Abstract
Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and address the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. This narrative review is divided into three main sections: (1) the role of the pharmacist in mental health care in multidisciplinary teams and in supporting early detection of mental illness; (2) the pharmacists’ role in supporting quality use of medicines in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and (3) barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma. In the first section, the review presents new roles for pharmacists within multidisciplinary teams, such as in case conferencing or collaborative drug therapy management; and new roles that would benefit from increased pharmacist involvement, such as the early detection of mental health conditions, development of care plans and follow up of people with mental health problems. The second section describes the impact of medication review services and other pharmacist-led interventions designed to reduce inappropriate use of psychotropic medicines and improve medication adherence. Other new potential roles discussed include the management of antipsychotic polypharmacy and involvement in patient-centered care. Finally, barriers related to pharmacists’ attitudes, stigma and skills in the care of patients with mental health problems and barriers affecting pharmacist-physician collaboration are described, along with strategies to reduce mental health stigma.
Highlights
There has been an increasing recognition that primary health care practitioners play an important role in the identification, support and management of mental disorders; the clinical contribution of pharmacists has not been universally accepted or comprehensively defined
This narrative review is divided into three main sections: (1) the general role of pharmacists in mental health care; (2) the pharmacists’ role in supporting the quality use of medicines with in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma
A recent Australian study highlighted that when consumers developed a trusting relationship with their pharmacist they felt the community pharmacy was a safe place to discuss their mental health concerns, showing the importance of not just the physical space but the rapport with health professionals that is important in mental health care delivery [41]
Summary
There has been an increasing recognition that primary health care practitioners play an important role in the identification, support and management of mental disorders; the clinical contribution of pharmacists has not been universally accepted or comprehensively defined. Medicines are a major treatment modality of management for many mental illnesses and pharmacists are well positioned to enhance mental health services with the potential to reduce the associated burden of mental disorders. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. Papers written in English or Spanish (the native languages of the authors) were included in the synthesis
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