Meeting Mental Health Needs


A mental health education focus area at the University of Minnesota College of Pharmacy encourages comprehensive patient care.

By Emily Jacobs

Health experts across the United States are looking for every opportunity to ease an increasing demand for mental health services. Mental health patients can have complex needs and often require the expertise of multiple providers. Minnesota is no exception to this demand. At the same time, many primary care providers throughout the state do not feel qualified to treat mental health conditions like depression and anxiety. Instead, they often refer patients to specialized psychiatric providers. This approach can cause delayed care and a lack of coordinated, comprehensive care.

“Mental health psychiatric care is often thought of as a specialty area, and it is, just like every other area,” said Dr. Amy L. Pittenger, professor and the head of Pharmaceutical Care & Health-Systems at the University of Minnesota (UMN) College of Pharmacy. “But it is also a chronic condition that can and should be managed within the primary care setting by ambulatory care, primary care providers.”

To help alleviate some of these issues, UMN College of Pharmacy established the Interprofessional Integrative Mental Health Focus Area, initially as a grant-funded effort through the U.S. Health Resources and Services Administration. Within this focus area, Pharm.D. students are paired with psychiatric Doctor of Nursing Practice (D.N.P.) students on a 1:1 ratio. This helps them “develop additional collaborative practice skills and expanded knowledge of psychiatric-specific practice approaches,” according to UMN.

Rather than creating a specialty psychiatric pharmacy path, the focus area encourages collaboration among primary care clinicians. This prepares them to offer better team-based care for patients with mental health needs. Focus area participants gain additional knowledge and experience in caring for the whole patient, both physically and mentally. In particular, student pharmacists are better prepared to provide medication management for chronic mental health conditions.


Students do come in much more comfortable with that patient encounter, how to interact with other health professionals within the clinical setting, and so they definitely have a head start and a bit of an accelerated path toward those important practice goals.

Dr. Amy Pittenger

A More Robust Perspective

In their second year of pharmacy school, UMN students receive an invitation to join the focus area. The focus area begins in the fall semester of the third year and lasts through the end of the program. Student pharmacists must complete several additional courses, as well as a Patient Care Elective Psych APPE.

The first semester of the focus area concentrates on clinical interviewing. With their interprofessional partner, students interview patients while under academic observation. The students learn to plan meetings with patients, debrief with their partner afterward and make clinical decisions based on the interview. The second semester focuses on diagnosis and therapy selection as a team. As the Pharm.D. and D.N.P. students develop knowledge and skills specific to their respective degrees, they can increasingly contribute a more robust perspective to their collaborations throughout the academic year.

Over the yearlong elective series, focus area participants deliver 15-16 hours of team-based care to standardized patients. Within their APPE year, students must also demonstrate three additional learning objectives around the delivery of care as an interprofessional team. They must consider the whole patient, including physical and mental health, and incorporate knowledge from multiple clinicians in their decisions. Focus area participants complete the program under direct observation and preceptor evaluations in a clinical setting.

While many pharmacy schools build mental health experience into their curriculum, UMN considers its approach unique. The focus area provides essentially a two-year academic, hands-on experience that is not widely available elsewhere. By focusing on interprofessional partnerships, UMN has provided a way for Pharm.D. and D.N.P. participants to learn from each other and contribute to patient care in distinct ways. Almost 100 students have completed the focus area so far.

After their experience in the focus area, student pharmacists who go on to pharmacy careers show more interest in collaborating with other primary care providers. They intentionally seek practices that follow a team-based, interprofessional care model that allows for comprehensive patient care. “Students do come in much more comfortable with that patient encounter, how to interact with other health professionals within the clinical setting, and so they definitely have a head start and a bit of an accelerated path toward those important practice goals,” Pittenger observed.

While some students from this cohort have gone on to board-certified psychiatric pharmacy careers, most have pursued ambulatory care and generalist positions. Rather than referring all patients with mental health needs to specialists, Pittenger noted that these graduates recognize that “as a generalist, this is a part of their responsibilities, but they’re confident in helping patients across the spectrum of chronic conditions.”

Emily Jacobs is a freelance writer based in Toledo, Ohio.