Julie Dopheide, PharmD, BCPP
Professor of Clinical Pharmacy, Psychiatry and Behavioral Sciences
University of Southern California
Los Angeles, CA
CPNP Commission on Innovation and Advancement Committee Member
Dr. Julie Dopheide is a Professor at USC with over 30 years of teaching experience and clinical practice divided between adults, adolescents and children with psychiatric illness. As part of a multidisciplinary treatment team, Dr. Dopheide makes recommendations to optimize treatment for psychiatric illnesses including schizophrenia, mood disorders, anxiety, attention-deficit hyperactivity disorder, chronic insomnia and substance abuse. She is the PGY2 psychiatric pharmacy residency program director and supervises the resident in providing comprehensive medication management for outpatients in the Center for Community Health safety net clinic located in downtown Los Angeles. Dr. Dopheide served as President of CPNP in 2013-2014 and was selected as the 2020 Judith J. Saklad Memorial Award recipient. She just concluded a term as member and chair of the BPS Psychiatric Pharmacy Specialty Council.
The History and Evolution of Psychiatric Pharmacy
In 1972, there was a vision that pharmacists could become contributing members of the mental health care team and the first psychiatric pharmacy residency was founded. About 25 years later in the mid-to-late 1990’s, the Board Certified Psychiatric Pharmacist (BCPP) credential was established and 116 dedicated pharmacists had a vision of an organization that would advance the specialty and provide the education they needed. They created the College of Psychiatric and Neurologic Pharmacists (CPNP). Now, 25 years later in the year 2022, CPNP has robust education, recertification, and advocacy programs and services. Clearly a profession and an organization that doesn’t rest on its laurels, CPNP has recently developed a vision for the next 25 years.
CPNP: Casting a Vision for Our Profession
Over the last few years, CPNP has published important work on curriculum in pharmacy schools, a literature search on the impact of psychiatric pharmacists, a description of the role of the BCPP, a study of what psychiatric pharmacist practices look like across the US, and a study of prescriptive authority. The Commission on Innovation and Advancement (CIA) was formed last year to draft a vision of how psychiatric pharmacists can help address the growing mental health crisis both today and 5 years from today. This will be the first of many vision-oriented papers published by the Commission.
The last broad effort toward vision-casting was undertaken by the Past Presidents Council in 2015, when they updated the Psychiatric Pharmacy Manifesto. Since that year, the number of filled PGY2 slots has increased 85% (53 to 98), and the number of BCPPs has increased 58% (845 to 1331) [https://aapp.org/career/residencies/survey]. While there is further to go, we can celebrate the real progress on workforce issues. For example, the manifesto calls for expanded advocacy, noting that “the public needs to understand the value of what psychiatric pharmacists do.” Since 2015, CPNP has contracted with a Washington DC based government affairs/lobbying firm, reorganized and expanded the Government Affairs Committee, formed a Professional Affairs Committee, and made advocacy central to the new strategic plan. The growth of the BCPP and the investment in building an advocacy infrastructure gives CPNP and the specialty a greater degree of self-determination than ever before.
CPNP’s Updated and Expanded Vision
Against that backdrop, the CIA has drafted the vision paper, “Positioning Psychiatric Pharmacists to Improve Mental Health Care.” The commission considered discussions and findings from CPNP’s 18-month strategic planning process, which generated hundreds of pages of reports and days of recordings. The vision is grounded in current person-centered practice, and it emphasizes how the unique skills and inherent adaptability of BCPPs will help current practice evolve into the future. However, it also attempts to clarify central issues in current practice, such as when a BCPP should be used versus other pharmacists and health care professionals. In the paper, we elaborate on the specific roles and practice settings where we see BCPPs growing over the coming years. It also notes the importance of incorporating mental health training into all pharmacy schools and residency programs to decrease stigma and improve patient care regardless of access to a BCPP.
Finally, in this vision, we recommit ourselves as an organization to comprehensive medication management (CMM) as the best practice for all psychiatric pharmacists. Indeed, the combination of this process with our expertise is so important for patients living with mental illness that we recommend developing population health strategies to proactively identify patients in need of those services from a BCPP. One such strategy is “psychotropic medication stewardship”. We are excited to introduce this concept in the vision paper and will dive deeper into the implementation in future papers.
The CIA solicited feedback from 30 thought leaders in October 2021, and the Board of Directors had a focused discussion around the paper in November 2021. We also took the extraordinary step of having an open comment period to allow all CPNP members to provide feedback in February 2022. The final step will be blinded peer review by the Mental Health Clinician. Thanks to everyone who contributed to the vision, whether it was during the strategic planning process, during an open comment period, or during the MHC peer review process.
The vision is reflective of the strategic plan, and work is ongoing to push it forward. Watch for the paper in an upcoming issue of the MHC. We look forward to our work together with you to further position psychiatric pharmacists to improve mental health care.