Growing Number of PAs Seeing, Treating Mental Health Disorders

Unrecognizable female mental health professional explains to a male patient the side effects of an anti-depressant medication
Researchers sought to document and describe the contributions of certified PAs across practice areas in addressing mental health conditions.

As a result of the growth of the physician assistant (PA) profession, certified PAs may be an innovative and practical resource to expand the mental health workforce capacity and address unmet needs within mental health services, according to research presented at Psych Congress 2019, held October 3 to 6 in San Diego, California.

Researchers from the National Commission on Certification of Physician Assistants conducted a web-based survey of PAs to describe the contributions to the mental health field from certified PAs across practice areas. The survey included mental health diseases and disorders as well as knowledge and skill statements that PAs rated from 0 (never) to 5 (daily).

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Data analysis identified the top 10 psychiatric diseases and disorders seen by PAs. The same diseases and disorders were analyzed from PAs who practice across 5 primary care practice areas: emergency medicine, family medicine, general internal medicine, hospital medicine, and pediatrics.

PAs practicing in emergency medicine, family medicine, general internal medicine, and hospital medicine saw patients with depressive/bipolar disorders and anxiety/obsessive compulsive/trauma/stressor disorders weekly. PAs in primary care saw patients with sleep/wake disorders, schizophrenia disorders, personality disorders, and disruptive impulse control and conduct disorders monthly or less often.

In addition, PAs practicing in pediatrics saw patients with attention-deficit/hyperactivity disorder weekly. PAs in emergency medicine saw patients with psychological emergencies such as suicidal behavior weekly.

PAs practicing in all primary care settings evaluated patients with psychiatric symptoms at least weekly. However, not all PAs conducted risk assessment for suicidal ideation, homicidal ideation, and violence or harm to self or others on a weekly basis (45%).

The majority of PAs working primarily in cardiology, family medicine, general internal medicine, pediatrics, and hospital medicine did conduct education on modifiable risk factors with an emphasis on primary and secondary prevention (such as smoking cessation, diet, and exercise).

While the majority of PAs working in psychiatry saw patients with substance-related and addictive disorders weekly to daily, the majority of PAs in primary care treated these patients monthly.

“This analysis establishes a baseline to track PA contributions longitudinally and informs efforts to advance PA roles and strengthen partnerships with the mental health community,” the researchers concluded.

For more coverage of Psych Congress 2019, click here.


Morton-Rias D, Kozikowski A. Partners in mental health: certified PAs as an innovative strategy to expand access. Presented at: Psych Congress 2019; October 3-6, 2019; San Diego, CA. Poster 222.