How is mental health care provided through community pharmacies? A quest for improvement

Abstract

Background: Mental disease burden is increasing globally, and a substantial shortage of mental health professionals remains. Community pharmacists can improve population mental health outcomes to bridge the mental health care gap. However, there is a paucity of data on community pharmacists’ provision of mental health care. Objective: To assess community pharmacist-delivered care to people with mental illness in the United Arab Emirates (UAE), focusing on dispensing and counseling practices, pharmacists’ confidence and comfort in providing care, and attitudes and beliefs towards mental illness. Methods: This was a mixed-methods study with an exploratory, sequential design. Semi-structured interviews explored community pharmacists’ practices, challenges and strategies to improve care. Data were analyzed thematically, and the results guided questionnaire development. The questionnaire was also informed by the Framework of Core Mental Health Competencies for All Pharmacy Professionals and other relevant literature and administered to community pharmacists in four out of seven emirates. Logistic regression was used to identify the predictors of pharmacist practices. Results: In the interviews, community pharmacists described adopting a precautionary attitude and perceived their role as a dispensing one. They reported challenges such as emotional discomfort and lack of training but highlighted the need for a different approach to patients with mental illness. In total, 252 pharmacists completed the questionnaire, and 74% reported performing at least five counseling practices. Logistic regression showed that pharmacists who performed a higher number of practices (≥5) were younger, received continuing education on mental health care in the last two years, and had higher confidence levels. Conclusion: UAE community pharmacists performed basic dispensing practices and reported discomfort during encounters with patients with mental illness. Training on patient-centered communication skills and psychiatric therapeutics is needed to improve pharmacist-delivered services, alongside increased collaboration with other providers and services.

A Comparison of Knowledge, Attitude, and Practice (KAP) Between Private- and Government-Sector Pharmacists With Regard to Psychotropic Medications in Riyadh City

“…In line with our findings, the results of a survey on pharmacists’ perceptions of the adequacy of their training for addressing mental health-related medication issues indicated that, in a group of experienced pharmacists, many did not feel comfortable counseling patients on mental health-related medications [ 29 ]. This finding is also consistent with another study regarding community pharmacists’ attitudes towards mental illness conducted in Riyadh, which found that pharmacists reported feeling uncomfortable counseling and solving drug-related problems for patients with mental illness [ 23 , 30 ]. Furthermore, several studies revealed that pharmacists were significantly more confident and comfortable in providing services to consumers with cardiovascular disease than with mental illnesses [ 30 , 31 ].…”

“…This finding is also consistent with another study regarding community pharmacists’ attitudes towards mental illness conducted in Riyadh, which found that pharmacists reported feeling uncomfortable counseling and solving drug-related problems for patients with mental illness [ 23 , 30 ]. Furthermore, several studies revealed that pharmacists were significantly more confident and comfortable in providing services to consumers with cardiovascular disease than with mental illnesses [ 30 , 31 ]. Another study conducted in the United Arab Emirates on how to provide mental healthcare through community pharmacies revealed that pharmacists described feelings of emotional discomfort when dealing with patients with mental illnesses.…”

“…Researchers found that pharmacists cited two main challenges in providing care for mentally ill patients: the emotional distress felt by them and a lack of awareness and training. Moreover, pharmacists highlighted that training in effective communication with mentally ill patients is often not provided in pharmacy programs [ 30 ].…”

Pharmacist-Led Assessment of Anxiety Levels and Associated Factors: A Prospective Observational Survey

“…Pharmacists can enhance patient-centered care to promote positive outcomes in an underserved population by improving communication between healthcare professionals, coordinating the treatment of patients, improving access to and safety of medications, and optimizing medication regimens [8,[21][22][23]. On the other hand, in the study completed by Samorinha et al, pharmacists may encounter barriers in providing mental health services [24]. It was stated that the most important of these barriers are emotional discomfort with the patient's current situation and lack of practice.…”

Universal mental health training for frontline professionals: evaluation of pilot trial in Ukraine

“…Also, many mental health training programmes target specific frontline professionals: police ( Fiske et al ., 2021 ; Thomas & Watson, 2017 ; Weaver et al ., 2022 ), education workers ( Anderson et al ., 2019 ; Whitehurst, 2008 ), pharmacists ( Frick et al ., 2021 ; Samorinha et al ., 2022 ) etc.…”