The Application of Motivational Interviewing by Specialist Mental Health Clinical Pharmacist in Acute Mental Health Wards and Psychiatric Intensive Care Unit (PICU)

Abstract

The role of Clinical Pharmacists, and more specifically the Specialist Mental Health Clinical Pharmacist, has been widely acknowledged for both economic efficiency within healthcare systems and for improving patient safety and experience1,2. Supported by the Royal Pharmaceutical Council of Great Britain (RPSBG)3,4 and the General Pharmaceutical Council5 “patient-centred care” is a key component of our success, a concept placed firmly on the agenda with the NHS Constitution6, which gives people the right to be involved in discussions and decisions about their healthcare, and to be given information to allow them to do this. The need to improve patient-centred compassionate care in the NHS has received huge media attention, with the success of the #hellomynameis campaign, started in 2013 by Dr Kate Granger MBE7. Through her experiences as a health service user, she showed that healthcare professionals often did not even show the basic curtesy to introduce themselves to her. Since then, the pharmacy profession has strived to improve consultation skills, by developing a clear set of standards and training, around a concept of establishing a “shared agenda” between the patient and pharmacist8. In this article, I describe how the psychological techniques of “Motivational Interviewing”, can be beneficial for pharmacists working in the challenging environments of the Acute Mental Health wards and the Psychiatric Intensive Care Unit, to help reaching this “shared agenda” (See Figure 1). Considering that people, who are mentally unwell, almost by definition, may have reduced capacity to identify problems and generate solutions, reduced motivation to change or increased resistance to change, their success in these settings is testament to the strength of these techniques. However, the negative experiences faced by many of these people, highlights that competence in this area is crucial to improving their care2.