Mental Health Lifeline

The most important visitors to Stacy Ramirez’s office walk around her desk and sit in a chair next to her. As they talk, Ramirez catches subtle cues about her visitors’ emotions, whether or not they are taking their pills or maybe hearing voices again. “I can tell by their eyes if there’s something going on that I need to ask them about,” she says.

Ramirez is a clinical assistant professor in the College of Pharmacy. In addition to teaching classes on pharmacy management and operations, she meets daily with a dozen or more residents at Mid Valley Housing Plus, a residential support facility in Corvallis for people with mental illness. She shares an office with Mid Valley case manager Sam Ortiz where she answers residents’ questions, administers medications — some by court order, others on request — and serves as a liaison with physicians.

No longer focused only on dispensing prescriptions, pharmacists increasingly serve as consultants and sometimes as lifelines for people with chronic illness — diabetes, high blood pressure, schizophrenia. The hope is that as specialists in drug effectiveness and interactions, pharmacists can help stabilize lives and reduce hospital visits. For people with mental illness, that includes staying out of jails and homeless shelters.

In collaboration with OSU faculty members Ann Zweber in Pharmacy and Ray Tricker in the Department of Public Health, Ramirez will evaluate the consequences of her work at Mid Valley, documenting impacts on patient quality of life, interactions with police and visits to the emergency room. Just getting started, the research could have broad implications for developing an innovative role for pharmacists in the health care system.

“I have a patient that I see once a week,” says Ramirez, who serves on boards of directors at Mid Valley and the Oregon State Pharmacy Association. “He let me know that he was hearing voices, and the voices were telling him not to take his medications, not to listen to me anymore. So I got a hold of his physician, made some adjustments to his medications, called and checked on him to make sure he was taking them, to see if the voices had come back. He’s doing much better now.

“Now that’s hard to quantify. What did that do? Did it save him a hospital trip? Maybe,” she adds.

As a mental health specialist, Tricker served on the Governor of Oregon’s Task Force on Mental Health in Oregon. In 2006, he invited Ramirez to work at Mid Valley. The nonprofit organization now accommodates about 65 clients. Two to three new requests for services — a warm apartment, transportation, counseling, case management (known in mental health circles as an Assertive Community Treatment model) — arrive weekly, says Tricker, who is also on Mid Valley’s board and has worked with the nonprofit organization for more than a decade.

At OSU, he offers students in his public health courses the chance to work with Mid Valley residents. Students gain valuable field experience, assisting residents with everything from shopping to a regular exercise program known as Walking Warriors.

“The goal is to find ways to create conditions that prevent people from relapsing,” Tricker says.

In her meetings with Mid Valley residents, Ramirez sees the need daily. “These patients have multiple psychiatric issues,” she says. “They know that unless they see someone every day, their chances of staying on their medication are not as good.”