Searching for Solutions

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.

As burnout continues to tear through the medical community, it is clear that pharmacy is not immune. Therefore, strategies to manage and prevent burnout should be a crucial part of training new health care professionals and maintaining experienced ones. Considering the Oath of a Pharmacist specifically states “I will consider the welfare of humanity and relief of suffering my primary concern,” we have an ethical obligation to care for the wellbeing of the professionals providing care to our patients. We know, however, that intention and effective implementation are very different.

My all-time favorite comment from a student evaluation would have to be: “this rotation did not scar me for life.” This particular student found themselves on my inpatient acute psychiatry rotation as their final Advance Pharmacy Practice Experience (APPE) rotation, randomly assigned to them by their college of pharmacy. This student had no particular interest in psychiatric pharmacy and admitted to feeling nervous due to “horror stories” they had heard from classmates who had completed similar rotations at the state mental hospital and their perception of serious mental illness (SMI) from the media. This is a scenario I often find myself in as an APPE preceptor for an inpatient acute psychiatric pharmacy rotation.

Congratulations to Deanna Kelly, Clayton English, Alicia Sasaki, Lucas Hill, Ian McGrane, Richard Silvia, and all the other members making an impact in psychiatric pharmacy!

AAPP is at work for psychiatric pharmacists! Learn more about these initiatives by viewing the AAPP Forum on Our Future presented at AAPP 2023 and by reviewing posters highlighting our focus. AAPP is investing heavily in the strategic plan to advance psychiatric pharmacy!

The AAPP board officer transition will occur on July 1. AAPP thanks outgoing board members Robert Haight, PharmD, BCPP, and Sarah Melton Thomason, PharmD, BCPP, BCACP, FASCP, for their dedicated service. Continuing on the Board for 2023-2024 are Ben Chavez, PharmD, BCPP, BCACP, Cindy Gutierrez, PharmD, MS, BCPP, Suzanne Harris, PharmD, BCPP, Amy Werremeyer, PharmD, BCPP, and Andrew Williams, PharmD, BCPP, BCGP.

Congratulations to Deanna Kelly, Jessica Ho, Archana Jhawar, Marnie Noel, Michelle Geier, Joe Cusimano, and all the other members making an impact in psychiatric pharmacy!

As we start a new year, it is heartening that our society is beginning to recognize that whole health begins with mental health. However, as the need for mental health care grows, it is clear that the mental health workforce is inadequate. AAPP continues to beat the drum through our communications and initiatives that psychiatric pharmacists are already, and can be even more so, part of the solution to the workforce shortage.

For the 2022 Residency Program Director Survey, 89 distinct Residency Program Directors (RPDs) were contacted and 68 submitted a survey response (74% response rate, an improvement from our last RPD survey). From the results of the survey, 83 PGY-2 in Psychiatry positions completed residency in 2021-2022.

AAPP congratulates those individuals who were successful in obtaining the BCPP designation in the Spring and Fall of 2022. There are now over 1,480 individuals who are credentialed as Board Certified Psychiatric Pharmacists.

Since the declaration of the opioid epidemic as a public national health crisis in 2017 there has been an emphasis on opioid stewardship practice in health care. Many health care systems have developed formal opioid stewardship programs to provide best practice guidance and metrics to analyze prescribing as well as harm reduction practices. However, opioid related deaths continue to rise, leading to the need to better identify and treat opioid use disorder (OUD) with appropriate medications and develop management processes.1

Congratulations to M. Lynn Crismon, Charles Caley, Jeremy Daniel, Megan Ehret, Stephanie Nichols, Amy Vandenberg and all the other members making an impact in psychiatric pharmacy!

Happy New Year! This issue of AAPP Perspectives is supported by the Resident and New Practitioner Committee with several articles focused on issues and trends impacting residents and new practitioners. Additionally, we release and analyze the biennial residency program director survey results for your benefit. Wishing you all a great start to the New Year!

Congratulations to Megan Ehret, Jennifer Martin, Emma Palmer, Elayne Ansara, Amber Douglass and all the other members making an impact in psychiatric pharmacy!

How quickly a year comes and goes! It’s hard to believe that it’s been nearly a full 12 months since I assumed the role as your President. As I prepare to hand off the reins to Incoming President Michelle Geier on July 1st and reflect back on the year, it’s fun to think about what has been accomplished. The AAPP Board of Directors has been busy and has engaged in activities that are likely to impact AAPP’s trajectory into the future.

Viana Salinas, PharmD, has tips for pharmacy trainees working in an interdisciplinary team! As a current trainee, both personal and professional growth are key to avoid undermining my potential and success. Attaining growth in both simply cannot be taught, but must be achieved through learning experiences that an individual is presented with. An opportunity for a trainee to be a part of an interdisciplinary team not only allows for trainees to come into their own but showcases the importance of their role in contributing to the delivery of quality patient care. Although my interdisciplinary team experience has stemmed from being in an acute inpatient psychiatry setting, I am confident that I as well as other trainees, can apply interdisciplinary skills to any practice setting.

My teaching philosophy is deeply influenced by my mother, who dedicated her life to her students. From her, I learned that every individual deserves to be treated with dignity, respect, and compassion. I strive to create a nurturing environment where each learner feels supported, recognizing that they are unique individuals with their own stories, backgrounds, and challenges.

Generations are often used to define an age cohort of people, typically spanning a 15–20-year period.1 The current pharmacy workforce is composed of three generations; Baby Boomers (born 1946-1964), Generation X (born 1965 to 1980), and Millennials (born 1980-1996). The next generation to enter pharmacy school and the workforce is Generation Z (Gen Z) born 1997-2012. As Gen Z becomes a significant part of our profession, we must adapt precepting strategies for these learners to align with their preferences to promote learner success.

View results of the AAPP 2024 Residency Program Director Survey. Responses represent 2/3 of PGY2 psychiatric resident slots currently available.

It never ceases to amaze me how quickly the months and years pass. Seems like yesterday we were at AAPP 2024 with many of you, and now we are in the final weeks of 2024 fresh off our November Board retreat where we evaluated goals, strategies, and measures of success for your association. During the retreat, we set our eyes on the future and acted to evolve our strategic planning processes to be more fluid and continual to support quick reaction and shifts as needed. Early next year, we will start to introduce the components of this iterative strategic planning process which you will play a critical role in as AAPP members.

We know you are living and breathing the rapidly changing health care and pharmacy environment we operate within, and we urge you to plan for how you and your organization can best position psychiatric pharmacy. As AAPP enters this strategic planning cycle and begins to consider future directions and actions, we will be working to define the role of psychiatric pharmacists in these areas so that others don't do so on our behalf. As we traverse this journey together, be prepared to share your thoughts and opinions with Board members via surveys and/or focus groups that may be scheduled.

Complete your volunteer interest profile/application on or before November 19! AAPP is truly a member-driven organization with 1 in 6 members volunteering for AAPP in some capacity. From now through November 19, AAPP is encouraging members to sign up to serve on one of over 25 committees, councils, editorial boards, and/or task forces. These opportunities range from well-known committees like our Program Committee to more narrowly focused task forces such as our Employer Resource Center Task Force.

Completion of a quality improvement or research project is a common requirement of all ASHP-accredited pharmacy residencies. While many residents seem to dread this aspect of postgraduate training for various reasons, it stood out as one of my favorite components. Over and over, my patient encounters energized me with ideas of innovations I could explore to improve the quality of psychiatric care. That excitement helped me realize my goal of integrating research into my career as a clinical psychiatric pharmacist. I leaned on my mentors to gain a better understanding of how to accomplish this and ultimately chose to pursue a research fellowship after finishing my PGY2 Psychiatric Pharmacy residency. I’m delighted to share some of the insight I learned along the way.

Opioid overdose deaths remain a prevalent issue throughout the United States, with over 81,000 reported deaths due to opioid overdose in 2023 (CDC, 2024). There is an urgent need to spread awareness regarding drugs of abuse and counterfeit drugs, as well as to reduce harm in our communities. The AAPP-University of Southern California (USC) student chapter has established our NaloxoneSC Program to do just that.