Among the many collateral effects of COVID-19, the pandemic has exacerbated the mental health crisis in the United States. For some, the global shutdown interrupted ongoing mental health care. For others, the stress and isolation triggered new mental health issues. It was against this backdrop earlier this year that CVS started adding licensed clinical social workers trained in mental health care to MinuteClinics at select HealthHUB locations in Houston, Philadelphia, and Tampa. The move underscores pharmacists’ and pharmacies’ unique placement in the health care landscape and positions them to help close a longstanding gap in access to mental health care. Increasingly, retail pharmacies—from the corporate giants to the community independents—are harnessing their position and taking steps to address unmet mental health care needs for their patients. CVS Health's program offers in-person or virtual therapy sessions by appointment or to walk-ins. The services include mental health assessments, referrals, counseling, and personalized care plans. Many insurance plans cover these services. For those without coverage, out-of-pocket costs range from $129 for an initial assessment to $69 for a half-hour session with many options in between. “With accessible, low-cost services available in community-based MinuteClinics at select HealthHUB locations, CVS Health is offering new access points for populations who are struggling with the unprecedented stressors of recent months, helping to avoid costly ER visits, and providing a pathway to symptom relief,” said Sharon Vitti, president of MinuteClinic and senior vice president at CVS Health. Walgreens connects patients with mental health care through its app, where they can access in-person or online services through a variety of providers. “Every day our pharmacists talk with patients with a wide range of conditions, including mental health conditions,” said Jude Pierre-Louis, senior director of Healthcare Services Development and Delivery at Walgreens. “With a sharply rising need for mental health resources since the onset of the COVID-19 pandemic, Walgreens expanded Walgreens Find Care® to help address these needs.” Both corporations stress the role that pharmacists can play in the expanding mental health offerings at the two retailers. “Pharmacists advise patients on recommendations and next steps to manage their conditions or concerns in person or over the phone, including recommending or referring to mental health services. Having access to mental health services in store or virtually provides pharmacists with another timely care option for patients,” Vitti said. Independent pharmacies are leveraging their position with patients, too. That position was never clearer to Randy McDonough, PharmD, than when Iowa City police officers brought one of his patients to him one night in a patrol car. Police had picked up the man, who had stopped taking his medications for schizophrenia, after he had been seen wandering around town. When they approached him, he repeated, “I need to talk to Randy. I need to go to Towncrest Pharmacy.” McDonough, co-owner of Towncrest Pharmacy, managed to calm his patient down and then recommended that the officers take him to a hospital. He said the National Community Pharmacists Association's Mental Health First Aid Training equipped him for this encounter. “Sometimes we can be hesitant, or we can have biases with individuals with mental illness, and I think the training that I received helped me get rid of those biases,” McDonough said. He said the trusting, respectful relationship he has with the patient may be what brought him there that night. While small independents may lack the muscle to embed therapists in their stores or link patients to telehealth for mental health care through an app, they have the clinical expertise to recognize and address unmet mental health needs. Mental Health First Aid Training is an eight-hour, in-person program that prepares pharmacists to identify, understand, and respond to signs of mental illnesses and substance use disorders. The program encourages pharmacists to leverage their role in the community to reach out to the patient's provider or connect them with appropriate care. “Pharmacists, technicians, and staff are on the frontlines in their communities,” said Hannah Fish, PharmD, associate director of strategic initiatives at the National Community Pharmacists Association. “They may see changes that are happening in their patients more frequently than a physician would.”
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