Assistant Professor Lisa Goldstone wants to see people who suffer with mental illness, and the medications they take, come out of the darkness. Goldstone’s patients deal with the stigma attached to these issues on a daily basis. She looks forward to a day when this is not the case.
Goldstone, who completed her PharmD at UA COP in 2007, has spent the last 20 years in the behavioral health field. She already had her master’s degree in clinical psychology, but when in her daily work she saw the lack of knowledge related to treating mental illness with the proper medications, Goldstone decided to go to pharmacy school and learn all she could about this important aspect of the mental healthcare field.
For about three years, Goldstone has divided her time between teaching at the College of Pharmacy and clinical practice at the University of Arizona Medical Center-South Campus in the inpatient behavioral health units. She enjoys the fact that each day is a new experience with a chance to be kind to a segment of society that has, in many cases, experienced a lot of unkindness.
Many of her patients stop taking their medications simply out of embarrassment. Some resort to picking up prescriptions at pharmacies far from their neighborhood, or asking family members to pick them up for them, so others don’t learn of their conditions. Goldstone hopes that education about mental illness, and the drugs used to help regulate some of the behaviors associated with it, will help quell the shame that so often accompanies the disease. She sees pharmacists as having an important impact in this field.
“I really enjoy providing direct patient care services to my patients,” says Goldstone. “Pharmacists can make a huge difference by making sure patients understand how to take their medications, including how to appropriately handle side effects and how to remember to take medications. These are two of the biggest challenges to pharmaco-adherence for patients with psychiatric disorders.”
Goldstone works as a preceptor for fourth-year PharmD students doing their Advanced Pharmacy Practice Experience (APPE) rotations. She works with up to three students at a time in the inpatient behavioral health units. Students may choose between the adult and geriatric programs. The center has two adult units with 24 beds each, and one geriatric unit with 14 beds.
"It is important that students learn how to effectively work with patients with psychiatric disorders, especially due to the stigma of mental illness that still exists among some healthcare professionals, including pharmacists," says Goldstone.
The impact Goldman has on those she teaches is made clear through the comments of some of the fourth-year PharmD students she worked with during the past spring semester:
“It was a complete honor to have the opportunity to work with her and be able to spend six weeks at her practice site. I truly believe she is an extraordinary individual and her passion as a psychiatric pharmacist is admirable,” says Suesan Jacobs.
“From my experiences with Lisa, I gained a higher understanding of psychiatric patients and learned the true value of the impact pharmacists can have on their care,” says Natalee Tanner.
Sarah Norman echoed the praise of her fellow students: “I had such a great experience on my first psychiatric rotation on the adult acute unit at UAMC-South Campus that I added the geriatric psych rotation at the UAMC-South Campus during my vacation slot.”
Goldstone tells students that the door is wide open for pharmacy jobs in this field. One out of every two adults will have some kind of mental health concern in his or her lifetime. This can include depression, anxiety, substance abuse and bipolar disorder, to name a few. The proper medication, in many cases, is of great help in dealing with these issues. Goldstone recognizes the need for psychiatric pharmacy in the primary care setting so that problems can be addressed before they reach a critical stage.
When asked what the downside is to her work, Goldstone points to her discouragement that Arizona often doesn’t have the mental health benefits that patients need, which leads to limited access to the care and medications they should have. Patients often end up in a cycle of inpatient hospitalizations rather than treatment because follow-up care is not provided in many cases. Managing her time between her responsibilities at the COP and UAMC-South can also be a challenge.
Goldstone seems to be handling her tasks quite well. Her bright smile and positive attitude must certainly make many of her patients’ days brighter.
Story by Rebecca Wingate, communications assistant