Alumni Spotlight: Psychiatric Pharmacy, Public Health and the Human Experience

Jacqueline Parizher, PharmD ’22, began her journey into pharmacy from a desire to make meaningful impact in her community. Today she is at the forefront of psychiatric and substance use disorder care as a psychiatric clinical pharmacist at the San Francisco Department of Public Health (SFDPH), taking her expertise to the streets to serve the city’s most vulnerable populations.

Parizher’s daily routine involves prescribing buprenorphine for patients with opioid use disorder, with a focus on those living in permanent supportive housing.

“We try to minimize barriers to care for patients who might struggle to access traditional clinics,” she said. “Sometimes that means delivering medication directly to their doors.”

Parizher, who worked for a homeless services organization as an undergrad, always knew she wanted a career in health care. Through a pre-pharmacy society at University of Southern California, she learned about the many different avenues of pharmacy.

“I reached out to pharmacists, and they all enjoyed the continuous learning and being such a great resource for health care providers with all the new drug information and clinical guidelines that are always coming out,” she said, describing what convinced her to pursue a PharmD.

While studying at the UCSF School of Pharmacy, she continued working in public health, as a volunteer and coordinator of the Pharmacy Homeless Clinic. Then she completed an inpatient psychiatry rotation at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG), which, she says, gave her “an eye-opening experience about what it’s like to work with underserved communities and underinsured or uninsured patients.”

The pharmacist’s evolving role in mental health

In an outpatient clinic setting, pharmacists are often the primary psychiatric provider for clients, which Parizher said gives her autonomy when it comes to not just prescribing, but also monitoring, safety and efficacy.

Cindy Chew

Parizher carries information about buprenorphine delivery for her outreach efforts.

“In addition to seeing clients for behavioral health and substance use, I serve as a resource for other providers, answering questions about drug therapies and making treatment recommendations,” said Parizher. She collaborates with a broad team of health care professionals — including social workers, nurse practitioners and physicians — to understand whether other medical issues are impacting her prescriptions. “Interdisciplinary teamwork is a huge part of my practice.”

She also works with case managers, who often help find her patients if they don’t have cell phones. “You get creative in your ability to track people down, and you really learn the importance of continual outreach,” she said.

Overcoming psychosocial barriers to mental health treatment

What honed her interest in working in psychiatric pharmacy, Parizher said, was a backdrop of personal events that unfolded in her family combined with the specific way information — about neuropsychiatry in particular — is presented in UCSF’s PharmD curriculum.

“You see acutely sick people who also have various social issues going on. Seeing the interplay of that really resonated with me,” she said about her rotation at ZSFG. “It made me want to be part of that kind of interdisciplinary team.

“Rounding together every day with pharmacists, attendings, medical residents, social workers and occupational therapists, and discussing patients together showed how important each role is to the team — how everyone values pharmacy and the insight that my preceptors had,” she continued. “I learned so much about mental health and other psychosocial issues, like housing insecurity and food insecurity, which really impact a patient’s ability to manage their mental health and medications.”

Rewarding and challenging patient-centered care

Parizher credits her training at UCSF with shaping her approach to patient care at SFDPH, where she completed both her first- and second-year residencies. “The focus on patient-centered care was so ingrained in our curriculum, and that’s how I practice now, advocating for patients and connecting them with resources,” she said.

Cindy Chew

Parizher takes her expertise to the streets to serve the city’s most vulnerable populations.

“Unlike a traditional clinic, we’re a drop-in clinic for people experiencing homelessness, so we have limited time to review charts before seeing patients,” she continued. “We manage opioid use disorder, alcohol use disorder and stimulant use disorder, and we do tobacco cessation as well. We also see a lot of people with schizophrenia, bipolar disorder, and depression, as well as anxiety and personality disorders. Even though we can’t formally diagnose, we have to recognize disease states and be able to treat accordingly.”

She said providing care with extra sensitivity toward creating a safe space for her patients to open up about their mental health — for example by avoiding stigmatizing language — is one of her favorite parts of the job.

“Hearing about what my patients have been through teaches me to have empathy and patience, and to be open-minded,” she said. “There’s a lot of value in understanding the human experience more. You learn so much, and it has been extremely meaningful.”