In honor of May being Mental Health Awareness Month, the NCAPA is spotlighting Marisa Isbell, PA-C, CAQ-PSYCH, NCAPA Member and psychiatric physician assistant (PA) who owns her own mental health clinic in Asheville, North Carolina. PA Isbell shared her journey into discovering the profession to owning her own practice, and recounts her experience during Hurricane Helene, where she saw her neighbors and treated patients who were affected by insurmountable obstacles – while also seeing beauty within the storm.
A central-Illinois native, PA Isbell attended the five-year PA program at New York’s Daemen University. “This consisted of two years of a really intense undergraduate phase, and three years of PA school,” she explained. “When applying for it, you are intending to apply to become a PA. It’s not the typical college experience for sure!”
Marisa and her husband eventually made their way to North Carolina, moving to the Asheville area in Spring of 2019 after graduating from PA school.
“My husband and I were really interested in North Carolina because of the practice environment for PAs,” she explained, also mentioning that they had extended family in the area that provided a great support system for them both.
First, a Patient
Her introduction to medicine was not a smooth one – and started with her getting an intense bout of stomach flu at the age of fourteen, where she suffered from excruciating abdominal pain. “I basically did not function for six months,” she recounted. In an experience that eventually led to misdiagnosis after misdiagnosis, and testing and biopsies with no clear answers, she was given guidance to cut out gluten and slowly began to recover from her symptoms. She was eventually diagnosed with Celiac disease.
“They didn’t know where to test then for Celiac disease,” PA Isbell said. “I remember having an upper and lower endoscopy, a biopsy that wasn’t taken in the right place, etc.”
“Going through all of the tests and stuff I did, I found it really fascinating and interesting,” she said to the NCAPA, recounting her first foray into the PA profession. “At my local practice, they had hired a PA who encouraged me to look into the profession. I got the chance to shadow them, and really learn about the role.” It was at this same practice that PA Isbell began working as a CNA to gain experience and patient contact hours.
A Practice Owner, Practicing in Psychiatry
When asked if she had always wanted to specialize and practice in psychiatry, PA Isbell shook her head. “Not at all – I loved GI, primarily because of what I had experienced.”
However, personal and professional circumstances had led to early exposure to behavioral health and psychiatry. “My oldest brother is my pride and joy. He has bipolar disorder, autism, and fetal alcohol syndrome. He is on the lower-functioning side of autism, and I’ve always loved working with him and supporting him. I’ve also volunteered with the Penguin Project in Illinois that is a theater program for individuals with disabilities.”
She also ended up loving her psychiatry rotation in PA school. “I knew it was definitely in my top specialties to pursue.”
One of her first jobs after PA school was at a community mental health center, where she gained experience working with patients diagnosed with schizophrenia, bipolar disorder, and substance use disorder.
“These were one-on-one mental health appointments, primarily walk-in, and primarily medication management for patients,” she stated. “After working for two years, I found myself constantly reinforcing a cycle. I had witnessed that patients who had the most complex needs and the most trauma were placed in centers with the highest rates of turnovers, and they were struggling to get access to care.”
She realized that she wanted to be part of the solution in a larger, more personal way. PA Isbell’s clinic, River of Hope, opened in May of 2023. Her tight-knit team includes herself, a therapist, a family nurse practitioner, and administrative staff. They treat adults with conditions inclusive of bipolar disorder, schizophrenia, generalized anxiety disorder, post-traumatic stress disorder, and more.
The Wake of Hurricane Helene
When the storm had hit, PA Isbell was not in Asheville at the time.
“I was not present, but we were texting our neighbors furiously while they had cell phone service. That was noon on Friday. After that – nothing. For forty-eight hours until Sunday, there was no communication, and I had no idea how bad it was going to be,” she recalled.
“On the way back, we had stocked up on supplies, wanting to help. When we came back, we saw spots of spotty cell service where we’d see people huddled in specific parts and just standing there, trying to connect to family and loved ones on the outside. Restaurants were cooking food that was left and serving it to neighbors on the streets, so it wouldn’t spoil.”
When it came to her practice, which was centrally located near downtown Asheville, she didn’t know if the building itself was still standing. “That Tuesday after the storm, we were able to go see the practice. Our office had electricity, but we did not have Wi-Fi. I was getting emails from the state and NCAPA trying to see what we needed, and my answer was clear – I can’t operate my clinic without Wi-Fi.”
She relied on her own resourcefulness to advocate for her patients and continued to find solutions during those early days after the storm.
“Once a day, I would go out to where they had set up the emergency cell towers and Wi-Fi, so that I could send out prescriptions to wherever my patients needed them.” –Marisa Isbell
PA Isbell continued trying to stay present, remaining in Asheville in case her patients required an emergency visit or simply someone to talk to. She recalls having seen patients with basic needs not being met, patients who struggled to find transportation to come to their appointments. She had even made a house call to one of her patients to drop off supplies after hearing of their needs.
Acting as both a provider and a neighbor, PA Isbell reflects on the calm within the chaos of rebuilding and recovering. “People were also incredibly resilient, and there was also beauty in the storm as well. I didn’t know my neighbors before, and now I do.”
PA Isbell continues her work in Asheville, acting as a resource to patients and providing her training and experience in different psychiatric diagnoses. In addition to her passion for working with patients with mental health conditions, Marisa enjoys spending time with her husband and her dog, Milo. If she were not a PA, Marisa says she would be a travel agent, having already traveled to Turkey, China, Australia, and more!
Written by Pauline Bulala
NC Academy of PAs Communications Coordinator
