By Phil Emberley PharmD, MBA
As the most accessible healthcare providers, pharmacists can and do play a key role in supporting patients with mental illnesses.
According to the Mental Health Commission of Canada1, one in five Canadians will experience a mental health problem or illness annually. In addition to the toll on lives, there is a cost of more than $50 billion to our economy. U.S. data suggest that about 25 per cent of suicides are caused by undiagnosed, or misdiagnosed, major depression.
In an effort to destigmatize mental health disorders, Canada embarked on its first mental health strategy in 2012; this was a multi-sectoral and designed to enhance awareness about mental health, improve the care and treatment of people living with a mental health illness and optimize the accessibility of services to those who need them.
Pharmacists, as the most accessible healthcare providers, can and do play a key role in supporting patients with mental illnesses.
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 U.S. study2 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 Australia3 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 study4 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.
Phil Emberley PharmD, MBA is a staff pharmacist at Respect Rx, a specialty pharmacy that addresses the needs of patients living with addictions. Adjoining a medical clinic with three addiction specialists, the pharmacy practice is the only one of its kind in Ottawa.
- Centre for Addiction and Mental Health. Mental Illness and Addictions: Facts and Statistics. CAMH. http//www.camh.ca/en/hospital/about_camh/newsroom/for_reporters/Pages/additionmentalhealthstatistics.aspx
- Cobb, CD. Optimizing medication use with a pharmacist-provided comprehensive medication management service for patients with psychiatric disorders. 2014;24 (12): 1336-40
- O’Reilly, CL, Wong E, Chen TF. A feasibility study of community pharmacists performing depression screening services. Res Social Adm Pharm. 2015; 11(3): 364-81
- Murphy AL, Martin-Misener R, Kutcher SP, Gardner DM. Pharmacists’ performance in a telephone-based simulated patient study after a mental health capacity building program. Int J Clin Phar. 2015; 37(6): 1009-13.