Maria Blaze, PharmD, BCPP

Narrator: Welcome to We’re Your Pharmacist, a new monthly podcast featuring ASHP members and colleagues sharing their stories and discussing the essential contributions pharmacists make as part of the patient care team.

Vicki Basalyga: Hello and welcome to the We’re Your Pharmacist series, where we sit down with pharmacists and other healthcare team members to share stories of the incredible impact pharmacists have on patient care. I’m Vicki Basalyga, Director of Member Relations at ASHP, and today I am joined by Maria Blaze, Mental Health Pharmacy Practitioner at the Lieutenant Colonel Luke Weathers Jr. VA Medical Center in Memphis, Tennessee. Maria, thank you so much for joining us.

Maria Blaze: Thank you for having me.

Vicki Basalyga: So can you start off with a little bit about your background and your current role and why you decided to focus on psychiatric pharmacy.

Maria Blaze: Sure. My career in pharmacy started when I actually was a teenager. I went to a high school that was really focused on getting students to college and helping with our decisions on like what to do. They gave us this exam or kind of like a test to see our interests and It kind of computed certain jobs that we may be interested in. And two jobs that came out for me was a psychiatrist and a pharmacist. And at that time, I’m like, well, psychiatrist is way far off, but I’ve seen young people work in a pharmacy. I wonder if I could work there too. And I just walked into Walgreens and asked for an application and I ended up getting the job and I really loved like being a pharmacy tech. Looking up to the pharmacist there, I just kind of knew that was going to be my track going forward. When it came to focusing on psychiatric pharmacy, I didn’t think that was going to be an Ave. for me anymore since I did choose pharmacy over psychiatry. However, once I got into pharmacy school, I met my first psychiatric pharmacist, which I thought was super amazing. I felt I could merge the worlds that I wanted to kind of go into initially, and it was just a dream opportunity. And so from there, I knew I needed to complete residency I did my first year residency with a focus in mental health. And what that just really meant is that any, as many electives as I could take in psychiatry, I did as the PGY1 requirements allow. And then I went on to do my second year in psychiatric pharmacy to specialize. And currently in my role, I actually manage an independent panel at the Memphis VA, which is a little bit of a unique role. just because typically we see pharmacists in a shared panel situation with our other mental health prescribers. And it’s just a very rewarding opportunity to be able to have an independent panel because it just shows how far clinical pharmacists and psychiatric pharmacists just enjoy how far we’ve come.

Vicki Basalyga: What an amazing journey. How do pharmacists contribute to the mental health care team? Can you walk us through how you work with psychiatrists, psychologists, and other clinicians?

Maria Blaze: Yes, I am really proud of how the VA really brings collaborative practice together. So within many of the mental health outpatient clinics within the VA system, we are in teams. And on these teams, typically we have our mental health prescribers. So that usually includes a psychiatric pharmacist, either a nurse practitioner, a PA, or a psychiatrist. We have our licensed clinical social workers, our therapists, including our psychologist as well. And then we have a nurse. And so every, depending on what team you’re on, some teams meet twice a week, some teams meet once a week, but we always have these huddles where we collaborate on different patient cases. We provide support for each other. We usually share our patients with our therapists. And with that, we contribute not only as the psychotropic drug expert on the team outside of our own panels, but we provide a lot of side consultation too. So anytime our interdisciplinary colleagues kind of have like a really complex patient, they really tag us in to kind of help them navigate through that. And it’s just nice to be able to do that in a team atmosphere that we see and work with on a weekly basis.

Vicki Basalyga: What’s the one thing you wished more people understood about the role of the pharmacist that might surprise them?

Maria Blaze: This is a big one, although we have a lot of clinical pharmacists in general. The general population don’t even realize that there are a lot of clinical pharmacists and we tend to be pretty underutilized. This is not only in the VA sector, but also in the private sector, probably even more. But there is such an access to care issue. And if the general masses, that’s not just patients, but that’s in the medical community as well, knew more about how useful a clinical pharmacist could be, that we could really work together to address patient concerns, improve outcomes. And they would just be surprised that we just don’t count pills. I can’t tell you how many people that I meet that they’re like, what do you do? You’re a psychiatrist? No, you’re a pharmacist? Wait, you’re a psychiatric pharmacist? And so merging that together and just having to like sit down and explain like, yes, I’m a pharmacist and I specialize in psychiatry and I also prescribe. I kind of have those conversations on a weekly basis.

Vicki Basalyga: Yeah, I always also kind of find it funny when people in patient care teams have a pharmacist and then for some reason maybe the pharmacist is like, the service is supposed to be downgraded or they’re gone, they’re on vacation and there’s like a general like panic once they realize that like they don’t have access to their pharmacist anymore, even if it’s for a short period of time.

Maria Blaze: Oh yeah.

Vicki Basalyga: Can you tell me a little bit more about working at the VA? What makes caring for veterans different from caring for the general population?

Maria Blaze: Yes, so our veterans is they’re really a unique population and they’re a unique population for many different reasons. the number one thing is that they are the epitome of why we have so much freedom in our country. And so just even just speaking from that aspect and giving them, thanking them for their service just from that aspect. But then when it comes to health concerns, when it comes to things such as even just general health concerns like diabetes, hypertension, and then mental health on top of that, substance use disorders. We have PTSD thrown into that. Unfortunately, they’re at a higher incidence of all of those disease states as compared to the general population. So we really need a team that is compassionate about serving them at the highest of vulnerability because of this increased atmosphere where we see them have a lot of these mental health disorders. And with that being said, it’s very rewarding to be a part of an organization that focuses on our veteran population. And so with that comes a lot of responsibility as us as providers, because since we are working with a higher acuity population, it’s gonna be really important for us to be on top of our toes with our continuing education, making sure that we’re working together for shared goals and shared outcomes of the patient. So I think that there is a little bit more weight on our shoulders as providers and as a team to make sure that we are addressing the concerns of this very special population.

Vicki Basalyga: Suicide prevention is another priority for both ASHP and the VA. ASHP’s policy, Suicide Awareness Prevention and Response, is a policy that supports a zero suicide goal by promoting collaboration among healthcare stakeholders to strengthen suicide awareness prevention and response efforts. Maria, what role do pharmacists play in suicide prevention?

Maria Blaze: Yeah, we are at the front line of suicide prevention because our veterans do have that higher risk. It’s not. That’s something that we see occasionally. I address suicidality at every single visit that I have with our patients. We work very closely with our suicide prevention team. Even a higher level of that, I run a clinic called the post-discharge engagement clinic, which helps the transition for veterans who are leaving a psychiatric discharge and getting them back connected with their general mental health care. So I am seeing these patients who have even higher risk of suicidality since they just finished an inpatient discharge. We have to stay on top of the best practices when it comes to suicide prevention, and we are a forefront team member when it comes to making sure that we are addressing these special needs of these patients.

Vicki Basalyga: I think one of the things also associated particularly with mental health is stigma. Can you talk to us a little bit about how you as a pharmacist help reduce the stigma around mental health?

Maria Blaze: Yeah, so I actually do that in my everyday life outside of even my professional capacity. Having just, regular conversations with people that you meet, and they may be talking about different challenges that they have. one of my questions that I always say is, have you ever thought about therapy? I am a firm believer that everybody needs therapy, no matter if you are going through really good things or really bad things. It’s just that we all have our rose colored glasses on based on how we grew up, our environments, and it would never help to get a different unbiased outside perspective. of somebody who’s not your family or your friends because we know sometimes that they although may have the best interests at heart they also have the rose-colored glasses on and so it is something that I am pushing and talking about and normalizing. And it should be a part of our normal conversation. And so the more that we talk about it, the less stigma that is there. I kind of believe it starts at home. And then being a mental health advocate, you have to practice what you preach as well. Sometimes when I ask people, have you ever thought about therapy? Their question is, have you ever done it? I’m like, yeah, I love my therapist, you know? And so it’s really important that the conversation around mental health isn’t scary anymore, isn’t taboo anymore. It’s something as easy as, hey, did you get up and eat breakfast this morning? Hey, did you talk to your therapist this week? And as more as we normalize that personally in the different communities and circles that we run in, addition to professionally, it does make a significant impact in reducing stigma.

Vicki Basalyga: I love that. It’s just another piece of the self-care puzzle. Can you, looking ahead, tell me what innovations in mental health care from a pharmacist perspective that you’re most excited about?

Maria Blaze: Yeah. I have discovered that AI is a very useful tool when it comes to doing the background of our patient histories. And what I mean by that is sometimes in the mental health realm, we have people with higher level mental health disorders such as like schizophrenia and bipolar dating back 20, 30 years that have these super long med recs. I have seen how and experienced how AI can kind of help with compiling that information so that it’s not taking us hours of going through the charts and pulling that in and writing down dates and writing down max doses. And it really comes back to it being an efficiency tool. What I do want to make clear is that it does not in any capacity replace clinical assessment, clinical judgment and clinical decision making. But what it can do is help with some of those administrative tasks that kind of take up a little of our time, writing the labs down one by one or typing them. It just pulls it all in and compiles the information with the last six months. And I have even seen it in my practice that especially when I have high acuity patients, a high complex patient, it allows me to be more efficient in completing my notes and getting things done and focusing on the areas where my clinical judgment has to be there with HPIs and assessments and plans, I can leave all the other administrative stuff to AI, which has been really great.

Vicki Basalyga: I always feel like the VA is like forefront as well in a lot of these innovations that we see in practice. So why is pharmacy an exciting career choice for students considering the healthcare field? If somebody is interested in pursuing a federal pharmacy career or specifically a psychiatric pharmacy role, how should they go about doing that?

Maria Blaze: Yeah, I wish this was something that was talked about more in schools. Literally, when I do mentorship with middle school students and high schoolers, they only know about Walgreens, our CVS pharmacists, which is very needed and reputable areas of pharmacy. And they’re our forefront. They are grandfathers when it comes to the clinical world. But what is less known is the many different possibilities that they can kind of go in. The possibilities are literally endless. If you want to do oncology, there’s a role for that. If you want to do industry, if you want to do psychiatric pharmacy, if you want to do diabetes, like there are just so many avenues that are just not talked about. And even me I didn’t even know a lot about clinical pharmacy until I got to pharmacy school. So we’re having these conversations very, very late. And I think that if students knew the vast number of areas that we can kind of go into, it would be a lot more exciting. They would be a lot more excited going to or considering a field of pharmacy. Now, when it comes to pursuing federal pharmacy career, I’m really passionate about this. And the reason why is because We practice at the highest level of our scope in the federal sector. Our collaborative practice agreements have been in place for decades. So when you are walking out of that residency and coming into your job, it is such an easy and seamless transition. A lot of times the clinical team already knows and knows the utilization and the benefit of a pharmacist. And it is just beautiful to see how the people who came before us have really paved the way. and that allows us to impact patient outcomes at the highest of our ability. When it comes to psychiatric pharmacy, making sure that they review ASHP’s residency directory is the best place to start. The VA is forefront when it comes to mental health residencies, and we are very connected with our ASHP partnerships and collaborations our trainees and looking at the vast number of psychiatric pharmacist positions nationwide, which is amazing. And then that’s something a lot of residents and students don’t know about federal pharmacy career. Once you get licensed in one state, you can literally work anywhere in the federal facility off of that one license. I am licensed in Texas. I’ve worked in Indiana. I’ve worked in Illinois. I’ve worked in New York. Now I’m in and that is because under the federal umbrella, we’re all interconnected and you don’t have to get licensed and take that law exam in every city or state that you go into. So #1, start at that ASHP website, look at that residency directory, see the vast number of VA residency programs that we have, and that should be where you start.

Vicki Basalyga: Well, it’s all the time we have today. I want to thank Maria for her time and thank our listeners for joining us on the We’re Your Pharmacist podcast series. We hope that today’s conversation gives you a new perspective on the invaluable role of pharmacists. Don’t forget to subscribe and tune in for our next episode, where we’ll continue to explore the many ways pharmacists make a difference. Until then, visit yourpharmacist.org to share your own story and read more about the critical role of pharmacists on the patient care team.

Narrator: Thank you for listening. Be sure to visit yourpharmacist.org to learn more about how pharmacists provide essential patient care. For more podcasts from ASHP, visit ashp.org/podcast. If you love the episode and want to hear more, be sure to subscribe, rate or leave a review.