., BCPP, FCCP; Valerie Ruehter, Pharm.D., BCPP; Patricia Marken, Pharm.D., BCPP; Ellie Elliott, Pharm.D., BCPP; and Courtney Iuppa, Pharm.D., BCPP

The origins of the UMKC School of Pharmacy affiliated Psychopharmacy Research and Education program (PREP) dates back to 1980. The program, from its inception, was designed as a two-year program with the first year being a residency and the second year being a research focused fellowship year. The founding Residency Program Director was Dr. R. Lee Evans who was hired by the UMKC School of Pharmacy in 1975. His first responsibility was to establish clinical practice role models in the community for pharmacy practitioners as part of a Health, Education, and Welfare (HEW) grant from the federal government. Dr. Evans started his mental health focus in 1978 which led to the development of the PREP program in 1980 and the hiring of the first resident, Janet Parker. Dr. Evans also noted that the UMKC PREP program was the second ASHP accredited psychiatric pharmacy residency program with the first accredited program being attributed to Jim Wilson at the University of Nebraska.

While Dr. Evans is recognized as a leader in the development of clinical psychiatric pharmacy practice as a specialty, he had some assistance in his own development process. While at the University of Tennessee, Dr. Evans worked with Dr. Jim Coleman who was a Director of Pharmacy at Tennessee Psychiatric Hospital and Institute. Perhaps of more influence was his relationship with Dr. Sidney A. Rosenbluth who was serving as the Associate Dean for Student Affairs. Dr. Rosenbluth was leading a HEW grant to advance training for the pharmacy health professions and Dr. Evans was one of the first to go through the program. In addition, Dr. Evans noted that Allan Brands and Vi Brands were also critical in helping shape his views and attitudes towards working to push for the extension of pharmacist roles in practice. Dr. Evans noted that both he and Dr. Glen Stimmel (pictured right) were products of the same HEW grant program which started the emergence of psychiatric pharmacy with Dr. Stimmel in California and Dr. Evans in Tennessee and eventually Missouri.

In looking back at the history of the program, Dr. Evans noted that starting the PREP program in Kansas City, Missouri was met with an abundance of support from the Western Missouri Mental Health Center’s Department of Psychiatry that was led by physician Robin Hornstra, Sr. Dr. Evans noted that any obstacles to starting the program were “more internal than external” and that not many doors were shut, but really you rather had to set limits on what you would do because there were numerous opportunities. Dr. Evans also noted that the Department of Pharmacy at Western Missouri Mental Health Center was also very supportive of the PREP program.

Dr. Evans noted that one of the first directives he received from Dr. Hornstra was to start a lithium clinic in the outpatient program. This was in part because of the dramatic benefits seen in the inpatient setting for pharmacist assisted lithium management. This was in part because of the large readmission rate for bipolar disorder patients and the impact clinical pharmacist had in general medication maintenance clinics with this population. Dr. Evans noted that the psychiatrists were pleased with any assistance they could get when it came to medication management.

When asked to speak to the “legacy” that he has helped create for psychiatric pharmacy in Missouri and across the country, Dr. Evans reflected on a number of issues. He noted that through his early involvement with psychiatry, one of his goals was to see psychiatric pharmacy recognized and credentialed and noted there was a “huge effort” dedicated towards this for years before it actually happened. He noted that the establishment of the College of Psychiatric and Neurologic Pharmacists (CPNP) is what finally helped that dream be realized. He has been encouraged by witnessing the growth of the profession and knowing that psychiatric pharmacists are making a positive impact in patient care.

Another item highlighted by Dr. Evans in reflecting on his experiences was that he truly values his initial psychiatric experiences in starting and growing the PREP program. He noted that “we influenced a ton of psychiatric practitioners and building that program has allowed me to do what I’ve done here (Harrison School of Pharmacy-Auburn University) for the last 22 years, I use my experiences every day.” In addition, he notes that that PREP program created a “practice and academic platform for people to grow in.” While at the UMKC SOP, Dr. Evans not only served as the Chair of the Department of Pharmacy Practice, but he also served as an Acting Director of Pharmacy for Western Missouri Mental Health Center for a brief time before they hired Thomas Garrison as Pharmacy Director.

Dr. Evans’s first faculty hires for psychiatric pharmacy were Dr. Roger Sommi (1987; pictured left) and Dr. Patricia Marken (1988). Part of his goal in hiring two faculty members was to create a critical mass of psychiatric pharmacy specialists. Dr. Marken remained a part of the program and served as the residency program director from 1994 until 1999 when she assumed the position of Department Chair with the Division of Pharmacy Practice at the UMKC SOP, where she is currently the Associate Dean for Student Affairs. Dr. Sommi is currently the Associate Dean for the Columbia Campus at the UMKC SOP and continues to be involved with the PREP program, assisting primarily with the research and educational delivery. Other UMKC SOP faculty hires have included Dr. Daniel Dugan (University of Texas specialty trained), Dr. Beth Winans (University of Texas specialty trained), Dr. Leigh Anne Nelson (Albany College of Pharmacy specialty trained and UMKC SOP graduate), and Dr. Steven Stoner (PREP program specialty trained, University of Nebraska graduate, and mentored by Dr. Jim Wilson). Dr. Valerie Ruehter (UMKC SOP graduate) served as the Residency Program Director for the Kansas City based residency from 1999 through 2006.

The PREP program has maintained an interprofessional focus since its inception. The pharmacy faculty and hospital pharmacy preceptors have been largely responsible for providing education to both psychiatry and pharmacy residents, as well as hundreds of students from the UMKC Schools of Pharmacy and Medicine. In addition, there has been and continues to be a strong connection with the State of Missouri Department of Mental Health.

Graduates of the PREP program who have gone on to lead the PREP program since its inception are Steven Stoner, Ellie Elliott, and Courtney Iuppa. Dr. Stoner was a graduate of the program in 1996 and was hired by the UMKC School of Pharmacy to expand clinical pharmacy services to Northwest Missouri at the Northwest Missouri Psychiatric Rehabilitation Center (NMPRC) located in St. Joseph, Missouri. This expansion was largely lead by Ron Dittemore, NMPRC COO and Salvador Valera, NMPRC Medical Director. Dr. Stoner coordinated and directed an affiliated program at NMPRC from 1997 to 2006 and served in that capacity for both the Kansas City and St. Joseph based residents in 2007, stepping down from the Residency Program Director position to assume the Department Chair position at the UMKC SOP’s Division of Pharmacy Practice and Administration. Dr. Elliott, a graduate of the program in 1999, returned to Western Missouri Mental Health Center in 2007, and subsequently became the residency program director from 2007 to 2015. In 2007, the residency program officially became a one-year ASHP Accredited PGY2 Psychiatric Pharmacy residency program, moving from the original two-year model. Dr. Elliott became the pharmacy director in 2014, replacing Sheila Schmidt who retired. Dr. Elliott transitioned out of the residency program director position in 2015 and turned that responsibility over to Dr. Courtney Iuppa, a 2012 program graduate as well as being a graduate of the UMKC School of Pharmacy.

All told, there have been 55 psychiatric pharmacy residency and fellowship graduates of the Western Missouri Mental Health Center – Center for Behavioral Medicine– Northwest Missouri Psychiatric Rehabilitation Center – UMKC School of Pharmacy affiliated psychiatric pharmacy research and education program. The job placement of these graduates has varied with graduate tendencies leading to careers in academia, clinical practice, and pharmaceutical industry. Many have gone on to assume leadership positions with their respective institutions and organizations. Another element evident with the establishment of the PREP program and reviewing the genealogy, is the strong link of volunteering and leading within CPNP. Past and present members of the PREP program have been heavily engaged in CPNP Committees, Task Forces, Board Leadership, and two are Past-Presidents of the organization.

While the interest and links to psychiatric pharmacy started out small, a couple of seeds were planted that led to a tremendous expansion over the course of the past 36 years. The number of psychiatric pharmacy residency programs have gone from a handful of programs located in Missouri, Texas, California, Nebraska, Tennessee, and South Carolina to not only expansions of these programs but offerings in many other states and most all share some link or common connection.

Dr. Ellie Elliott
Dr. Leigh Anne Nelson
Dr. Steven Stoner

 

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