Looking Toward the Future: Serious Mental Illness


Troy Trygstad, PharmD, MBA, PhD; Adrienne Cervone, PharmD; Carla Cobb, PharmD, BCPP; and Tripp Logan, PharmD, summarize the discussion on patients with serious mental illness with hopes for the future for these patients including affordable medications, improved access to team based care, and keeping care locally.

Troy Trygstad, PharmD, MBA, PhD: This sounds to me like the very definition of community-based care, right? And one wonders why we don’t encourage community-based care. With severe mental illness, certainly I don’t know that mail order could accomplish that. So, with this practice model, it seems to me there’s an opportunity to highlight why it’s important to have your pharmacies in the community. And, of course, the whole basis with community health centers also in the community.

Well, as we always close with this Peer Exchange®, I want to offer you the magic wand. So, if this represents your magic wand, you only get one of them, and one only produces one magic spell that fixes one problem. And so, there’s all sorts of problems as we’ve described. But when it comes to severe mental illness, whether it’s therapies or it is healthcare financing, or care coordination, or housing or food, or stigma, or the other list of 20 things that need to be fixed for this population, what would be the one thing that you would wish away or wish for? Adrianne, you’re first.

Adrienne Cervone, PharmD: I would wish that patients could afford their medicines, because they are switched to medicines that might not be that great for them, but it’s what the insurance covers or it’s what they can afford. And I know that if they had access to other medications without the insurance stopping that, at least try it. You know? At least give them the chance to see if this medicine works. I think that’s where I would wave my magic wand.

Troy Trygstad, PharmD, MBA, PhD: All right, she can use her magic wand to fix health care financing. Carla?

Carla Cobb, PharmD, BCPP: Yes. I would use my magic wand to facilitate and improve access to team-based care. As I said earlier, we need everybody at the table, and part of that program is to involve physicians, pharmacists, social workers, case managers, everybody needs to be involved to be able to do a better job of taking care of the unmet needs of this population. And since we’re pharmacists and it’s a pharmacy audience, I feel that getting pharmacists more engaged in learning, understanding about mental illness, and coming up with innovative practices that can help meet that need is what I would like to see more of.

Troy Trygstad, PharmD, MBA, PhD: You’re not a middle child, are you?

Carla Cobb, PharmD, BCPP: No.

Troy Trygstad, PharmD, MBA, PhD: That sounded very middle child-ish. I’m a middle child, I just want everybody to work together and get along. But I think that’s great, you’ve evolved from the birth order. Tripp?

Tripp Logan, PharmD: So, I’m going to put both of these together to stamp the finale here and keep not only just mental health but patients with chronic conditions, and keep the care local. Because there are a lot of conditions that can be treated remotely. But some of these really sensitive conditions, like we’re speaking of today, it has to be done locally if it’s going to be successful. And so, we all are aware of many barriers that keep us from doing a lot of things locally, from costs and access and team and so on. So, local care.

Troy Trygstad, PharmD, MBA, PhD: All right. Well, thank you all for some great contributions to this discussion. On behalf of our panel, we thank you for joining us and we hope you found this Peer Exchange® discussion to be useful and information. And I would encourage all of you to check out CPNP—really good folks doing really good things. That’ll be all for today, and we’ll see you next time.

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