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Suicide risk and antidepressants – How can a community pharmacist help?

Hadar Zaman

 

I am passionate about mental health and especially the role community pharmacists can play in supporting patients taking medication for a mental health condition.

 

As community pharmacists, we are the most accessible healthcare professionals with expert knowledge on medicines within the NHS. The recent economic recession and the strong correlation between socioeconomic disadvantage and deprivation outcomes can be related to poor mental health. This said, there has been an exponential increase in the prescribing of antidepressants for depression (165% in England between 1998-2012) with clear geographical variation between the North and South.

 

As pharmacists situated in the heart of our communities with strong relationships with our patients, I believe we can provide a positive and lasting experience for our patients suffering from mental health conditions.

 

As the key document Making Every Contact Count shows, we are perfectly positioned to deliver on some of its objectives and ensure our patients with mental health conditions receive personalised healthcare advice to support their condition. Having talked to many pharmacists, they are not confident in consulting patients with mental health conditions, but  CPPE recently released learning materials on mental health and dementia, which I would strongly encourage all pharmacists to read. You may want to start reading this ASAP with newspaper headlines like this:  “Antidepressants can raise the risk of suicide, biggest ever review finds”, which appeared in the Telegraph (28/01/2016).

You may find patients coming in and asking for your advice about their treatment. I do not want to go into the detail of this article, but needless to say that compliance rates for medication for patients suffering from mental health conditions ranges between 50-70%, and this headline does not help that. Back to the point, what can we as community pharmacists do? The answer is plenty.

 

Taking 2 minutes to ask a patient how they are getting on with their medication (antidepressants/antipsychotics), or how they are doing, can be so impactful for the patient, bearing in mind that you may be the only person they talk to. I’m not saying pharmacists should become counsellors (although there is a big market and opportunity to do so), but talking to the patient about progress on medication, and signposting them to support groups can make a huge difference to a patient’s life.

 

Having worked in community pharmacy and talked to patients about their condition, and to see the smile on their faces because somebody has taken time with them is priceless. I have been pushing really hard to extend the ‘new medication service’ to include antidepressants because we as pharmacists can have a huge impact on patients beliefs/compliance and ensure they receive optimal benefit from their antidepressants.

 

I hope this materialises sooner, rather than later. But, in the meantime let’s start engaging with our patients on mental health conditions and perhaps, where appropriate, providing services such as ‘medication use reviews’ to them. On Feb 4, it was the Time to Talk campaign, which is designed to get the nation talking about mental health. It can serve as a catalyst for us as pharmacists to increase our awareness and confidence in mental health conditions. Did you get involved? If not perhaps you’ll consider doing so the next time.

 

Hadar Zaman is a clinical and professional advisor at the Care Quality Commission, a lecturer in pharmacy practice at the University of Bradford, a consultant mental health pharmacist and a pharmacist independent prescriber. 

 

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