In the UK, we seem to easily fall into the trap of stigmatising mental health conditions, automatically assuming that if someone has a mental health condition, they must be violent.
This is a dangerous assumption to make, which could end up with people being isolated and not given the support and care that they need. Particularly in the pharmacy setting, the challenge is always there to not assume that everyone taking aripiprazole, methadone, quetiapine etc is a violent person. Sometimes they might be – but is it appropriate to label them as such? I don't think so.
It is a well-established view that mental health services need more support from our government. With more patients presenting to emergency care services, and GPs who are less equipped to support mental health crises compared to specialists, further work needs to be done in this area of our NHS.
The sector is in a transitional phase, where pharmacists are encouraged to move away from dispensing by modernising through technology. Pharmacy technicians and accuracy checking technicians are encouraged to take leading roles in the dispensary, and healthcare assistants are encouraged to provide expert advice and over-the-counter recommendations. So, are pharmacists in a position to help support the historically struggling area of mental healthcare provision?
Some might argue that using pharmacists in this way is not addressing the core issue of why mental healthcare provision needs support in the first place. Over the past few years we have seen several mental health facilities close. When this happens, patients are directed back to GP surgeries, who can only provide symptomatic relief through medication, but can't address the root cause.
Take a lonely woman suffering from severe depression. A GP would give medication to help her with the depression – but ultimately she will still be lonely. Social groups would be far more beneficial. Of course, GPs do an excellent job in referring to services such as these, but it's getting more difficult to do so.
The big advantage of pharmacy is its accessibility. Nearly all the services it provides are offered on an ad-hoc basis. You need a prescription fulfilled? You will get it almost immediately. Need to speak to a pharmacist? They are always available. Need direction on a variety of healthcare issues? Pharmacy technicians and support staff are ready and willing to point you in the right direction. It's a benefit unique to the pharmacy.
Some of the best pharmacies have strong links with various local services. Signposting patients who may be struggling to these services can only be helpful. Are pharmacists equipped to handle mental health crises? Mental health is a field of healthcare that requires specialised training and, while pharmacists are experienced in communicating with patients, is it sufficient? Are consultation rooms in pharmacies suitable for mental health discussions?
I have to admit, from my experience I have seen consultation rooms that are smaller than my boiler room at home – retrofitted to comply with legislation to have one in place, knees touching, and usually filled to the brim with various bits of paperwork locked away. It is my opinion we would need an extensive overhaul for these rooms to be suitable. Something that many would find to be unfeasible.
It's clear that pharmacists are going to do more consulting, providing service-led healthcare, while the routine activities will be more focused on a technician-led approach. With this in mind, are pharmacists going to see issues such as mental health in a more front-and-centre focus?
Time will tell.
Benjamin D’Montigny is a locum dispenser working in the south of England