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Julie A. Dopheide, PharmD, BCPP, FASHP

As one of the first pharmacists awarded Board Certification in Psychiatric Pharmacy (BCPP) back in 1996, I appreciate the opportunity to share:

  1. the value of BCPP to my career,
  2. lessons learned at the 2021 BPS Fall meeting about how BCPP compares to other specialties and
  3. my experience on the BCPP council, as an item writer, and what sets the BCPP apart from other certifications.

All have confirmed my belief that BCPP is the gold standard for pharmacists practicing in mental health and SUD recovery.

Value of Board Certified Psychiatric Pharmacist (BCPP) to My Career

Achieving the BCPP credential after my PharmD has opened doors for me as a “pharmacist specialist” in psychiatry, with well-recognized expertise in caring for persons with severe mental illness through patient communication and by recommending safe and effective drug treatment. This recognition has been helpful for both the interdisciplinary acceptance of my place on psychiatric treatment teams for children and adults and validation of my role as a credentialled mental health provider in nonpsychiatric settings including as a Patient Centered Medical Home (PCMH) provider on “Skid Row” in Los Angeles. The BCPP credential has also made it possible for me to serve as a residency program director (RPD) and preceptor. The American Society of Health Systems Pharmacists (ASHP) requires that all RPDs for post-graduate year 2 (PGY2) psychiatric pharmacy residencies maintain the BCPP because it verifies expertise in psychiatry.

In 2013, Veterans Administration Healthcare (VHA) realized that funding additional PGY2 psychiatric pharmacy residencies was the best way to recruit appropriately trained pharmacists to serve the mental health needs of Veterans. PGY2 psychiatric pharmacy residency graduates can immediately qualify to take the BCPP certification examination and add to the VA pharmacy workforce. Kaiser Permanente, Genoa Healthcare and other national health systems have also expanded their BCPP workforce aiming to improve mental health outcomes and population health. The expansion of residency programs and increasing demand for BCPPs has helped my home organization, CPNP, grow to nearly 3,000 members strong! BCPP members of CPNP are active in developing toolkits and programming that have and continue to advance my practice.

Comparing BCPP to Other Specialty Certifications

As of October 16, 2021, the Board of Pharmacy Specialties (BPS) reports 51,519 Board Certified Pharmacists in the United States and Internationally.  I know, that’s amazing! Currently, BCPS is the largest and fastest growing certification with 28,123 pharmacists, (compared to 17,771 pharmacists in 2015). This is followed by BCACP (5,045), BCGP (4,646) and BCOP (3,665). There are 1,379 BCPPs (compared to 903 in 2015); compared to ~15% growth per year for BCPS, this only represents growth of approximately 5% per year. One reason for the exponential growth of BCPS is the ability of newly graduating post graduate year 1 (PGY1) residents to take the exam immediately after completing their residency while general clinical content and expertise is sharp. These more general certifications will enable a board-certified pharmacist to apply for credentialing, work directly with patients, and meet the certification requirement for many general clinical positions. BCPS and BCACP are excellent credentials, but they fall short of confirming a pharmacist is ready to pursue a career at expert level practice in mental health and substance use recovery. In my opinion, they do not sufficiently evaluate the necessary depth and breadth of expertise needed to provide CMM for individuals with these conditions which frequently coexist.

What Sets BCPP Apart from Other BPS Specialties; BCPP Role Delineation and Item Writing

With lived experience practicing in settings where persons with severe mental illness receive treatment, a BCPP knows how challenging it can be for a person to experience hallucinations, delusions, and/or suicidal thoughts. This fosters the development of a special brand of empathy, communication, and connection skills necessary to meet patients where they are and help them achieve their recovery goals. BCPPs combine this “person-factor” with broad knowledge of dosing, monitoring, and psychiatric medication response assessment (“psychiatric medication expert factor”). This combination of expertise ensures the BCPP can select the best medication treatments for persons recovering from mental health and substance use disorders. While broad credentials (e.g., BCPS, BCACP or BCGP) verify some psychiatric medication knowledge and application skills, they are limited in assessing the breadth of mental health patient assessment, advocacy, and ability to educate on psychiatric diagnoses and clinical course; they just have too much other content to assess.

BPS conducts role delineation studies (RDS) every five to six years for each specialty to keep current with practice advances and set the content for certification exams. BCPPs from a variety of practice settings, including acute care, ambulatory care, pediatrics/geriatrics, academia, neurology, and SUD, all participate in determining the knowledge and skills necessary for successful person-centered care as a BCPP. Once the knowledge and skills are identified through the RDS, practicing BCPPs are surveyed to assess how crucial each competency is for entry level practice as a BCPP.

Items on the BCPP examination cover a broad range of mental health settings and special populations within psychiatry. Pharmacists who achieve BCPP have verified entry level competency for psychiatric practice working with children, adults, older adults, and persons with substance use disorders. Attaining the BCPP verifies specialized expertise in dosing, monitoring, and adverse effect management of high alert medications such as clozapine, lithium, and methadone. Pharmacists with current BCPS, BCACP or BCGP credential who take on a clinical position in mental health and substance use recovery should obtain an additional BCPP credential to ensure they have the knowledge and skills needed for assisting patients with severe mental illness in achieving their treatment goals.

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