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How can we as an industry help address the growing need and demand for quality mental health services? One of the more promising solutions is the expanded use of certified physician assistants.
Mental and behavioral health conditions, including substance misuse, are reaching epidemic proportions throughout the U.S. How can we as an industry help address the growing need and demand for quality mental health services?
One of the more promising solutions is the expanded use of certified physician assistants (PA-Cs) to share the workload of busy psychiatrists by filling gaps in care in mental health clinics, hospitals, busy EDs and other settings. PA-Cs are prepared through classroom and clinical education at the graduate level and certification maintained by earning substantial CME and passing rigorous assessments every 10 years.
Here are five ways PA-Cs can help plans and provider groups meet the growing demand for effective and quality focused behavioral healthcare services:
The realities of psychiatric care shortages in the U.S. are well documented. The good news is that four of the top mental Health Professional Shortage Areas, are also four of the top five states with the largest numbers of certified PAs: California, Texas, Florida and New York. In these states, a strong PA workforce is already in place, working in collaboration with psychiatrists and other mental health providers.
Depending on their chosen specialty and clinical setting, PA-Cs diagnose and manage a range of mental disorders including ADHD, depression, anxiety, addiction, bipolar disorder, autism and schizophrenia. Utilizing PAs to provide initial intake and manage urgent cases, as well as communicating with family members and coordinating discharge with community physicians, helps free psychiatrists to focus on the most difficult cases.
PA-Cs are educated in graduate level programs that include about 1,000 didactic hours of general medical science, including behavioral health, followed by approximately 2,000 hours in clinical rotations. In addition, PAs maintain certification through an ongoing program that includes earning 100 hours of CME every two years, as well as rigorous assessments every 10 years. PAs in psychiatry typically chose that specialty and are committed to ongoing education in the field. Many PAs further their education by securing a Certificate of Added Qualification in Psychiatry from the National Commission on Certification of Physician Assistants.
Just because a patient has a mental illness or even an addiction does not mean that their needs for other healthcare services stop. Because PAs are educated and certified as generalists, they can also provide care for patients’ routine and urgent healthcare needs, whether that be a cold, flu, or managing an existing chronic condition such as diabetes. That enables healthcare teams to provide more integrated care and to better coordinate on the interaction of non-psychiatric medications on patients’ overall health status and recovery.
Medication management is one of the key services provided by PAs in behavioral health settings. With changing laws, PAs in most states can prescribe medications such as buprenorphine, and other opioid agonists used to relieve drug cravings. As psychiatrists are currently limited in the number of patients they can prescribe this class of medications for, the incorporation of a PA-C into addiction treatment programs can further expand the practice’s ability to treat those with opioid addictions.
Current data shows that over 70% of PAs now work in specialties like psychiatry–outside of primary care. As demand for mental health services continues to escalate, Certified PAs can be counted on as prepared and proven to provide high-quality, cost-effective care in this field.
Dawn Morton-Rias, EdD, PA-C, is the president and CEO of the National Commission on Certification of Physician Assistants (NCCPA), which is the sole certification organization for the nation’s 115,000-plus PAs. The NCCPA supports a range of public health initiatives through its nccPA Health Foundation. In 2017, the Foundation convened the PArtners in Mental Health Summit to focus on mental health initiatives and to expand the ability of certified PAs to improve mental health through community based efforts.
Graphic information: According to the 2016 Statistical Report of Certified PAs by Specialty, more than 1,200 certified PAs work specifically in psychiatry. Full-time psychiatry PAs see an average of 68 patients a week, treating over 80,000 patients a week or more than 4,000,000 patients a year. In addition, many of the nation’s 115,000 Certified PAs recognize, screen, and treat mental illness in primary care settings, hospitals, and EDs across the country.