The Role of PAs in Whole-Person Mental Health Care

By Rosanne Washington, MHS, PA-C, Program Director, Physician Assistant Program, Associate Professor, Department of Public Health & Community Medicine

As part of our three-part faculty op-ed series celebrating PA Week 2026, Tufts PA faculty share their perspectives on the profession, the future of healthcare and the impact PAs can make in the lives of their patients.

As a physician assistant (PA) practicing in family medicine, I have seen firsthand how a patient’s challenges with their mental health often lurk in the shadows of their physical health and vice versa. A patient may come to the office for a routine follow up on their chronic medical disease, an acute sick visit, or a routine wellness visit, and as we talk, I gather information about not just their physical health, but their mental health to ensure I am evaluating the whole patient. These conversations provide me with the insight I need to assess their overall physical and mental health, opening the door to providing more holistic, whole-person healthcare.

October 6-12 is national PA week, which is a time to recognize our amazing profession and how we contribute to the current healthcare system. But this also provides us with an opportunity to recognize how important the role of a primary care PA plays in addressing one of the many challenges facing patients daily, which is accessing mental health care. According to the National Alliance on Mental Illness (NAMI), it is estimated that 1 in 5 U.S. adults experience mental illness each year and estimates show that only 52.1% receive treatment. In the primary care setting, PAs are in a unique position to both screen for mental health disorders and initiate evidence-based treatment while assisting the patient in connecting with mental health providers when access can be challenging and time consuming.

Mental and physical health are directly connected. Depression and anxiety can affect daily functioning, sleep, work performance, relationships and negatively impact a patients’ ability to manage their chronic medical conditions. On the other hand, living with and managing chronic disease and other health challenges can negatively impact a person’s overall mental health. This is why PAs working in primary care medicine are essential in addressing the current mental health crisis by engaging in whole-person healthcare.

Working in primary care medicine as a PA provides me with the opportunity to develop long-lasting relationships with my patients. I see them for their annual physicals, routine chronic disease follow-up visits, and acute sick visits throughout the year depending on the patients’ individual needs. This continuity in care creates an essential quality of the patient-provider relationship, which is trust.

It is this trust that supports patients’ willingness to engage in difficult conversations, specifically when talking about their mental health. Some patients are open to sharing their personal struggles while others may be reluctant initially, but with time will feel more comfortable. Often, verbalizing their concerns and asking for help can be the biggest hurdle. When a patient is ready to seek care, they often encounter another hurdle, which is access to care. I’ve seen first-hand how time consuming it can be for patients to find mental health providers within their network, who are taking new patients and/or can offer an appointment within a reasonable timeframe. While waiting for an appointment, symptoms can worsen, negatively impacting their daily functioning.

This is where primary care providers, including PAs, can make a significant difference. PAs working in primary care can recognize signs and symptoms of mental illness, appropriately screen patients and engage in meaningful conversations surrounding their mental health and educate them on the benefits of early diagnosis and evidence-based treatment. If appropriate, we can refer and help our patients pursue therapy or more specialized mental health care. If indicated and when appropriate, we can prescribe medications, monitor symptoms and their response to treatment while referrals are pending to prevent progression of their disease due to delayed care.

By no means should primary care providers replace mental health specialists, but we can serve as a bridge in treatment while awaiting appropriate referral given the current challenge in access to mental health care. Once engaged in therapy and/or specialty care, we can partner with the patient and their specialist to ensure quality care and ongoing support.

As a PA educator, I recognize the importance of preparing future PAs to engage in whole-health care as a primary care provider. Primary care medicine is more than just diagnosing and managing a patient’s physical illness but engaging in whole-person care, which includes both physical and mental health. They need to build a trusting relationship with their patients as this is one of their most valuable clinical tools. They need to be comfortable asking difficult questions, engage in active listening without judgement, identify mental health concerns and work with the patient on creating an individualized, patient-centered approach in the same way they would manage a person’s physical health.

For this PA week, I hope we recognize PAs for the medical care they provide, but also the trust they build with their patients. In the current healthcare system where access to mental health services can be challenging, the familiar primary care PA may be the patients first contact who recognizes a concern and asks the difficult questions, opening the door to taking positive steps towards feeling better. When we make room for these conversations in the primary care setting, we have an opportunity to identify mental health concerns, educate our patients and begin individualized care while awaiting specialty referral practicing whole person care.

Author Bio:

Rosanne Washington, MHS, PA-C, is the Program Director of the Tufts University School of Medicine Physician Assistant Program. She works clinically at Beth Israel Lahey Health Primary Care in Southern New Hampshire. She enjoys running, hiking, baking and spending time with her husband and three children.
 

Related Links:

2026 PA Week
PA Program at Tufts
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How to Apply to Tufts PA Program