Every PA Has a Role in Mental Health

More than 200,000 board certified physician assistants (PAs) in the United States provide care to an estimated 11.4 million patients each week. PAs serve on the frontlines of healthcare and are uniquely positioned to recognize, screen for, and impact mental illness and substance use disorders during their daily patient encounters. No matter the specialty or practice setting, every PA can have a role in mental health care.

In its 2024 Statistical Profile of Board Certified Physician Assistants, the National Commission on Certification of Physician Assistants (NCCPA) described the significant opportunity that PAs have to address mental health care, noting that 83.3% of PAs encounter patients at least monthly who need mental health treatment. On average, 26.7% of patients seen by PAs require some type of mental health care.

Drilling down, NCCPA reported in its 2024 Statistical Profile of Board Certified PAs by Specialty that more than 3200 PAs are practicing in psychiatry, a 2.4% increase since 2020, which makes psychiatry proportionally one of the fastest growing PA specialty areas. Psychiatry PAs report providing the following services in their principal clinical position for most patients:

• 88.7% counsel and educate patients
• 85.8% diagnose, treat, and manage chronic illnesses
• 70.5% conduct physical examinations and obtain medical histories
• 67.8% diagnose, treat, and manage acute illnesses
• 59.4% provide care coordination

These findings are particularly important given the state of mental illness in our country. Mental Health America found that 55% of the over 50 million Americans experiencing a mental illness received no treatment, citing accessibility and cost as the primary reasons. Further, the National Alliance on Mental Illness reports that:

• 1 in 5 US adults experience mental illness each year¹
• 1 in 20 US adults experience serious mental illness each year¹
• 1 in 7 US youth aged 6-17 experience a mental health disorder each year²
• 50% of all lifetime mental illness begins by age 14, and 75% by age 24³
• Suicide is the 2nd leading cause of death among people aged 10-14⁴

As early as 1999, then-US Surgeon General, David Satcher, MD, PhD, issued a report with a clarion call to the nation regarding its growing mental health crisis. Successive Surgeon Generals have expanded upon this groundbreaking work, issuing several mental health reports, including the effects on health care workers, the increasing prevalence among young people, the impact of social media, and our nation’s epidemic of loneliness.

NCCPA has long recognized PA involvement in addressing our nation’s mental health crisis. PAs are educated in the medical model; and accredited PA educational programs include over 2000 hours of clinical rotations. PA graduates complete the Physician Assistant National Certifying Exam to earn the generalist credential, the PA-C.

PAs maintain the credential through continuing medical education every 2 years and a recertification assessment every 10 years. Psychiatry and behavioral health science content is included in the content blueprints for both the certifying examination and recertification assessment. The inclusion of this content underscores what PAs are seeing in practice and that all PAs should be aware of signs that indicate a need to screen for mental health/substance use disorders during their daily patient encounters.

To further support PAs who practice in psychiatry, NCCPA created the Certificate of Added Qualifications (CAQ) in psychiatry for PAs practicing in this field who desired an additional credential to demonstrate their advanced specialty expertise. More than 1300 PAs have earned their CAQ in psychiatry. PAs that earn the CAQ must demonstrate a valid, unrestricted license and board certification, meet specialty CME and experience requirements, submit an attestation from someone who works in the specialty and is familiar with their practice, and pass an examination. PAs have 6 years to complete the process. PAs earn the CAQ for a period of 10 years and maintain the CAQ by meeting education and examination requirements.

The nccPA Health Foundation is also a leading advocate for PA awareness of mental health needs of patients and providers. The Health Foundation adopted mental health as a major focus of its programmatic activity and offers year-round grant funding to support PAs, PA faculty, PA students, and their interprofessional partners in efforts that raise awareness and improve health outcomes while addressing mental health needs.

In addition, the Health Foundation supports its Partners in Mental Health Steering Committee, which includes representatives from the major PA organizations, along with PA and interprofessional clinicians and advocates. The steering committee collaborates on ways to increase PA awareness of, and improve the profession’s impact in, addressing our nation’s mental health needs. To learn more about the steering committee’s efforts, review their annual reports here.

Given the alarming and increasing rates of mental illness that Americans confront daily, PAs are increasingly aware of this health crisis and prepared to fill this vital health care gap. When it comes to mental illness, every PA has a role.

Mr St. Cyr II served as NCCPA’s representative on the nccPA Health Foundation’s Partners in Mental Health Steering Committee from 2018-2025, including 2years as the steering committee’s chair in 2023-2024. In addition, he served as a member of the Board of Directors of both the NCCPA and the nccPA Health Foundation.

References

1. Key substance use and mental health indicators in the United States: results from the 2024 National Survey on Drug Use and Health. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. 2025. Accessed March 6, 2026. https://www.samhsa.gov/data/sites/default/files/reports/rpt56287/2024-nsduh-annual-national/2024-nsduh-annual-national-html-071425-edited/2024-nsduh-annual-national.htm

2. Whitney DG, Peterson MD. US national and state-level prevalence of mental health disorders and disparities of mental health care use in children. JAMA Pediatr. 2019;173(4):389–391.

3. Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593-602.

4. Suicide. National Institute of Mental Health. August 2025. Accessed March 6, 2026. https://www.nimh.nih.gov/health/statistics/suicide