Jerry McKee – PharmD, MS, BCPP
Clinical Pharmacy Specialist-Psychiatry
BalladHealth-Woodbridge Psychiatric Hospital
Many healthcare providers lack comfort and confidence in working with persons with mental illness, owing largely to a relative lack of specific training in the needs of this population. Pharmacists, in general, are less comfortable talking to patients about their medications for mental illness compared with medications for cardiovascular diseases and feel very uncomfortable monitoring the medications for mental illness.
The results of a College of Psychiatric and Neurologic Pharmacists (CPNP) Foundation-sponsored study about stigma and community pharmacists have been published in the International Journal of Clinical Pharmacy. The publication, “Community pharmacists and mental illness: a survey of service provision, stigma, attitudes and beliefs”, is the product of a research project between the CPNP Foundation and collaborators at Duquesne University Mylan School of Pharmacy1. The team sought to explore a national perspective regarding community pharmacists’ knowledge of and attitudes toward mental illness, comfort and confidence in dealing with persons with mental illness, and the services they provide to this patient population.
The comparative opinions section of the survey measured pharmacists’ attitudes, perceptions and beliefs about patients diagnosed with a mental illness. A brief overview of the findings are listed below:
- Pharmacists report overall willingness and interest to provide services for patients with mental illness, but comparatively lower comfort and confidence in their abilities.
- Survey respondents with personal experience with mental illness had higher scores across all four domains of service provision, lower levels of stigma and more positive attitudes.
- Pharmacists rated confidence and comfort as being low when needing to ask patients about their therapeutic goals, as well as when speaking with physicians about the patient’s medication.
- This study identified prevalent stigma among the surveyed sample of community pharmacists. These results are consistent with the findings of previous researchers. Thus, an opportunity exists to develop programs and services designed to reduce the level of stigma in community pharmacists.
With enhanced information, training, and insight comes improved clinical skills and understanding. Increased mental health training in pharmacy schools, post graduate continuing education in mental illness and substance use disorders, and engaging in clinical experiences by assisting individuals with mental illness are all means to achieve an enhanced understanding regarding the perspective and experience of those living with mental illness and substance use disorders.
In terms of a national effort to achieve this end, Walgreens has recently announced a collaboration with the National Council for Behavioral Health (National Council) and the American Pharmacists Association (APhA), to provide specialized Mental Health First Aid training for many Walgreens pharmacists and team members. Mental Health First Aid (MHFA) is typically an 8-hour course that teaches participants how to identify, understand, and respond to signs of mental illness, including suicide risk assessment and intervention steps. As the most accessible health care providers in the community, pharmacists can play an important role as part of patients’ care teams to help address the growing need for mental health resources. MHFA training, administered by the National Council’s trained facilitators, instructs participants in mental health literacy, understanding risk factors and warning signs for mental health and addiction concerns and strategies for how to help someone in both crisis and non-crisis situations.
Walgreens, the National Council and APhA are working closely together through the collaboration to customize MHFA training for pharmacists and it will be accredited by the Accreditation Council for Pharmacy education. Through this effort, and with Walgreens’ support, Mental Health First Aid training will eventually become available to any pharmacist industry-wide with the opportunity to earn continuing education credits through APhA.
Additionally, the National Community Pharmacists Association (NCPA) has supported MHFA training for community pharmacists for several years and has taken steps to allow the full 8-hour adult MHFA training program to become accredited for 8.0 contact hours (0.8 CEUs) of pharmacist/pharmacy technician continuing education. According to Clark Bishop, a community pharmacist colleague in Oklahoma and a MHFA trainer, pharmacists and pharmacy team members who have completed Mental Health First Aid training say they use it almost every day in assisting patients and families facing a mental health challenge.
For pharmacists looking to make a difference in patient’s lives, MHFA or similar training can be the foundation of a new direction in their clinical practice. Board certified pharmacists are encouraged to support and participate in this movement, as mental illness and substance use disorders are seen in all specialty and non-specialty practice settings. This national training initiative has the potential to be an important step in making inroads regarding improving pharmacists’ comfort and confidence in serving persons dealing with a mental illness, and correspondingly, improving access to much needed care for this population and can literally be a life-saving endeavor.
- Giannetti V, Caley CF, Kamal KL, Covvey JR, McKee JR, et al. Community pharmacists and mental illness: a survey of service provision, stigma, attitudes and beliefs. International Journal of Clinical Pharmacy 2018. https://doi.org/10.1007/s11096-018-0619-7.