Earlier this year the Scottish Government published its much-anticipated new Mental Health Strategy with an ambition to prevent and treat mental ill-health with the same commitment, passion and drive as physical health problems. Pharmacists have always been closely involved in the care of people with mental illness but, as John Macgill has been finding out, the profession’s potential is perhaps only beginning to be seen.
Ask once, get help fast?
In her introduction to the Mental Health Strategy 2017-2027, Scotland’s first Minister for Mental Health, Maureen Watt MSP, sets an ambitious tone:
‘We want to see a nation where mental healthcare is person-centred and recognises the life-changing benefits of fast, effective treatment. We want a Scotland where we act on the knowledge that failing to recognise, prioritise and treat mental health problems costs not only our economy, but harms individuals and communities.’
‘Our Mental Health Strategy states that we’ll support the development of new multi-disciplinary models of supporting mental health in primary care to ensure that people can ‘ask once, get help fast,’ Maureen Watt told Scottish Pharmacist. ‘Given the role of pharmacists in providing both advice and medicines, there is potential for them to have a role in helping to support this ambition. A wide range of clinical and non-clinical staff, including pharmacists, can provide problem-solving, listening and signposting for physical, mental and social problems and can work with people to optimise their own physical and mental wellbeing.’
One person with a unique perspective as a Member of the Scottish Parliament with a career in psychiatric pharmacy, is Maree Todd MSP. She believes pharmacists play a vital role in supporting people with mental ill health:
‘Medication can be the cornerstone of treatment for illnesses like schizophrenia and bipolar affective disorder,’ she told SP, ‘but the medicines are not easy to use and it can be hard to find the one that best suits the patient. Even when non-drug treatments are the preferred option, drugs are often still prescribed, like in personality disorders, and a pharmacist’s role can be helping to avoid harm from medication in these conditions.
‘Some mental illnesses are very common and because treatment is needed during childbearing years, specialist advice on drugs in pregnancy and breastfeeding is essential. For illnesses like depression, where there are non-drug treatment options too, a pharmacist can help weigh up the pros and cons of both options of the individual patient. Those with severe depression will need medication before they will be able to engage with talking therapies. Those with mild depression would be best treated with talking therapies. Pharmacists have a key role to play in choosing the right medicine, minimising and monitoring for side effects, and helping the patient to keep taking the medicine for as long as they need to.’