Clinical Associate Professor Dedicates Life to Improving Mental Wellness of Veterans
Serving Those Who Have Served Us
As the sole psychiatric pharmacist on faculty at the University of Houston College of Pharmacy, Austin De La Cruz, Pharm.D., BCPP, wears many hats. Or, perhaps one could say many "coats." He is a clinical associate professor in UHCOP’s Department of Pharmacy Practice and Translational Research and a clinical pharmacy specialist-psychiatry at Michael E. DeBakey Veterans Affairs (VA) Medical Center. His other appointments include psychiatry instructorships at Baylor College of Medicine and Houston Methodist Hospital, as well as an adjunct professorship at the University of St. Thomas Psychiatric-Mental Health Nurse Practitioner certificate program.
"In addition to treating Vietnam veterans, we’ve been treating a lot of younger individuals from Operation Enduring Freedom and Operation Iraqi Freedom," De La Cruz explained. "Both of these cohorts need individualized treatment to address concerns related to generalized anxiety disorder, major depressive disorder, post-traumatic stress disorder (PTSD), and sleep-related issues, such as insomnia."
His expansive psychiatry experience working with veterans began in his final years of pharmacy school. During his third year, De La Cruz got his first taste of psychopharmacology and became fascinated by all the medications involved in psychiatry.
"Despite their similarities within class, our psychiatric medications all have different functions, unique indications, and various benefits and side effects," De La Cruz said. "It’s those individual nuances of each medication that really sparked my initial interest in the field of psychiatric pharmacy."
Translating what he was learning in class into hands-on patient mental health care, De La Cruz completed the majority of his fourth-year rotations at the Dallas VA Medical Center, where he observed the positive impact that psychiatric medications could make in an individual’s life in a geriatric setting. Though his fascination in psychiatric pharmacy was growing, his journey toward what would become his life’s work was not without setbacks.
"I didn’t have a dedicated psychiatric rotation during my fourth year of pharmacy school since my institution lost our contract with the psychiatric health care center I was supposed to rotate at just two weeks before my rotation was due to start," De La Cruz said. "Because of that missed opportunity, I was unable to obtain specialized psychiatric pharmacy experience."
He didn’t let this derail his blooming passion. While determining which residency he wanted to pursue, De La Cruz ensured the PGY-1 residency he chose had psychiatric pharmacy electives, in addition to a dedicated PGY-2 psychiatric residency program. De La Cruz ended up matching at the North Florida/South Georgia VA Medical Center in Gainesville, Fla., which had both opportunities.
Steadfast in his long-term goals, De La Cruz completed two back-to-back psychiatry rotations during his PGY-1 year which included an outpatient, transitionary care setting where he was able to help veterans who were recently discharged from an inpatient setting.
"Instead of the classic post-discharge model from inpatient mental health treatment where providers say, 'Take this medication and ensure that you're adherent; here are the possible side effects; hopefully this medication works, and see you back in several weeks,' the veterans now had the opportunity to enter what is called a domiciliary," De La Cruz explained. "This was a transitional program where we could still manage their medications with nursing staff on standby and have access to a full multi-disciplinary psychiatric-based treatment team. There were activities, games, financial classes, and a whole team looking after these veterans to ensure they were ready for that next step of living independently with this new mental health disorder and these new psychiatric medications."
His time in the domiciliary made it clear to him: This was an area in pharmacy where he could envision himself working and serving his patients for the rest of his pharmacy career.
"Being able to witness firsthand an individual’s progress from severe major depression – a state where they just could not function and may even experience suicidal ideations – to seeing them come out the other side with a renewed outlook and excitement at a future full of possibilities, was eye-opening," De La Cruz said. "I was able to observe what a psychiatric pharmacist can really do, and the interventions they can affect to aid their patients in transitioning to wellness. I knew that's where I was meant to be."
De La Cruz stayed on with the same VA hospital and completed a PGY-2 program in psychiatric pharmacy. That entire year was focused on and dedicated to the treatment of veterans with mental health disorders throughout various healthcare settings.
"I can help serve as a bridge to get more of these veterans' stories out to the younger generation so that our new practitioners have more empathy, awareness, and a better idea of the constant struggle that a lot of these veteran’s face on a day-to-day basis when they return to civilian life," De La Cruz said. "My hope is that future pharmacists will come to understand the kind of specialized care that this population requires."
De La Cruz brings years of expertise and compassionate care to veterans. They, in turn, have shown him the power of resiliency and the beauty of trust.
"One of the things that I have learned from my patients is the power of resilience," he said. "These veterans have been through so much that it’s sometimes hard for us to truly comprehend. Despite all they’ve endured, they persevere and remain optimistic. I appreciate their willingness to place their full confidence in me as their health care provider, trusting that I will make the best treatment decision for them.
"The trust they have in me consistently makes me strive to be the best provider for them on a daily basis. This is my way of giving back to those servicemen and women who our nation trusted to keep us safe during times of conflict and unrest."
De La Cruz was instrumental in starting an outpatient psychiatric pharmacy clinic at the Michael E. DeBakey VA Medical Center in 2017 and was the first psychiatric pharmacist in primary care mental health. He built and developed this clinic so that he could work alongside other providers to schedule face-to-face appointments, conduct interviews, and prescribe the most optimal medications to patients. He takes eight fourth-year pharmacy students throughout six months of the year, in addition to PGY-2 pharmacy residents on rotations.
"As we prepare to celebrate Veterans Day on Saturday, Nov. 11, we keep in mind this quote from Jeff Miller – 'The willingness of America’s veterans to sacrifice for our country has earned them our lasting gratitude,'" he said.