A qualitative study exploring opportunities for pharmacists to connect with young mental health consumers

Mental health support in community pharmacy: inclusion of the lived experience voice in supporting service provision

OBJECTIVES

Community pharmacists, as primary healthcare practitioners, play a crucial role in supporting mental health consumers. They often serve as the first point of contact and see mental health consumers more frequently than other healthcare professionals. While their contributions to mental healthcare are increasingly recognized, insight is emerging about the factors that support pharmacists in providing mental healthcare. The aim of this study was to assess the applicability of a framework for pharmacists, pharmacy staff and consumers' empowerment in mental health.

METHODS

This study used interview data from pharmacists and mental health consumers who had participated in the Australian PharMIbridge RCT. PharMIbridge pharmacists delivered a person-centred, goal-oriented medication support service to mental health consumers. The qualitative data investigating the experiences of pharmacists (n = 16) and consumers (n = 26) were categorized in relation to the existing framework and inconsistencies or differences discussed to identify new factors.

KEY FINDINGS

Study results supported many aspects of the published framework, with two new factors (prevalence of mental distress and looking beyond the mental illness) suggested for inclusion. Additionally, eight factors were expanded with further nuanced details and experiences from the data and are presented with supporting quotations.

CONCLUSIONS

This study adds further understanding of the factors that moderate the empowerment of pharmacists and consumers in mental healthcare within community pharmacy settings. The inclusion of consumer perspectives has enriched the framework, which can be further utilized by policymakers and community pharmacists to support targeted primary healthcare responses with mental health consumers.

Potential roles for pharmacists within youth mental health services: A qualitative exploration of staff views

Background

The prevalence and burden of mental illness among young people is rising, globally. Youth mental health services, such as headspace, offer young people access to multidisciplinary mental healthcare, specifically designed to address their needs. Pharmacists are medicines experts and possess a skillset increasingly being utilised in expanded areas of practice. There is potential for pharmacists to perform roles within youth mental health services, however sparse literature exploring pharmacist-delivered mental healthcare for young people exists.

Objective

To explore views of headspace staff on medication use among young people who use youth mental health services and pharmacists' potential roles within the headspace youth mental health service model.

Methods

Individual semi-structured interviews were conducted with staff from one inner city headspace centre in Sydney, Australia. An interview guide was developed to capture participants' views on medication use among young people using youth mental health services and potential roles for pharmacists within this context. Reflexive thematic analysis was conducted to analyse the findings of this exploratory pilot study.

Results

Twelve staff members were interviewed, allowing for a range of multidisciplinary perspectives. Four themes were identified from the data: (i) gaps in medication-related care, (ii) potential roles for pharmacists at headspace (iii) collaboration between pharmacists and general practitioners, and (iv) a "one-stop shop".

Conclusions

There are opportunities for pharmacists to improve young peoples' experiences using psychotropic medications through the provision of medication information to clients and caregivers. Pharmacists have a potential role to play in contributing to multidisciplinary case reviews but clarifying their specific roles when working alongside general practitioners is necessary. Uncertainty regarding the feasibility of pharmacist-led services within the headspace youth mental health service model and a lack of awareness regarding pharmacists' full scope of practice are barriers to pharmacists' potential roles within the headspace model.

Protocol for a qualitative study exploring the pharmacist's role in supporting postsecondary students with psychotropic medication management

INTRODUCTION

Findings from the National College Health Assessment (2019) stated that anxiety and depression are the most prevalent diagnosed mental illnesses among Canadian postsecondary students with one-fifth of students self-reporting a lifetime diagnosis. Psychotropic medications can be an important component of a multifaceted approach to the management and treatment of mental illness and are the most commonly dispensed via community pharmacies. Community pharmacies provide an opportunity for pharmacists to have a prominent role in supporting patients' psychotropic medication management. However, there has been limited exploration of how pharmacists can address patients' psychotropic medication management needs, experiences and opportunities for improvements especially for emerging adults.

METHODS AND ANALYSIS

This qualitative study will incorporate Thorne's approach to interpretative description. Purposeful snowball sampling will be used to identify students (18-25 years) taking psychotropic medication(s) to manage their mental health. Participants will be interviewed one on one using a semistructured interview guide virtually. Inductive thematic analysis is underway with data analysis being iterative and reflexive using NVivo. Information provided from the interviews will be reviewed and summarised into key themes.

ETHICS AND DISSEMINATION

This study was approved by the University of Toronto Health Sciences Research Ethics Board (REB #43185). It is expected that there will be a very low risk for mild psychological and social harm for participants as they will have the ability to stop the interview at any time and will be aware of confidentiality. The results from this study will be used to create or adapt healthcare team services including the role of pharmacists within the healthcare ecosystem at the university and contribute to developing the next stage of research to evaluate feasibility and effectiveness of programmes at the university that help postsecondary students to manage psychotropic medication.

Systematic review on the effects of the physical and social aspects of community pharmacy spaces on service users and staff

Aim:

This systematic review aimed to provide new insights into how pharmacy spaces, or the architecture of pharmacies, are experienced by pharmacy service users and staff. The review sought to identify environmental factors which may influence service users’ and staff participation in community-based pharmacy health services.

Method:

Ten databases were searched for English language publications, using a combination of search terms relating to pharmacy service users and staff; pharmacy spaces; and health and social care outcomes. Data from the final selected studies were extracted, thematically analysed using a narrative approach and the quality of each study assessed using the Integrated quality Criteria for the Review of Multiple Study designs (ICROMS).

Results:

80 articles reporting 80 studies published between 1994 and 2020 were identified; they were from 28 countries, involving around 3234 community pharmacies, 13,615 pharmacy service users, 5056 pharmacists and 78 pharmacy health staff. Most studies (94%) met the ICROMS minimum score, and half did not meet the mandatory quality criteria. Four themes likely to influence service users’ and staff experiences of pharmacy health services were identified: (1) privacy; (2) experience of the physical environment; (3) professional image; and (4) risk of error.

Conclusion:

To optimise the delivery and experience of pharmacy health services, these spaces should be made more engaging. Future applied research could focus on optimising inclusive pharmacy design features.

Medication management in the context of mental illness: an exploratory study of young people living in Australia

BACKGROUND

Young people face significant challenges when managing a mental illness, such as acquiring treatment autonomy, being inexperienced users of the healthcare system and associated peer-related stigma. While medication use can be challenging in its own right, there is comparatively little information about the associated experiences and needs of young people with mental illness, particularly in the Australian context. This exploratory study will provide valuable insight into how this group is currently supported in relation to medication use.

METHODS

Young people (aged 14-25 years) who had used a prescription medication for any mental illness for a minimum of 2 months were eligible to participate in this qualitative exploratory study. Semi-structured interviews were conducted between October 2017-September 2018 in consultation rooms at two youth-focused mental health support organisations in Brisbane, Queensland. Interview questions explored how participants managed their medication and related experiences. Interviews were transcribed verbatim and descriptively analysed using thematic analysis.

RESULTS

Eighteen young people discussed their lived experience during interviews averaging 50 min in duration. Finding the right medication that reduced symptom severity with minimal side-effects was identified as a complex experience for many, particularly when there was a lack of information, support or reduced financial capacity. Young people described a range of strategies to manage medication side-effects, changes and to support routine medication use.

CONCLUSIONS

Young people persevered with taking medication to manage a mental illness within a healthcare system that does not adequately support this vulnerable population. There remains a clear directive for healthcare professionals to provide credible information that proactively engages young people as healthcare participants, and for policy makers to consider financial burden for this population with limited financial capacity.