Expanding Psychiatry’s Reach

By considering different team members, it may be possible to address the broader needs of patients with mental illness.

FROM OUR READERS

I was heartened to read your recent articles on utilizing nurse practitioners (NPs) for mental health care, both “Partnering with Psychiatric-Mental Health Nurse Practitioners” and “Psychiatry 2021: Team Psychiatry.” Another important resource to address limited health care resources are physician assistants (PAs).

PAs have similar training to NPs. They are trained according to the medical model of care (which primarily consists of diagnosis, treatment, and cure). PAs provide mental health care in primary care settings.

All PAs are required to complete the rigorous general medical training, clinical rotations for (27 months average). All states require certification which is obtained by passing an exam administered by the National Commission for Certification of PAs (NCCPA) following graduation. The certification is renewed every 10 years (recently updated from 6). Re-certification requires 100 hours of Category I CME, 50 of Category II and passing. The certification is required to be current by most states.

They can earn a certificate of added qualifications in several fields, including psychiatry. These are generally 1 year in length and involve didactic work as well as ongoing clinical work (often with residents).

In response the NCCPA developed a further certification in several specialties, requiring CMEs and passing a specialty exam. The specialty certification is called a CAQ or Certification of Added Qualifications. The CAQ requires 75 credits of specialty continuing education (over 6 years), 2000hours of practice in the specialty or 1 full year of practice in the specialty which may be spread over 6 years. There is also attestation of procedure and patient case experience.

Although there are differences between NPs and PAs, both have a long history of providing quality care in diverse populations and settings. Ultimately, the goal is to extend access and improve care for individuals with unmet mental health needs, and PAs are ready to their part.

Ms Peterson recently retired as an associate faculty member at the Texas Tech University Health Care Center.

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