Rosana Steavenson, PharmD, BCPS, BCPP
Program Manager, Mental Health Clinical Pharmacy Programs; Mental Health Clinical Pharmacy Practitioner
South Texas Veterans Health Care System
San Antonio, TX
Chair, Theory to Practice Case Editorial Board
Ten years ago, I was in the middle of pharmacy rotations, traveling for interviews, and crossing my fingers and toes that come the summer of 2012, I would start residency with a program that offered a psychiatric pharmacy experience. Now, I am preparing for the BCPP recertification exam, engaging with CPNP as a committed member, and am part of an amazing and growing group of BCPP’s in my workplace. I found my true north in Psychiatric Pharmacy and I am inspired to stay the course as I witness recovery and resiliency in action from my patients and unwavering commitment from other Psychiatric Pharmacists in advancing our profession.
Finding my passion in mental health was clear to me early on; I immediately connected with the content of the psychiatry module in pharmacy school and I never looked back. Despite this, the saying “Do what you love and you’ll never work a day in your life” doesn’t really resonate with me; the work we do in health, especially mental health, can be exhausting. Instead, I am inspired by knowing without a doubt that even through the toughest days during pharmacy school (like when I was memorizing CYP P450 enzymes and thinking I’d never actually need to know that information), residency, or in my career, who I am working with and what I am working towards has meaning. It’s about striking a delicate balance of acknowledging that the chaos, stress, and hard work in the moment is worth it because you are actively looking for and can see the light at the end of the tunnel. This is a constant practice of mindfulness and gratitude, and it’s definitely a work in progress for me.
I remember early on during my student pharmacy rotations being inspired by young adults who were learning to live with schizophrenia, and realizing the impact a psychiatric pharmacist could have on their lives and functioning. I realized, not long after I was complaining about memorizing those CYP enzymes, that I had a foundational knowledge that was different than the other members of the health care team and I could make a real difference. I’m now able to apply that specialized skillset to improving the mental health care of veterans every day. The trauma some of these individuals have endured is unimaginable in many cases, and their resiliency is astounding. A crisis peaks, individuals seek help, a treatment plan is started, and recovery begins – and we as psychiatric pharmacists get to be a part of that journey. That journey is not usually linear, and while it can be stressful, helping see a person through a crisis is one of the most inspiring parts of my work. It’s so important to actively inventory the victories along the way. Remember the PHQ-9s that went from 25 to 3, the intolerable side effects keeping someone from working that you remedied, the patients who were suicidal but effectively used their safety plan, those on the brink of divorce that you connected to care, and everything in between.
Difficult times in any career are inevitable, and having a village of people who are equally inspired about Psychiatric Pharmacy has made those challenges much less isolating. My alma mater didn’t have a CPNP student chapter, so it wasn’t until residency that I really started to take note of the incredible work of the CPNP staff, leadership, and membership. Once I became aware of the comprehensive continuing education, networking, and the legislative and advocacy work CPNP was organizing, I knew I wanted to be involved. What I didn’t know at the time is that CPNP would be the outlet I would need to become re-energized when feeling disheartened and would be a “breath of fresh air” when I needed it most. Involvement in CPNP offers fulfillment and fosters leadership skills that are different than what professionals might experience in their direct patient care or supervisory work. It’s been humbling to sit in the same room, be on a committee, and exchanges ideas with of some of the people who were the first BCPPs – who literally paved the way for me as a newer practitioner to do the hard work I love. I am inspired by the fact that for 25 years, CPNP members have poured their heart (and brain) into every annual meeting, recertification product, and toolkit, with the aim that we’ll be better prepared to take care of patients living with mental illness.
My wish for psychiatric pharmacy is that our profession is understood, in its most advanced concept, by patients, payers and other providers. I hope that as the world copes with the sequalae of the COVID-19 pandemic, psychiatric pharmacists become recognized as a core mental health professional that can improve access to needed care and help save lives, just as the CPNP Strategic Plan envisions. I hope that the number of BCPP’s, currently at about 1,450, grows to meet this need because I believe board certification is one of the keys to expanding the advanced practice of pharmacists. Lastly, I hope that all psychiatric pharmacists, particularly new practitioners, recognize that our wishes for our profession are to be realized only if we jointly remain inspired, reach that light at the end of the tunnel, set new goals, and continue on the journey together.