Mental health professionals are scarce in Doña Ana County, N.M., a federally designated health professional shortage area. “The most recent
estimate is that there are 100 psychiatrists for 2 million people”
in the state, says Christina Vento, PsyD, training director in New
Mexico State University’s psychopharmacology program. The
New Mexico Board of Psychologist Examiners estimates that
720 psychologists are practicing statewide. “There is a huge
unmet need,” Vento adds.
The county is situated 40 miles from the Mexico border,
and its fast-growing population is predominantly Hispanic.
About one-fourth of residents live below the poverty line, a
proportion higher than in the rest of New Mexico or the United
States. Per capita income is well below that of the state and the
nation, too. Violence and poverty, which can lead to depression,
anxiety and post-traumatic stress
disorder, beset the county’s rural
So, when Jonathan Schwartz,
PhD, arrived four years ago at
New Mexico State University
to head the counseling and
department, he sought to better
serve that population by tapping
into the department’s considerable
strengths — the program is one
of only three U.S. postdoctoral
training programs for prescribing
psychologists, and its doctoral
program in counseling psychology
emphasizes integrated care, a
focus of reforms in the Affordable Care Act.
Now, Schwartz and his faculty have succeeded in his goal.
They’ve created a new clinical training ground in partnership
with La Clinica De Familia, a federally qualified health center
with eight sites in and around Las Cruces, N.M. During the last
academic year, six doctoral students and two trainees in the
postdoctoral prescribing psychology program together spent
64 hours weekly treating clients who had little or no access to
behavioral health care.
“La Clinica didn’t have adequate behavioral health services,
and in our county La Clinica health professionals really serve
the people who don’t have resources,” says Schwartz.
As a federally qualified health center, La Clinica receives
government funds to provide comprehensive health services
for underserved populations. Seven of its clinic sites provide
primary health and dental care; the eighth is based in a
local high school. With a Counseling Psychology Graduate
Psychology Education Grant from the federal Health
Resources and Services Administration (HRSA) to train health
professionals in primary-care medical settings already in place,
the match was ideal.
About 20,000 patients seek care annually at La Clinica sites,
says its chief executive officer, Suzan Martinez de Gonzales.
“About 30 percent to 40 percent of the patients need some type
of mental health care,” she says.
Before the partnership began, La Clinica patients who needed
behavioral health services were referred to social workers,
psychologists and psychiatrists, says Daniel Armistead, MD, its
chief medical officer. “But they’re overwhelmed, and patients
were waiting months to get services,” he adds.
Under an agreement forged last year, La Clinica and New
Mexico State University split the salaries of two full-time faculty
members who spend half their time teaching and supervising
students, and the other half providing services at La Clinica.
Of the doctoral students
working at clinic sites, one
is completing his internship
and another works at La
Clinica as part of her graduate
assistantship. The training at
clinic sites is being designed as
a behavioral health practicum
for third-year doctoral students
who have taken the primary-care
Vento, a licensed prescribing
psychologist, is one of the half-
time faculty working at the clinic
sites. Depression and anxiety are
common among clinic patients,
As the partnership develops, Armistead hopes a prescribing
psychologist from the university will contribute to La Clinica’s
continuing medical education programs for its physicians.
The psychopharmacology residency program at New Mexico
State offers psychologists the unique opportunity to work with
clients such as those at La Clinica sites while they obtain their
certificate to prescribe medications. This type of training is in
demand. Schwartz says psychologists travel from as far away as the
Netherlands to complete certificates through the program.
Vento offers her patients treatment options that include
medication, counseling and self-care techniques, such as spending
more time with upbeat, positive people and getting more exercise.
“I try to use a patient-centered team approach,” she says.
The treatment model doesn’t resemble the traditional
50-minute office session, says Schwartz. “You may do rounds
with a [physician] seeing a patient who had gallbladder surgery,
“Integrated care is our
goal. Not just to be
co-located, but truly
La Clinica De Familia
Las Cruces, N.M.