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January 2017 Most people are comfortable going to their doctor or medical provider when they don’t feel well, but when it comes to mental health treatment, fear and social stigmas often get in the way. In Lake and Mendocino Counties, we have a shortage of psychiatric care and counseling services, so it is often medical providers who see patients with mental health (also called behavioral health) issues. I’ve been a physician assistant for more than five years, and I’ve always worked in partnership with counselors and psychiatrists to care for my patients who need mental health treatment. About a year ago, I began thinking it would be great if I had some additional training to identify and diagnose common behavioral health problems for my patients. As luck would have it, UC Davis had just developed a new program to help primary care providers like me gain additional experience and training in psychiatric care. It’s called the Train New Trainers (TNT) Primary Care Psychiatry (PCP) Fellowship. The program included on-site education, online education, and collaboration with a professional mentor for case reviews and support. This inter-professional fellowship certificate program helps improve access to mental health care by expanding medical providers’ knowledge of common illnesses like depression, anxiety, bi-polar disorder, post-traumatic stress disorder (PTSD), substance abuse and more. The program helped me become more aware of signs and symptoms of people who may be suffering from undiagnosed mental illnesses. It provided excellent training so I can work with patients to figure out what’s really bothering them. Research demonstrates that we are all influenced by our physical, emotional, and social (bio-psycho-social) situations. None of these conditions occurs in a vacuum—they all influence each other. For example, back pain that never goes away can be emotionally draining and make you feel hopeless about your future. Or, being in a relationship that causes constant stress can cause physical symptoms like headaches or insomnia. We are all products of our environments. When patients spend a lot of time at the health center without making good progress toward getting better, it’s often worth exploring issues that don’t necessarily seem related to their medical symptoms. Sometimes counseling can help patients work through bothersome issues. Sometimes psychiatric medication can allow people to manage mental illnesses that would otherwise become debilitating. One of the biggest benefits of medical providers receiving mental health training is that we can help patients who are too afraid to ask for help directly. Patients may want to make an appointment with a therapist or psychiatrist, but they are too worried about what friends and family would think, or they fear they will be thrown into a mental facility or have their children taken from them. While friends and family may have prejudices about mental health care, the truth is that millions of Americans seek treatment for common disorders like depression, anxiety, bi-polar, and post-traumatic stress. Having a mental illness does not mean you will be hospitalized or make you unfit to be a parent. At our health centers, mental illness is just like any other illness: it is a condition getting in the way of optimum health and our goal is to help you get as healthy as you can. We don’t judge our patients; we care for them and we care about them. If you would like to discuss a mental health problem, you can call any of our health centers and ask for a medical appointment with a primary care provider. Larry Aguirre is a physician assistant who recently completed a mental health fellowship at UC Davis. Aguirre works at Little Lake Health Center in Willits, one of several sites owned and operated by MCHC Health Centers, a local, non-profit, federally qualified health center offering medical, dental and behavioral health care to people in Lake and Mendocino Counties.