Is There a Role for Physician Assistants in Community Mental Health?

The authors briefly describe the history anddevelopment of the medical discipline of physicianassistants (PAs). A careful review of the literaturereveals the limited use of PAs in psychiatry, usually only for primary health care needs. A model forusing PAs as psychiatric assistants is presented,including the training required and a description of theclinical and administrative functions. The advantages of such a model are multiple. These include: 1)more effective and efficient use of the psychiatrist; 2)reduced costs of service; 3) increased primary medicalscreening capability in the CMHC; and 4) increased presence of ethnic minorities on theprofessional staff of the CMHC. Disadvantages of themodel relate to training and “turf” issues.In view of the shortage and dissatisfaction ofpsychiatrists in CMHC settings, and other challenges to the provisionof quality mental health care in the community, thismodel should be considered as a logical and positiveresponse to that challenge. If the model is valid, then training facilities must make a systematiceffort to recruit, train, and place psychiatricphysician assistants in community agencies.