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Karla Opheim, PharmD

Primary care providers prescribe almost 80% of antidepressant prescriptions and see approximately 60% of people being treated for depression in the United States.1 There is typically limited support from specialty services for this type of prescribing in primary care.

Primary Care Mental Health Integration in the VA Setting

The Veterans Health Administration developed a program titled Primary Care Mental Health Integration (PC-MHI) to offer expert mental health care support in the primary care setting. Psychiatric pharmacists fill the role of a prescribing provider in PC-MHI, working alongside therapists for treatment of mild-to-moderate cases of mental health conditions such as anxiety, depression, post-traumatic stress disorder (PTSD), substance use, and insomnia. Pharmacists without this specialized training or experience also work with many patients who have mental health conditions in the community and general setting. Although these pharmacists endorse a positive attitude toward a role in depression care, they perceive a lack of education in mental health as a potential barrier in providing optimal care to these patients.2

The Value of Primary Care Rotation

Given this perceived barrier of lack of mental health education in the pharmacy curriculum, it would be of great benefit for pharmacy students rotating in a primary care clinic to spend time in PC-MHI. Not only will students gain valuable knowledge on mental health conditions and medications, but they will also learn how mental illness may complicate other medical conditions that are commonly treated in primary care. Providing this experiential education in the pharmacy curriculum could improve the care provided by nonclinical or nonspecialized pharmacy professionals, who frequently come into contact with patients with mental health conditions. This may be especially important as the shortage of psychiatrists continues to grow in the United States – some sources estimate a decrease in 27% by the year 2030.3

Overall, psychiatric clinical pharmacy specialists working in PC-MHI offer expert and accessible pharmacotherapy treatment for mental health conditions in primary care patients. They also preserve access in the outpatient mental health clinic for severe or complex patient cases. Given the benefits that PC-MHI affords to primary care providers and patients in general, it would be beneficial for pharmacy students to gain experience in this area. It may also expand upon and solidify knowledge of mental health treatment that is learned by students in pharmacy school.


  1. Barkil-Oteo A. Collaborative care for depression in primary care: how psychiatry could "troubleshoot" current treatments and practices. Yale J Biol Med. 2013 Jun 13;86(2):139-46. PMID: 23766735; PMCID: PMC3670434.
  2. Scheerder G, Coster I, and Van Audenhosve C. Pharmacists’ role in depression care: A survey of attitudes, current practices, and barriers. Psychiatry Online. 2015 Jan 13; 59(10).
  3. HRSA Health Workforce. Behavioral Health Workforce Projects: Psychiatrists (Adult), Child and Adolescent Psychiatrists. June 29, 2023.
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