Since community psychiatry involves reaching out to people wherever you find them (at home, in restaurants, even under bridges) to provide care and support, it is difficult to find psychiatrists who want to practice community psychiatry. As such, this allows a pharmacist to step into the role where a psychiatrist is difficult to find.
According to Places for People, pharmacist Kelly Gable is approved to “provide medication and consultation services through the collaborative practice agreement with and under the supervision of a physician.”
She is also approved to participate as a member of the community psychiatric rehabilitation team. She is also involved in plan treatments, and approves treatment plans for people she provides medication management services for. The services Gable provides are reimbursable by Medicaid, which is helpful for low income clients.
Gable and her IMPACT Team are just one of four assertive community treatment teams that Places for People operates. Places for People is a community psychiatric rehabilitation provider. The IMPACT Team is just one of 10 groups the Missouri mental health department recognizes.
The assertive community treatment model first emerged decades ago as a result of deinstitutionalization of psychiatric hospital residents. The state requires the community treatment services to use a multidisciplinary team to help the patient. The team must have “adequate prescribing capacity” which includes nursing, substance abuse treatment, a qualified mental health professional to serve as the team leader, an assistant, and someone with vocational specialization.
Since Places for People operates in a location with a federal government designation as a Mental Health Professional Shortage Area, the prescribing capacity requirement can be met by having a psychiatrist available for 10 hours per week for no more than 50 clients. Alternatively, they can have an advanced practice nurse for 16 hours a week to serve no more than 50 clients. Either the psychiatrist or the nurse must attend a minimum of two weekly team meetings.
In order to participate in an assertive community treatment team, pharmacists must have an active state license and attend classes to receive a certificate of medication therapeutic plan authority – a rule that’s been in place since August 2012. Because Gable had the certification, Places for People petitioned the state mental health department to allow her to step into the role of care provider and prescriber at the agency. The IMPACT team was formed in November 2012, and Gable has excelled in her role since.