Bridging Mental Health Care Gaps Through Ambulatory Pharmacy Practice

As mental health needs continue to rise across patient populations, pharmacists are playing an increasingly important role in bridging gaps in access, continuity, and quality of care. In ambulatory settings, these clinicians are uniquely positioned to identify barriers, monitor treatment response, and collaborate with interdisciplinary teams to support patients’ clinical and emotional well-being.

For Mental Health Awareness Month, Pharmacy Times interviewed Cristina Vargas, PharmD, a clinical ambulatory pharmacist at Baptist Health South Florida, who specializes in oral oncology. In this Q&A, she discusses how pharmacists contribute to mental health care, the challenges patients face when accessing services, and the evolving opportunities to integrate pharmacy expertise into holistic, team-based care models.

Pharmacy Times: Can you introduce yourself?

Cristina Vargas, PharmD: I am a clinical ambulatory pharmacist at Baptist Health South Florida, specializing in oral oncology. My role encompasses medication order review, patient education on specialty therapies, oversight of the dispensing process with delivery coordination, and ongoing drug therapy monitoring to optimize outcomes and minimize adverse effects.

Pharmacy Times: What role do ambulatory care pharmacists play in supporting patients with mental health conditions, and how do you work with other health care professionals on the care team?

Vargas: Clinical ambulatory pharmacists are among the most accessible health care professionals in a patient's continuum of care. We routinely assess how patients are tolerating treatment. By evaluating the quality of life, medication experience, and [adverse] effect burden, we identify gaps in care that may not come about during traditional clinic visits. We communicate clinical concerns to physicians, nurses, and behavioral health professionals, recommend therapy adjustments, and facilitate referrals to psychiatry, social work, symptom management, and other support services. Pharmacists help optimize the entire patient experience.¹

Pharmacy Times: What are the biggest barriers patients face when trying to access mental health care, and how can pharmacists help bridge those gaps?

Vargas: The most significant barriers include limited availability of mental health professionals, high cost of therapy, health care system complexity, and persistent stigma. These barriers manifest as patient hesitation, delayed care, or difficulty maintaining engagement in treatment.

Pharmacists are uniquely positioned to address these challenges through their accessibility and trusted relationships with patients. Ongoing follow-up, medication counseling, and therapeutic monitoring place pharmacists at the forefront of recognizing changes in adherence, mood, or engagement. Pharmacists can then facilitate referrals, coordinate care across providers, navigate insurance barriers, and normalize conversations around mental wellness. With expanding scopes of practice supported by professional organizations and evolving policy, pharmacists are becoming increasingly integral to holistic patient care.

Pharmacy Times: In what ways do social determinants of health (SDOH) impact your approach to patient care?

Vargas: SDOH have a greater influence on outcomes than traditional clinical risk factors, especially among individuals with mental health disorders. Financial instability, transportation barriers, and housing insecurity have all been significantly associated with poor medication adherence, and socioeconomic disadvantage has been linked to worse treatment prognosis. My approach is to identify these barriers early on and provide seamless care transitions.^2-4

Pharmacy Times: What emerging trends or new treatments in mental health are you most excited about?

Vargas: I am most excited about collaborative care models. [Data from] many collaborative care trials have demonstrated significant improvements in depression and anxiety outcomes. NCCN [National Comprehensive Cancer Network] guidelines now incorporate this model for delivering psychosocial interventions to patients [with cancer]. These models represent a paradigm shift toward truly integrated, team-based mental health care.^5,6

Pharmacy Times: How can the broader health care system better leverage pharmacists to improve mental health outcomes?

Vargas: Pharmacists remain among the most underutilized professionals when it comes to mental health care. Expanding collaborative practice agreements, embedding pharmacists within interdisciplinary care teams, and advancing policy and funding support for pharmacist-delivered mental health services would strengthen medication management, therapeutic monitoring, and continuity of care. Ultimately, we can make a positive impact on improving mental health outcomes in our patients.⁷

Pharmacy Times: Any final or closing thoughts?

Vargas: Many [patients] experience psychiatric disorders throughout their cancer journey. [American Society of Clinical Oncology] guidelines highlight that psychological symptoms in this population are often undertreated.¹ With years of experience in oncology, I have witnessed firsthand [how] addressing a patient’s emotional and mental well-being is just as essential as treating their physical disease to achieve optimal outcomes.

[NCCN] standards emphasize that distress should be recognized, monitored, documented, and treated promptly at all stages of disease through interdisciplinary collaboration.⁵ Through ongoing education, therapeutic monitoring, and teamwork across the care continuum, pharmacists play a vital role in closing gaps in mental health care. When fully integrated into the care team, we can improve treatment adherence and meaningfully elevate the quality of care patients receive.^2-4,8

REFERENCES

1. Andersen BL, Lacchetti C, Ashing K, et al. Management of anxiety and depression in adult survivors of cancer: ASCO guideline update. J Clin Oncol. 2023;41(18):3426-3453.

2. Jeste DV, et al. Addressing social determinants of health in individuals with mental disorders. Transl Psychiatry. 2025;15(1):120.

3. Yang G, et al. The association of social determinants of health and medication adherence. Am J Emerg Med. 2025;95:16-17.

4. Buckman JEJ, et al. Socioeconomic indicators of treatment prognosis for adults with depression. JAMA Psychiatry. 2022;79(5):406-416.

5. NCCN. Clinical Practice Guidelines in Oncology. Distress management, version 2.2025. Accessed May 13, 2026. https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1431

6. Rollman BL, Belnap BH, Abebe KZ, et al. Effectiveness of online collaborative care for treating mood and anxiety disorders in primary care. JAMA Psychiatry. 2018;75(1):56-64.

7. Kroenke K, Unutzer J. Closing the false divide: bridging mental and physical health. J Gen Intern Med. 2017;32(4):404-410. doi:10.1007/s11606-016-3967-9

8. Laiteerapong N, Ham SA, Ari M, et al. A quasi-experimental evaluation of a primary care behavioral health integration program. J Gen Intern Med. 2026;41(4):913-921.