Pharmacists need to gain competency in mental health care: whether they’re ready or not, writes Shanae Hancey.
Pharmacists are in a unique primary health care position, with the accessibility of our profession placing us at the forefront of professional health services.
As the role of community pharmacists expands (particularly with the changes to the supply process for clozapine), pharmacists are required to take a more active role in the management of mental health disorders.
However, I cannot help but wonder if pharmacists are equipped for this change.
While it seems ingrained for pharmacists to routinely ask patients purchasing antihypertensive agents what their blood pressure readings are averaging, or likewise antidiabetic medication with blood glucose levels, there may be stigma attached to enquiring about the mental state of patients purchasing psychotropics.
Psychotropic medications account for a significant proportion of prescribing, with the Pharmaceutical Society of Australia reporting 31.1 million prescriptions between 2010-11 related to mental-health disorders .
With recent data indicating one in five Australians have an episode of mental illness per year, it is evident pharmacists play a crucial role in the treatment and management of mental health conditions .
One particular incident has curbed my conviction that we as pharmacists ought to be more proactive in relation to mental health.
While working in a community pharmacy, a patient entered displaying severe symptoms of a manic episode: switching from topic to topic every minute, persecutory delusions, bursting with energy and speaking at a very fast rate.
It was clear that her condition was not being appropriately managed with her current therapeutic regimen.
What alarmed me the most was not her erratic behaviour, but the propensity of the staff to ignore these signs without intervening. Upon questioning, the staff responded that they “didn’t know what to do” and that it was “out of their hands”.
What I find more concerning, however, is this lack of awareness is entirely preventable given the correct training and willingness to help.
So what can we, as pharmacists, do to equip ourselves to best manage mental health disorders?
The excellent part about starting a conversation in mental health is that you do not have to be an expert to talk about it. Community initiatives such as R U OK? Day have highlighted that it is often the small things we do that can make the greatest difference.
Don’t be afraid to ask a patient how they are. Some may want to talk about it but others might not. However, by letting them know they don’t have to avoid the issue with you will be helpful if they ever need to seek advice. Questions such as “You don’t seem yourself today, is everything alright?” can provide great starting points for patients to open up.
Ask how you can help. Different people will want support in different ways. Keep copies of a current list of community resources such as mental health services or helplines that you can suggest to patients. Some people may not accept the suggestion, but others will.
Find out more. If you think you might feel uncomfortable talking about mental health, then take advantage of these services:
- Mental Health First Aid training course for pharmacists and pharmacy staff as supported by the 5th Community Pharmacy Agreement Pharmacy Practice Incentives;
- PSA Mental Health Care Project: A framework for pharmacists as partners in mental health care;
- R U OK? Website; and
- Free mental health training for health professionals at Beyond Blue.
Above all, be respectful to the patient. When someone feels respected and heard, they are more likely to return respect and consider what you have to say. By allowing ourselves to become more comfortable with talking about mental health, we can change the stigma that exists and better improve the quality of care we give to all patients, regardless of their condition.
Shanae Hancey is the Pharmaceutical Society of Australia Pharmacy Student of the Year for 2015. She also has a degree in psychology.
- Pharmaceutical Society of Australia. Mental health care project: A framework for pharmacists as partners in mental health care [Internet]. c2013 [cited 30 August 2015]. Available from: http://www.psa.org.au/download/policies/mental-health-framework.pdf
- Australian Bureau of Statistics. 2009. National Survey of Mental Health and Wellbeing: Summary of Results, 4326.0, 2007. ABS: Canberra.