The pharmacist's role in mental health
As the most accessible health care provider, pharmacists can and do play a key role in supporting patients with mental illnesses
By Phil Emberley, Director, Professional Affairs, Canadian Pharmacists Association
As a frontline pharmacist, I see firsthand the many gaps and challenges that exist within our health care system, especially for those with mental health issues.
As 1 in 5 Canadians will experience a mental health problem or illness this year, we probably all know at least one person—a friend, family member or colleague—who has faced a mental health challenge or lives with mental illness.
Shelita Dattani, Associate Director, Professional Affairs, discusses the role of pharmacists in mental health.
Significant progress has been made through initiatives like Bell Let’s Talk to break the stigma by encouraging open conversations surrounding mental health, but there is still much work to do to provide better access to mental health care, including prevention, detection and ongoing treatment.
Pharmacists, as the most accessible health care providers, can and do play a key role in supporting patients with mental illnesses—we are often the first point of contact with the health care system for those experiencing mental health issues.
Patients often take multiple medications with complex regimens which can result in drug interactions and poor adherence. For this reason, patients with mental illnesses should be identified for the purpose of conducting medication reviews.
A retrospective US study in 2011 of 154 patients with mental health diagnoses investigated the impact of pharmacist-initiated comprehensive medication management. On average, patients presented 5.6 drug therapy problems—typically adverse reactions, unnecessary medication, excessive doses and poor adherence. Pharmacists’ involvement resulted in 52 per cent of patients showing improvement and net cost avoidance of an estimated $90,484, mainly through reduced hospitalizations as well as drug cost savings.
Pharmacists also play an important role in disease screening and, again, studies have demonstrated this value with respect to mental health disorders. A study from Australia showed the benefit of pharmacists involved in depression screening; many patients in this study had not been able to access mental health services elsewhere, highlighting the accessibility of pharmacists. The significant number of referrals to general practitioners in this study demonstrates the need for such services in primary care, and that pharmacists are well placed to provide the service.
Moreover, it’s clear that pharmacists, through education, can play a role in supporting the mental health of their communities. In Nova Scotia, the More Than Meds program addressed the learning needs of pharmacists to better understand the needs of mental health patients.
Pharmacists within a study were provided with communication strategies to enhance their ability to respond to mental health needs. The results indicated that their effectiveness in this role was enhanced through an educational program involving readings, live training, an online community of practice and the provision of a comprehensive list of community resources and health services.
Also in Nova Scotia, pharmacists are helping to improve the health and well being of people living with mental illness through the Bloom Program. The program, the first of its kind in Canada and internationally, has a growing number of Nova Scotia’s pharmacists providing enhanced services to people living with mental illness and/or addiction. These include comprehensive consultations reviewing their physical and mental health conditions and medications; greater collaboration among health providers; regular patient-centred longitudinal follow-up care; and support, resource and service navigation. So far about two dozen of the province’s 300 pharmacies are taking part in the program.
We all have a role to play in being partners in mental health. As highly accessible health care providers, pharmacists can have a meaningful impact on mental health care in the community.