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Ung TX, O'Reilly CL, Moles RJ, Collins JC, Ng R, Pham L, Saini B, Ong JA, Chen TF, Schneider CR, El-Den S. Evaluation of Mental Health First Aid Training and Simulated Psychosis Care Role-Plays for Pharmacy Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:101288. [PMID: 39304009 DOI: 10.1016/j.ajpe.2024.101288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 08/23/2024] [Accepted: 09/13/2024] [Indexed: 09/22/2024]
Abstract
OBJECTIVE This study explored the impact of Mental Health First Aid (MHFA) training and simulated psychosis care role-plays on pharmacy students' stigma, confidence, and behaviors when supporting people experiencing mental health symptoms or crises. METHODS MHFA training was delivered to final year pharmacy students. Post-MHFA training, students were invited to participate in simulated psychosis care role-plays (co-designed and content validated with mental health stakeholders) with trained actors. Role-plays were observed by peers, tutors, and mental health consumer educators (MHCEs). Students immediately engaged in self-assessment, feedback, and debrief discussions with peers, tutors, and MHCEs. Quantitative analyses (ANOVA and chi-square tests) were conducted on scores awarded by each rater (self, tutor, MHCE) and for each scenario (n = 3). Students completed a 15-item survey exploring mental health stigma and mental health confidence, at 3 timepoints (pre-MHFA training, post-MHFA training, and post-role-plays). Survey scores were analyzed using paired t tests. RESULTS Of 209 MHFA-trained students, 86 participated in role-play. The self-assessment mean score was the lowest and the MHCEs' mean score highest. Post-MHFA training, 14 survey item scores significantly improved, implying reduced stigma and increased confidence in providing psychosis care. Post-role-play scores suggested improvements in 12 survey items. CONCLUSION Psychosis care role-plays are associated with short-term improvements in pharmacy students' stigma and mental health confidence post-MHFA training; students' self-assessment scores are lower than tutors and MHCEs. It is recommended that future studies further integrate observed behaviors with self-reported data and use simulated patients in clinical practice to evaluate MHFA outcomes longitudinally.
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Affiliation(s)
- Tina X Ung
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia.
| | | | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Ricki Ng
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Lily Pham
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Bandana Saini
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Jennifer A Ong
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Timothy F Chen
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Carl R Schneider
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
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Strowel C, Raynes-Greenow C, Collins JC, Pham L, El-Den S. Education professionals' perceptions on perinatal mental health education in Australian and New Zealand medical and pharmacy curricula. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:102108. [PMID: 38852209 DOI: 10.1016/j.cptl.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 05/01/2024] [Accepted: 05/06/2024] [Indexed: 06/11/2024]
Abstract
INTRODUCTION Primary healthcare workers, including doctors and pharmacists, are well-positioned to detect and support women experiencing mental health disorders in the perinatal period. However, research exploring their education and training to fulfil these roles is limited. This study aimed to examine the perspectives of medical and pharmacy educational program representatives on perinatal mental health education in medical and pharmacy curricula at Australian and New Zealand universities. METHODS A web-based search (e.g., Australian Health Practitioner Regulation Agency) was used to identify potentially relevant medical and pharmacy educational program representatives. Eligible participants were invited to participate in audio-recorded semi-structured interviews which were transcribed verbatim. Data regarding perinatal mental health content within each program were extracted and tabulated for comparisons. Thematic analysis of participants' perspectives on perinatal mental health education was conducted. RESULTS Fifty medical and pharmacy educational program representatives were invited to participate (December 2022-March 2023), of which 13 participated representing 14 programs. The extent and content of perinatal mental health education varied considerably across programs. Thematic analysis resulted in four themes: How much perinatal mental health content is enough?; Reflections on perinatal mental health related content; Perinatal mental health education in and beyond the classroom; Challenges associated with delivering perinatal mental health content. CONCLUSIONS Participants acknowledged the importance of perinatal mental health content for medical and pharmacy students; however, limited time and lack of opportunities for students to complete placements were key challenges to curricular integration.
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Affiliation(s)
- Clara Strowel
- The University of Sydney School of Public Health, Edward Ford Building, A27 Fisher Rd, University of Sydney NSW 2050, Australia.
| | - Camille Raynes-Greenow
- The University of Sydney School of Public Health, Edward Ford Building, A27 Fisher Rd, University of Sydney NSW 2050, Australia.
| | - Jack C Collins
- The University of Sydney, School of Pharmacy, Pharmacy and Bank Building, Science Road (A15), The University of Sydney, Camperdown Campus, NSW 2006, Australia.
| | - Lily Pham
- The University of Sydney, School of Pharmacy, Pharmacy and Bank Building, Science Road (A15), The University of Sydney, Camperdown Campus, NSW 2006, Australia.
| | - Sarira El-Den
- The University of Sydney, School of Pharmacy, Pharmacy and Bank Building, Science Road (A15), The University of Sydney, Camperdown Campus, NSW 2006, Australia.
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Huon JF, Nizet P, Tollec S, Vene E, Fronteau C, Leichnam A, Tching-Sin M, Michelet-Barbotin V, Foucault-Fruchard L, Nativel F. A systematic review of the impact of simulation on students' confidence in performing clinical pharmacy activities. Int J Clin Pharm 2024; 46:795-810. [PMID: 38632204 DOI: 10.1007/s11096-024-01715-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/13/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Although confidence does not automatically imply competence, it does provide pharmacy students with a sense of empowerment to manage a pharmacotherapeutic problem independently. Among the methods used in higher education, there is growing interest in simulation. AIM To evaluate the impact of simulation on pharmacy students' confidence in performing clinical pharmacy activities. METHOD Articles that reported the use of simulation among pharmacy students with fully described outcomes about confidence were included. Studies for which it was impossible to extract data specific to pharmacy students or simulation were excluded. The search was carried out in Medline, Embase, Lissa and PsycInfo from inception to August the 31th, 2022. The results were synthesized into 4 parts: confidence in collecting information, being an expert in a procedure/pathology, counselling and communicating, and other results. The quality assessment of included studies was conducted using the Mixed Methods Appraisal Tool "MMAT" tool. RESULTS Among the 39 included articles, the majority were published in the last 5 years and conducted in the United States. The majority included pharmacy students in years 1 through 3 (69.2%). The most common study design was the pre-post uncontrolled design (66.7%). Studies measuring the effects of human and/or virtual simulation were mainly focused on confidence to counsel and/or communicate with patients and colleagues (n = 20). Evaluations of the effects of these types of simulation on confidence in information gathering by health professionals were also well represented (n = 16). CONCLUSION Simulation-based training generally yielded positive impact on improving pharmacy students' confidence in performing clinical pharmacy activities. Rigorous assessment methods and validated confidence questionnaires should be developed for future studies.
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Affiliation(s)
- Jean-François Huon
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France.
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France.
| | - Pierre Nizet
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Sophie Tollec
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Orléans, Orléans, France
| | - Elise Vene
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Rennes, Rennes, France
| | - Clémentine Fronteau
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Alison Leichnam
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Martine Tching-Sin
- Nantes Université, CHU Nantes, Pharmacie, 5 allée de l'île Gloriette, 44000, Nantes, France
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
| | - Vanessa Michelet-Barbotin
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Rennes, Rennes, France
| | - Laura Foucault-Fruchard
- Réseau HUGOPharm : réseau des pharmacies hospitalieres des Hopitaux Universitaires du grand ouest, Nantes, France
- CHU Tours, Service Pharmacie, Tours, France
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Fabien Nativel
- Nantes Université, Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, 44000, Nantes, France
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Ung TX, El-Den S, Moles RJ, O'Reilly CL. Simulated psychosis care role-plays for pharmacy curricula: a qualitative exploration of student experiences. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1269-1277. [PMID: 38103057 PMCID: PMC11178615 DOI: 10.1007/s00127-023-02598-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Mental Health First Aid (MHFA) training is embedded in various tertiary healthcare curricula. However, opportunities for students to practise their newly acquired MHFA skills before entering the clinical practice workforce are lacking. The purpose of this study was to explore pharmacy students' experiences of MHFA training and post-MHFA simulated psychosis care role-plays. METHODS Final-year pharmacy students received MHFA training, after which they were invited to participate in simulated patient role-plays with trained actors, whilst being observed by peers, pharmacy tutors and mental health consumer educators (MHCEs). Immediately after each role-play, the role-playing student engaged in self-assessment, followed by performance feedback and debrief discussions with the tutor, MHCE and observing peers. All MHFA-trained students were invited to participate in audio-recorded focus groups to explore their experiences. Audio-recordings were transcribed verbatim and thematically analysed. RESULTS MHFA training was delivered to 209 students, of which 86 participated in a simulated patient role-play as a role-player and the remaining students observed. Seven focus groups were conducted with 36 students (mean duration 40 min, SD 11 min). Five themes emerged: scenario reactions, realistic but not real, mental health confidence, MHFA skills application, feedback and self-reflection. CONCLUSION Students enjoyed the post-MHFA simulated psychosis care role-plays, which provided opportunities to apply and reflect on their newly-acquired MHFA skills in a safe learning environment. These experiences enhanced students' confidence to support people in the community, experiencing mental health symptoms or crises, and could be an add-on to MHFA training in the future.
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Affiliation(s)
- Tina X Ung
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia.
| | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
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Llopis N, Antoine E, Grové C, Marinucci A, Touchard F, Montagni I. A mixed-methods project on the impact of the mental health first aid training on French university students' knowledge, attitudes and practices. Early Interv Psychiatry 2024; 18:366-373. [PMID: 37749765 DOI: 10.1111/eip.13471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/08/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023]
Abstract
AIM University students are increasingly affected by mental health problems and need prompt support. The aim of this project was to assess the impact of the mental health first aid (MHFA) training on students' knowledge, attitudes and practices (KAP) concerning mental health in the short, mid and long-term. METHODS Three studies were conducted in Bordeaux, France, from May 2021 to March 2022. The first study collected data from 55 students 1 to 6 months after they had followed the training to examine its efficacy in the mid-long term. The second study collected data immediately before and after the training to evaluate the KAP of 52 students in the short-term (1 to 10 days). The third study consisted of 14 semi-structured interviews with students trained since 2020 to identify the training's long-term impact (3 to 18 months). Descriptive statistics were used for studies one and two, and framework analyses for study three. RESULTS Most participants reported that their KAP about mental health had improved after the training. In the first study, 94.2% of students reported being ready to intervene during a psychotic crisis in their peers. In the second study, 75.0% of students reported improved mental health-related knowledge and decreased stigma. All students in the third study reported that they had assisted at least one person after the training. CONCLUSIONS These were the first data on the impact of the French MHFA on KAP. While not exhaustive, findings suggest that deploying the training would be beneficial to French students.
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Affiliation(s)
- Nathalie Llopis
- Bordeaux Population Health Research Center, INSERM U1219, University of Bordeaux, Bordeaux, France
| | - Emeline Antoine
- Bordeaux Population Health Research Center, INSERM U1219, University of Bordeaux, Bordeaux, France
| | - Christine Grové
- Fulbright Association, Canberra, New South Wales, Australia
- Faculty of Education, Monash University, Clayton, Victoria, Australia
| | | | | | - Ilaria Montagni
- Bordeaux Population Health Research Center, INSERM U1219, University of Bordeaux, Bordeaux, France
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Oliveira TZ, de Rezende CZ, Cardoso HW, Nascimento SF, Cunha JPA, Lemos CA, Varallo FR, Pereira LRL. A Scoping Review of Pharmacists' and Pharmacy Students' Knowledge, Skills, and Attitudes in Medical Emergencies. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100606. [PMID: 37839555 DOI: 10.1016/j.ajpe.2023.100606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES Competence can be defined as a set of knowledge, skills, and attitudes. In a medical emergency scenario, competent pharmacists are increasingly required, mainly as a result of the expansion of professional functions in this context. Therefore, the objective of this study was to map the scientific evidence that shows the development of knowledge and/or skills, and/or attitudes in the training of pharmacists and pharmacy students to work in emergency care. FINDINGS The scoping review was conducted in the PubMed, Embase, Latin American and Caribbean Health Sciences Literature, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases in January 2021, as recommended by the Joanna Briggs Institute. Our study retrieved 6276 files, and 31 articles met the inclusion criteria. It was observed that the studies were developed mainly in the United States of America and addressed the development and/or assessment of knowledge and skills, and training in cardiac emergencies. The most used teaching strategy was simulation, and the most used assessment strategy was feedback and/or debriefing. SUMMARY Publications involving the development of at least 1 domain of clinical competence have increased in the last decade. Thus, the mapping of studies has provided subsidies for identifying gaps in the teaching-learning process, as well as the identification of methodologies applied in the development and assessment of clinical competence for the referred population.
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Affiliation(s)
- Thalita Zago Oliveira
- University of São Paulo, School of Pharmaceutical Sciences of Ribeirão Preto, Department of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil.
| | - Clara Zambon de Rezende
- University of São Paulo, School of Pharmaceutical Sciences of Ribeirão Preto, Department of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - Higor Weslley Cardoso
- University of São Paulo, School of Pharmaceutical Sciences of Ribeirão Preto, Department of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - Sofia Fernandes Nascimento
- University of São Paulo, School of Pharmaceutical Sciences of Ribeirão Preto, Department of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - João Paulo Alves Cunha
- University of São Paulo, School of Pharmaceutical Sciences of Ribeirão Preto, Department of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - Carla Assad Lemos
- University of São Paulo, School of Pharmaceutical Sciences of Ribeirão Preto, Department of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - Fabiana Rossi Varallo
- University of São Paulo, School of Pharmaceutical Sciences of Ribeirão Preto, Department of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - Leonardo Régis Leira Pereira
- University of São Paulo, School of Pharmaceutical Sciences of Ribeirão Preto, Department of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
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Pilbrow S, Staniland L, Uren HV, Shand F, McGoldrick J, Thorp E, MacKrill M, Moullin JC. Evaluation of an online advanced suicide prevention training for pharmacists. Int J Clin Pharm 2023; 45:1203-1211. [PMID: 37702959 PMCID: PMC10600280 DOI: 10.1007/s11096-023-01636-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/10/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND With the pharmacist role extending internationally to include health promotion and harm reduction, pharmacists are well-suited to adopt a frontline role within suicide prevention efforts. To maximise their abilities to implement suicide prevention strategies, suicide prevention training is essential to improve pharmacists' knowledge of, attitudes towards, and confidence in pharmacy-based suicide prevention. AIM This study aimed to evaluate the impact of an online Advanced Suicide Prevention Training for Pharmacists and explore how participant feedback may direct training improvements. METHOD One hundred and fifty pharmacists in Tasmania, Australia, completed the training. Of these, 109 participants completed surveys pre-, post- and 6-months post-training to evaluate changes in suicide prevention knowledge, confidence, and attitudes, and explore participants' perceptions of the training. RESULTS Significant improvements were observed in suicide prevention attitudes (F(2, 20) = 4.12, p = 0.032, partial η2 = 0.292), and self-efficacy (F(2, 20) = 7.84, p = 0.003, partial η2 = 0.439), across the three timepoints, with improvements to knowledge and confidence evident between pre- and post-training (p < 0.05). Qualitative data reflected that the training was beneficial in aiding the identification and support of at-risk individuals, however barriers such as the pharmacy setting, personal discomfort, and perceptions of the pharmacist role were identified as impeding the implementation of suicide prevention within pharmacy practice. CONCLUSION Training is an effective means of improving pharmacists' suicide prevention knowledge, confidence, and attitudes. While personal barriers to suicide prevention improved, contextual and social barriers continue to impede pharmacists' implementation of suicide prevention in practice.
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Affiliation(s)
- Samantha Pilbrow
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Lexy Staniland
- Curtin enAble Institute, Curtin University, Perth, WA, Australia
| | - Hannah V Uren
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Fiona Shand
- Black Dog Institute, Sydney, NSW, Australia
- University of New South Wales, Sydney, NSW, Australia
| | | | - Emily Thorp
- Pharmaceutical Society of Australia Tasmanian Branch, Hobart, TAS, Australia
| | - Monique MacKrill
- The Pharmacy Guild of Australia Tasmanian Branch, Battery Point, TAS, Australia
| | - Joanna C Moullin
- School of Population Health, Curtin University, Perth, WA, Australia.
- Curtin enAble Institute, Curtin University, Perth, WA, Australia.
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Ung TX, O'Reilly CL, Moles RJ, El-Den S. Co-designing psychosis simulated patient scenarios with mental health stakeholders for pharmacy curricula. Int J Clin Pharm 2023; 45:1184-1191. [PMID: 37505347 PMCID: PMC10600032 DOI: 10.1007/s11096-023-01622-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Pharmacists need knowledge and confidence to support people living with mental illness. Evidence-based educational materials for pharmacy students to provide psychosis care is limited. AIM To co-design, content validate and pilot-test, with mental health stakeholders, simulated patient scenarios to educate and assess students in providing psychosis care. METHOD Mental health consumers were invited to co-design three simulated patient scenarios (first-episode psychosis, carer of someone living with schizophrenia, non-adherence to antipsychotics), guided by published and psychometrically-tested materials. A panel of mental health stakeholders participated in two rounds of content validation (RAND/UCLA appropriateness model). Round 1 involved individual survey completion to calculate item content validity index (I-CVI) for relevance/clarity, content validity ratio for essentiality and overall scale content validity index (S-CVI/Ave and S-CVI/UA) scores for each scenario. Scores analyses and feedback comments informed revisions. Round 2 involved a panel meeting to discuss revisions and finalise content. The scenarios were then pilot-tested with pharmacy students. RESULTS Two consumers participated in co-design, nine stakeholders in content validation. All items showed excellent content validity for relevance/clarity. Eleven items were revised for essentiality, discussed, then re-rated at the panel meeting for consensus. The scenarios were pilot-tested with pharmacy students (n = 15) and reported to be realistic and relevant to future practice, contributing to students' confidence in supporting people experiencing mental health symptoms or crises. CONCLUSION Partnering with mental health stakeholders has enabled co-design of authentic, content valid educational materials for pharmacy students to provide psychosis care, in preparation for future provision of mental health support.
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Affiliation(s)
- Tina X Ung
- School of Pharmacy, The University of Sydney, Pharmacy and Bank Building A15, Science Rd, Camperdown, Sydney, NSW, 2006, Australia.
| | - Claire L O'Reilly
- School of Pharmacy, The University of Sydney, Pharmacy and Bank Building A15, Science Rd, Camperdown, Sydney, NSW, 2006, Australia
| | - Rebekah J Moles
- School of Pharmacy, The University of Sydney, Pharmacy and Bank Building A15, Science Rd, Camperdown, Sydney, NSW, 2006, Australia
| | - Sarira El-Den
- School of Pharmacy, The University of Sydney, Pharmacy and Bank Building A15, Science Rd, Camperdown, Sydney, NSW, 2006, Australia
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Ng R, O'Reilly CL, Collins JC, Roennfeldt H, McMillan SS, Wheeler AJ, El-Den S. Mental Health First Aid crisis role-plays between pharmacists and simulated patients with lived experience: a thematic analysis of debrief. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1365-1373. [PMID: 36928545 PMCID: PMC10423112 DOI: 10.1007/s00127-023-02443-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Healthcare professionals, including pharmacists, can recognise and assist people experiencing mental health crises. Despite this, little is known about how pharmacists assist and engage with people presenting with signs and symptoms of mental health crises. This study aimed to (i) examine pharmacists' mental health crisis assessment language during simulated patient role-plays (SPRPs) and (ii) explore participants' experiences of participating in SPRPs of Mental Health First Aid (MHFA) scenarios. METHODS Fifty-nine MHFA-trained pharmacy staff participated in audio-recorded SPRPs of three crisis scenarios enacted by a mental health consumer educator (MHCE). Post-SPRP, pharmacy staff members (including role-playing and observing participants), engaged in reflective debrief discussions with the facilitator and MHCEs. Debrief discussions were transcribed verbatim and analysed using inductive thematic analysis and suicide assessment language was explored. RESULTS The majority of role-playing pharmacists asked about suicidal ideation using appropriate, direct language (n = 8). Qualitative analyses of debrief discussions yielded four themes: (i) Relationship with the consumer, (ii) Verbal and non-verbal communication, (iii) Challenges with crisis assessment, which included difficulties associated with initiating conversations about suicide and mania, and (iv) Reflective learning. CONCLUSION While pharmacists demonstrated the appropriate suicide assessment language post-MHFA training, pharmacists felt uncomfortable initiating conversations around suicide and lacked confidence during crisis assessments. SPRPs provided pharmacists with opportunities to reflect on and practice MHFA skills in a safe learning environment. Future research exploring how MHFA training and SPRPs impact pharmacists' ability to provide MHFA in real-world settings is warranted.
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Affiliation(s)
- Ricki Ng
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia.
| | - Claire L O'Reilly
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
| | - Jack C Collins
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
| | - Helena Roennfeldt
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Sara S McMillan
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Sarira El-Den
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
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Ung TX, El-Den S, Moles RJ, O'Reilly CL. The Use of Mental Health Simulation in Pharmacy Practice and Education: A Systematic Review. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100058. [PMID: 37316135 DOI: 10.1016/j.ajpe.2023.100058] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/30/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To explore how mental health simulation has been used in the context of pharmacy practice and education, specifically what types of simulation techniques have been used, and which mental health-related content has been simulated. FINDINGS A literature search retrieved 449 reports, from which 26 articles pertaining to 23 studies were eligible for inclusion. Most studies were conducted in Australia. The most common type of simulation utilized was live simulated/standardized patient, followed by pre-recorded scenarios, role-play, and auditory simulation. While many study interventions included content relating to multiple mental illnesses and included activities other than simulation, the most simulated mental health content was enacting a person living with depression (with or without suicidal thoughts), mental health communication, followed by stress-induced insomnia, then hallucinations. Key outcomes from included studies were significantly improved student outcomes such as mental health knowledge, attitudes, social distance, and empathy scores, as well as highlighting the potential to further improve the mental healthcare skills of community pharmacists. SUMMARY This review demonstrates a varied use of techniques to simulate mental health in pharmacy practice and education. Future research is suggested to consider other simulation methods such as virtual reality and computer simulation, and to investigate how lesser-simulated mental health content such as psychosis could be incorporated. It is also recommended that future research provides greater detail on the development of the simulated content, such as involving people with lived experience of mental illness and mental health stakeholders in the development process to improve the authenticity of simulation training.
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Affiliation(s)
- Tina X Ung
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia.
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
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Evaluation of a training program to support the implementation of a community pharmacist-led support service for people living with severe and persistent mental illness. J Am Pharm Assoc (2003) 2023; 63:807-816.e2. [PMID: 36788042 DOI: 10.1016/j.japh.2023.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND With appropriate training, community pharmacists can support people living with severe and persistent mental illness (SPMI) by identifying and managing medication-related issues and physical health concerns. The Bridging the Gap between Physical and Mental Illness in Community Pharmacy (PharMIbridge) randomized controlled trial (RCT) tested the impact of an individualized, pharmacist-led support service for people living with SPMI. OBJECTIVE(S) To evaluate the impact of the PharMIbridge training program on pharmacy participants' knowledge and confidence, as well as stigma and attitudes, in relation to supporting, and providing services to, people living with SPMI; compared to Mental Health First Aid (MHFA) training alone. METHODS Pharmacy staff (n = 140) from 55 community pharmacies across four RCT regions attended face-to-face training. Both intervention group (IG) and comparator group (CG) participants received MHFA training while IG participants received additional PharMIbridge training, involving role-plays and mental health consumer educators (MHCEs). A questionnaire including validated instruments was administered at baseline, after training and after 12 months. Comparative analyses included paired t tests and mixed between/within analysis of variance (ANOVA). RESULTS Pre and post-training surveys were completed by 136 participants, most of which were pharmacists. Both IG and CG participants had significant reductions in stigma (P < 0.001) post-training. IG participants' confidence and knowledge regarding metabolic monitoring significantly improved compared to CG (P < 0.001). IG participants were significantly more confident and comfortable in providing medication counseling, compared to CG participants (P < 0.05). CONCLUSION MHFA training reduced participants' stigma toward mental health. However, the purpose-designed PharMIbridge training program provided pharmacists with additional knowledge and skills to confidently support the physical health care needs of people living with SPMI. The inclusion of role-plays and MHCEs allowed pharmacists to self-reflect and practice skills in safe, supportive environments. Future studies should continue to involve MHCEs in pharmacy training and explore whether these improvements are sustainable.
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Nguyen W, Moles R, O'Reilly C, Robinson J, Brand-Eubanks D, Kim A, Collins JC, El-Den S. Observed behaviours and suicide assessment language post-Mental Health First Aid training in Australia and the United States: a mixed methods study using discourse analysis. BMC MEDICAL EDUCATION 2022; 22:838. [PMID: 36471288 PMCID: PMC9720991 DOI: 10.1186/s12909-022-03920-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Mental Health First Aid (MHFA) training teaches participants how to respond to mental health crises, including suicide. Little is known about the impact of training on participants' observed MHFA behaviours. This exploratory study aimed to compare MHFA-trained Australian and US student pharmacists' performance and suicide assessment language during simulated patient role-play (SPRP) assessments. METHODS Student pharmacists (n = 265) completed MHFA training and participated (n = 81) in SPRPs with simulated patients (SP) who were people with lived experience of mental illness. Each SPRP was marked by three raters (student, tutor and SP). One-way ANOVA, chi-squared tests and independent samples t-tests were used to compare scores and pass/fail rates, where appropriate. Transcribed audio-recordings of suicide assessments underwent discourse analysis. A chi-squared test was conducted to investigate the differences in how suicide assessment language was coded across six discursive frames ('confident'/'timid', 'empathetic'/'apathetic', and 'direct'/'indirect'). RESULTS Three raters assessed 81 SPRPs, resulting in quantitative analysis of 243 rubrics. There were no significant differences between student pharmacists' mean scores and pass/fail rates across countries. Overall, both cohorts across Australia and the US performed better during the mania scenario, with a low failure rate of 13.9 and 19.0%, respectively. Most students in both countries passed their SPRP assessment; however, 27.8% did not assess for suicide or used indirect language during suicide assessment, despite completing MHFA training. Australian student pharmacists demonstrated, more direct language (76.9% versus 67.9%) and empathy (42.3% versus 32.1%) but less confidence (57.7% versus 60.7%) compared to US student pharmacists, during their suicide assessment; however, these differences were not statistically significant. CONCLUSIONS Findings indicate most MHFA-trained student pharmacists from Australia and the US can provide MHFA during SPRPs, as well as assess for suicide directly, empathetically and confidently. This exploratory study demonstrates the importance of practicing skills post-training and the need for further research exploring participants' hesitance to assess for suicide, despite training completion.
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Affiliation(s)
- William Nguyen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Rebekah Moles
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Claire O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Jennifer Robinson
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Damianne Brand-Eubanks
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Anne Kim
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
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Crespo-Gonzalez C, Dineen-Griffin S, Rae J, Hill RA. Mental health training programs for community pharmacists, pharmacy staff and students: A systematic review. Res Social Adm Pharm 2022; 18:3895-3910. [PMID: 35778317 DOI: 10.1016/j.sapharm.2022.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Primary care is often the first point of contact for people living with mental disorders. Community pharmacists, pharmacy staff and students are increasingly being trained to deliver mental health care. However, there is still a gap in the literature exploring the characteristics of all available mental health training programs and their components and their influence on pharmacists, pharmacy staff and students' outcomes. OBJECTIVES To summarize the evidence evaluating mental health training programs completed by community pharmacists, pharmacy staff and students. More specifically, to explore the components of mental health training programs and identify those that facilitate significant improvements in outcomes. METHODS A systematic review was conducted following the Cochrane handbook and reported according to PRISMA guidelines. A search for published literature was conducted in three databases (PubMed, Scopus, and Web of Science) in July 2021. Eligible studies were included if they described and evaluated the impact of mental health training programs delivered to community pharmacists, pharmacy staff and pharmacy students regardless of design or comparator. The methodological quality of included studies was appraised using both the NIH quality assessment, to evaluate studies with an uncontrolled pre-post design, and the Cochrane EPOC risk of bias assessment, to evaluate studies with a controlled (randomized and non-randomized) study design. RESULTS Thirty-three studies were included. Most of the identified mental health training programs contained knowledge-based components and active learning activities. Changes in participants' attitudes, stigma, knowledge, confidence and skills were frequently assessed. An extensive range of self-assessment and observational instruments used to evaluate the impact of the training programs were identified. Positive improvements in participants' attitudes, knowledge and stigma were frequently identified following participation in training programs. CONCLUSIONS This systematic review highlights the importance of mental health training programs in increasing pharmacists', pharmacy staff and pharmacy students' skills and confidence to deliver mental health care in community pharmacy. Future research should build upon this basis and further focus on finding the most efficient measures to evaluate these training programs and assess their long-term effectiveness, allowing comparison between programs.
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Affiliation(s)
- Carmen Crespo-Gonzalez
- School of Dentistry and Medical Sciences, Charles Sturt University, Panorama Avenue, Bathurst, New South Wales, Australia
| | - Sarah Dineen-Griffin
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - John Rae
- School of Dentistry and Medical Sciences, Charles Sturt University, Panorama Avenue, Bathurst, New South Wales, Australia
| | - Rodney A Hill
- School of Biomedical Sciences, Charles Sturt University, Boorooma Street, Wagga Wagga, New South Wales, Australia.
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Carpini JA, Sharma A, Kubicki Evans M, Jumani S, Boyne E, Clifford R, Ashoorian D. Pharmacists and Mental Health First Aid training: A comparative analysis of confidence, mental health assistance behaviours and perceived barriers. Early Interv Psychiatry 2022. [PMID: 36203236 DOI: 10.1111/eip.13361] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 08/01/2022] [Accepted: 09/18/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pharmacists are aptly positioned to provide first aid-level assistance to patients experiencing a mental health problem or crisis, yet often lack confidence or perceive barriers to intervention. One potential solution is Mental Health First Aid (MHFA) training-an evidence-based psycho-educational programme. This study evaluates MHFA training within pharmacy by (1) assessing pharmacists' perceptions of the prevalence of patients experiencing a mental health-related problem or crisis, (2) investigating whether MHFA is associated with increased confidence, intervention and assistance quality and (3) examining perceived intervention barriers. METHODS Pharmacists working in Australia were surveyed. The survey included validated measures and research objectives were assessed using descriptives and ANOVAs. RESULTS One hundred sixty-one pharmacists were included; 90 MHFA trained and 71 untrained. Overall, 86% of reported encountering at least one patient perceived to be experiencing a mental health problem or crisis in the last year. MHFA trained pharmacists reported being more confident, with notable differences in their confidence to recognize signs, approach and ask someone about suicide. Pharmacists did not intervene ~25% of the time in which a problem/ crisis was identified. When they did intervene, results suggest the assistance was similar in content. Intervention barriers were reported to impede MHFA trained pharmacists significantly less than untrained pharmacists. CONCLUSION Results suggest pharmacists frequently encounter patients experiencing a mental health problem or crisis and that MHFA training may support pharmacists in helping these patients. Future research can utilize experimental methods to provide causal evidence as to the utility of MHFA training for pharmacists and patients.
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Affiliation(s)
- Joseph A Carpini
- Management & Organisations Department, Business School, University of Western Australia, Crawley, Western Australia, Australia
| | - Aakanksha Sharma
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Mikaela Kubicki Evans
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Shaifuldeen Jumani
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Emma Boyne
- Health Promotion Unit, Student Life, University of Western Australia, Crawley, Western Australia, Australia
| | - Rhonda Clifford
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Deena Ashoorian
- Discipline of Pharmacy, School of Allied Health, University of Western Australia, Crawley, Western Australia, Australia
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A qualitative exploration of mental health services provided in community pharmacies. PLoS One 2022; 17:e0268259. [PMID: 35551556 PMCID: PMC9098086 DOI: 10.1371/journal.pone.0268259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/26/2022] [Indexed: 11/19/2022] Open
Abstract
The burden of mental health problems continues to grow worldwide. Community pharmacists’, as part of the primary care team, optimise care for people living with mental illness. This study aims to examine the factors that support or hinder the delivery of mental health services delivered in Australian community pharmacies and proposes ideas for improvement. A qualitative study was conducted comprising focus groups with community pharmacists and pharmacy staff across metropolitan, regional, and rural areas of New South Wales, Australia. Data were collected in eight focus groups between December 2020 and June 2021. Qualitative data were analysed using thematic analysis. Thirty-three community pharmacists and pharmacy staff participated in an initial round of focus groups. Eleven community pharmacists and pharmacy staff participated in a second round of focus groups. Twenty-four factors that enable or hinder the delivery of mental health services in community pharmacy were identified. Participant’s perception of a lack of recognition and integration of community pharmacy within primary care were identified as major barriers, in addition to consumers’ stigma and lack of awareness regarding service offering. Suggestions for improvement to mental health care delivery in community pharmacy included standardised practice through the use of protocols, remuneration and public awareness. A framework detailing the factors moderating pharmacists, pharmacy staff and consumers’ empowerment in mental health care delivery in community pharmacy is proposed. This study has highlighted that policy and funding support for mental health services is needed that complement and expand integrated models, promote access to services led by or are conducted in collaboration with pharmacists and recognise the professional contribution and competencies of community pharmacists in mental health care. The framework proposed may be a step to strengthening mental health support delivered in community pharmacies.
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16
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Kresin T, Forster EM. Suicide Awareness Training: A Literature Review with Application to Queensland Nurses. Issues Ment Health Nurs 2022; 43:13-21. [PMID: 34319837 DOI: 10.1080/01612840.2021.1948641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Despite decades of strategic intervention, Queensland's suicide rates exceed both national and global rates. This is surely an indicator that not enough is being done to address this cause of death. The authors suggest that this problem may be addressed, in part, by provision of improved suicide awareness training for nurses. The purpose of this review was to support this through examination of the contemporary status of suicide awareness training in Queensland nurses, the efficacy of suicide awareness training in general, and the experiences of nurses, other health professionals, and suicidal patients in healthcare settings. We concluded that while efficacious, suicide awareness training in Queensland nurses is presently inadequate, and that both nurses and patients may benefit from improved suicide awareness training.
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Affiliation(s)
| | - Elizabeth M Forster
- School of Nursing and Midwifery, Griffith University, Mount Gravatt, Australia
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17
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Exploring the impact of suicide care experiences and post-intervention supports sought among community pharmacists: a cross-sectional survey. Int J Clin Pharm 2022; 44:1247-1258. [PMID: 35445311 PMCID: PMC9718696 DOI: 10.1007/s11096-022-01398-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND There is a need to appropriately train, support and remunerate pharmacists for their expanding roles in mental healthcare. Pharmacists often care for people experiencing mental health crises, including suicidal thoughts and behaviours, but little is known about pharmacists' suicide care experiences. AIM This cross-sectional study aimed to explore the impact of professional experiences with people at risk of suicide and support accessed, among community pharmacists. METHOD A survey exploring pharmacists' experiences with people at risk of suicide and post-intervention support-seeking was disseminated through Australian and Canadian professional associations, conferences and social media (June 2016-May 2017). Quantitative data were analysed using Chi-squared, Fisher's exact and independent t-tests, where appropriate. Qualitative data exploring the impact of these experiences were thematically analysed, and reasons for not seeking help post-intervention were identified. RESULTS Among 378 respondents, 84% had encountered patients at risk of suicide and 28% had lost patients to suicide. Some were negatively affected personally and/or professionally (11%), of which 88% did not seek professional support, mainly due to uncertainty about available services. Pharmacists were significantly more negatively affected if they had a personal mental health diagnosis (p = 0.017) and previous suicide care experiences (p = 0.001). Qualitative themes included: expanding knowledge and skills, role limitation and emotional impact and response. CONCLUSION A large proportion of pharmacists have interacted with suicidal patients and are impacted by these experiences, yet few seek help due to lack of awareness and access. There is a need to recognize pharmacists' roles in suicide care, and develop pharmacist-specific post-intervention support.
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Nguyen W, O'Reilly CL, Moles RJ, Robinson JD, Brand-Eubanks D, Kim AP, El-Den S. A systematic review of patient interactions with student pharmacists in educational settings. J Am Pharm Assoc (2003) 2021; 61:678-693.e3. [PMID: 34483057 DOI: 10.1016/j.japh.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/10/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patients may contribute to various aspects of student pharmacists' education within clinical, experiential and educational settings. There is an emerging body of literature describing and evaluating the contribution of patients to health care education; however, little is known about patients' contribution to pharmacy education specifically within educational settings. OBJECTIVE To explore the evidence relating to the involvement of patients in the education of student pharmacists, in terms of the nature, extent, and outcomes of their contribution. METHODS A systematic literature search was undertaken within Embase, MEDLINE, Education Resources Information Center, International Pharmaceutical Abstracts, PubMed, PsycINFO, CINAHL, and Scopus databases from inception to April 10, 2020. Inclusion criteria included primary research studies reporting on the active involvement of patients in pharmacy education, within an educational setting. Quality assessment appraisal for the included studies was conducted using the Mixed Methods Appraisal Tool. RESULTS Twelve studies were eligible for inclusion in this systematic review. Nine studies explored the use of patients as educators providing valuable insight about their lived experience. Six studies involved patients in question-and-answer sessions, providing students with opportunities to inquire about their lived experience in relation to medicines, health care, and medical conditions. Studies that reported on students' learning outcomes demonstrated improvements in communication skills, deeper understanding of patients' lived experience particularly relating to mental illness, and increased confidence in providing care for patients. Among patients, participation in the educational process led to greater satisfaction, empowerment, and knowledge from sharing personal experiences. There were no clinical outcomes measured among patients participating in the included studies. The 5 nonrandomized quantitative studies ranged from low to moderate levels of quality, the 4 mixed-methods studies were of low quality, and the 3 qualitative studies were of high quality. CONCLUSION The involvement of patients in the education of student pharmacists was found to benefit both patients and students. Student-specific outcomes included development of communication skills and new insights about patients' lived experience. Further research is needed to better understand the long-term impact of patient involvement in pharmacy education, in terms of students' learning outcomes and clinical outcomes among patients.
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Tang D, Dinh H, Almansour H, Burlutsky G, Bussing J, Eisenhauer B, Gopinath B, Flood VM, Saini B. Evaluation of educational interventions on eye health for dietetic and pharmacy professions: a pre-post study. BMC MEDICAL EDUCATION 2021; 21:478. [PMID: 34493275 PMCID: PMC8424804 DOI: 10.1186/s12909-021-02905-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND We piloted an educational intervention that aimed to enhance awareness about nutrition-age-related macular degeneration (AMD) links among practising and student dietitians then expanded the scope of this intervention to include general eye health, which was delivered to pharmacy students. METHODS A pilot intervention was conducted in 2019 at the Dietitians Australia Conference (Gold Coast, Australia) where practising and student dietitians underwent a 2-hour small group educational workshop on nutrition and AMD links. Pre-post questionnaires were administered to participants, with voluntary completion of both questionnaires an indicator of consent to participate in the intervention. The primary intervention outcome was a change in AMD-related nutrition knowledge pre-post intervention. A larger intervention was then conducted at the University of Sydney (Sydney, Australia) where pharmacy students underwent a 4-hour educational module to improve general eye health knowledge, as well as student perceptions and attitudes towards a pharmacists' role in low vision care. Similarly, pre-post questionnaires were administered, with voluntary completion of both questionnaires an indicator of consent to participate in the intervention. The primary intervention outcomes were changes in total knowledge, total perception and total attitude scores pre-post intervention. RESULTS (1) Among 10 accredited and 5 student dietitians, there was significant overall knowledge improvement (mean pre-post score: 7.07 ± 1.94 vs. 10.8 ± 1.01, p = 0.001) specifically around appropriate dietary advice, food sources of key AMD-related nutrients, and awareness of supplements. (2) Among 179 second-year pharmacy students enrolled in the 'Pharmacy Practice' Unit of Study (Bachelor of Pharmacy, University of Sydney), total eye health knowledge (6.25 ± 1.93 vs. 6.64 ± 2.0; p = 0.011) significantly improved, along with total perception scores (41.54 ± 5.26 vs. 42.45 ± 4.95; p = 0.004). Total attitude scores were not significantly different. CONCLUSIONS The pilot intervention improved relevant nutrition-AMD knowledge among practising/student dietitians. The modified intervention for pharmacy students also significantly improved general eye health knowledge as well as students' perception of a pharmacists' role in low vision care.
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Affiliation(s)
- Diana Tang
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, 176 Hawkesbury Road, New South Wales, 2145, Sydney, Australia.
- Macquarie University Hearing, Macquarie University, North Ryde, New South Wales, Australia.
| | - Helen Dinh
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Hadi Almansour
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - George Burlutsky
- Centre for Vision Research, Department of Ophthalmology and Westmead Institute for Medical Research, University of Sydney, 176 Hawkesbury Road, New South Wales, 2145, Sydney, Australia
| | - Jocelyn Bussing
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Bamini Gopinath
- Macquarie University Hearing, Macquarie University, North Ryde, New South Wales, Australia
| | - Victoria M Flood
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Western Sydney Local Health District, Westmead Hospital, Westmead, New South Wales, Australia
| | - Bandana Saini
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
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Gorton HC, Macfarlane H, Edwards R, Farid S, Garner E, Mahroof M, Rasul S, Keating D, Zaman H, Scott J, Maidment I, Strawbridge J. UK and Ireland survey of MPharm student and staff experiences of mental health curricula, with a focus on Mental Health First Aid. J Pharm Policy Pract 2021; 14:73. [PMID: 34465394 PMCID: PMC8406829 DOI: 10.1186/s40545-021-00364-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 08/18/2021] [Indexed: 11/22/2022] Open
Abstract
Background One in four people experience a mental health problem every year and improving mental health care is an international priority. In the course of their work, pharmacists frequently encounter people with mental health problems. The experience of mental health teaching, including Mental Health First Aid (MHFA) training, in undergraduate pharmacy (MPharm) students in the UK and Ireland is not well documented. Students’ viewpoints, contextualised with curricular overviews provided by staff, were analysed to understand their experience. Methods An anonymous, online questionnaire was distributed to MPharm students and staff in the UK and Ireland. Students were asked closed questions regarding their course and exposure to MHFA, which were analysed using descriptive statistics. Open questions were included to enable explanations and these data were used to contextualise the quantitative findings. One member of staff from each university was invited to answer a modified staff version of the questionnaire, to provide a curriculum overview and staff perspective. Results 232 students and 13 staff, from 22 universities, responded. Three-quarters of students did not agree with the statement that ‘mental health was embedded throughout the MPharm’. Most students (80.6%) stated that they were taught neuropharmacology whilst 44.8% stated that their course included communicating with people about their mental health. One-third (33.2%) of students stated that their degree ‘adequately prepared them to help people with their mental health’. Twenty-six students (11.6%) had completed MHFA training of which 89% would endorse inclusion of this within the MPharm. Of those who had not completed the training, 81% expressed a desire to do so. Those who completed MHFA training self-reported greater preparedness than those who did not, but student numbers were small. Conclusions Mental health teaching for pharmacy undergraduates is more focussed on theoretical aspects rather than applied skills. MHFA was viewed by students as one way to enhance skill application. The association of the increased self-reported preparedness of those who completed MHFA could be confounded by a positive environmental cultural. MPharm programmes need sufficient focus on real-world skills such as communication and crisis response, to complement the fundamental science. Supplementary Information The online version contains supplementary material available at 10.1186/s40545-021-00364-1.
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Affiliation(s)
- H C Gorton
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
| | - H Macfarlane
- School of Pharmacy, College of Health and Life Sciences, Aston University, Birmingham, UK.,Pharmacy Department, Secure and Complex Care, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - R Edwards
- School of Pharmacy, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - S Farid
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - E Garner
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - M Mahroof
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - S Rasul
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - D Keating
- Pharmacy Department, Saint John of God Hospital, Stillorgan, County Dublin, Ireland
| | - H Zaman
- School of Pharmacy and Medical Sciences, Faculty of Life Sciences, University of Bradford, Bradford, UK
| | - J Scott
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - I Maidment
- School of Pharmacy, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - J Strawbridge
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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Piot MA, Dechartres A, Attoe C, Romeo M, Jollant F, Billon G, Cross S, Lemogne C, Layat Burn C, Michelet D, Guerrier G, Tesniere A, Rethans JJ, Falissard B. Effectiveness of simulation in psychiatry for nursing students, nurses and nurse practitioners: A systematic review and meta-analysis. J Adv Nurs 2021; 78:332-347. [PMID: 34378236 DOI: 10.1111/jan.14986] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/24/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022]
Abstract
AIMS Mental disorders constitute one of the main causes of disease and disability worldwide. While nurses are often at the frontline of mental health care, they have limited access to dedicated psychiatric training opportunities. Simulation training may foster the development of the appropriate competencies required when supporting people with mental disorders. To evaluate the effectiveness of simulation training in psychiatry for nursing students, nurses and nurse practitioners. DESIGN Systematic review and meta-analysis. DATA SOURCES Eight electronic databases, trial registries, key journals and reference lists of selected studies were searched from inception to August 20, 2020 without language restriction. REVIEW METHODS We included randomized and non-randomized controlled studies and single group pre/post studies. Cochrane Risk of Bias tool 2.0 was used for randomized controlled study appraisal, and the Medical Education Research Study Quality instrument was completed for all other studies. Meta-analysis was restricted to randomized controlled studies. The other studies were synthesized narratively. The main outcomes were based on Kirkpatrick levels. RESULTS A total of 118 studies (6738 participants) were found. Interventions included simulated patients (n = 55), role-plays (n = 40), virtual reality (n = 12), manikins (n = 9) and voice simulations (n = 9). Meta-analyses based on 11 randomized controlled studies found a significant large effect size on skills at immediate post-test for simulation compared with active control; and a small and medium effect size on learners' attitudes for simulation compared with inactive control, at immediate post-test and at three-month follow-up respectively. Three quarters of non-randomized controlled studies and pre/post-tests assessing attitudes and skills showed significant differences, and three quarters of participants in randomized controlled studies and pre/post-tests showed significant differences in behaviours. Among the few studies assessing people with mental health outcomes, almost all reported significant differences. CONCLUSION These findings support the effectiveness of simulation training in psychiatric nursing throughout professional development grades, despite heterogeneity in methods and simulation interventions.
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Affiliation(s)
- Marie-Aude Piot
- Université de Paris, Institute Mutualiste Montsouris, Department of Psychiatry, Paris-Saclay University, UVSQ, INSERM 1018, CESP, Ilumens, Simulation Center, Paris, France
| | - Agnès Dechartres
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP. Hôpital Pitié Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie de l'AP-HP (Cephepi), F75013, Paris, France
| | - Chris Attoe
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Marie Romeo
- Université de Paris, Institute Mutualiste Montsouris, Department of Psychiatry, Paris-Saclay University, UVSQ, INSERM 1018, CESP, Ilumens, Simulation Center, Paris, France
| | - Fabrice Jollant
- Université de Paris, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Department of Psychiatry, Moods Team, INSERM UMR-1178, CESP, Paris, France.,Nîmes academic hospital (CHU), Nîmes, France.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Grégoire Billon
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Sean Cross
- Maudsley Simulation, South London & Maudsley NHS Foundation Trust, London, UK
| | - Cédric Lemogne
- Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Carine Layat Burn
- Department of Orthopaedic Surgery, La Providence Hospital, Neuchâtel, Switzerland.,Department of Psychotherapy, Berger Psychotherapeutic Centre, Neuchâtel, Switzerland
| | - Daphné Michelet
- Department of Pediatric Anesthesia, CHU of Reims Hôpital Maison Blanche, Reims, France
| | - Gilles Guerrier
- Université de Paris, AP-HP, Cochin Hospital, Anaesthesiology Department, Ilumens, Simulation Center, Paris, France
| | - Antoine Tesniere
- Université de Paris, AP-HP, Cochin Hospital, Anaesthesiology Department, Ilumens, Simulation Center, Paris, France
| | - Jan-Joost Rethans
- Skillslab, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Bruno Falissard
- Public Health Department, School of Medicine, University Paris Saclay, INSERM 1018, CESP, Villejuif, Ile-de-France, France
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22
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Ní Chianáin L, Fallis R, Johnston J, McNaughton N, Gormley G. Nothing about me without me: a scoping review of how illness experiences inform simulated participants' encounters in health profession education. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2021; 7:611-616. [PMID: 35520981 PMCID: PMC8936821 DOI: 10.1136/bmjstel-2021-000886] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/28/2021] [Indexed: 11/04/2022]
Abstract
Background Person-centred simulation in health professions education requires involvement of the person with illness experience. Objective To investigated how real illness experiences inform simulated participants' (SP) portrayals in simulation education using a scoping review to map literature. Study selection Arksey and O'Malley's framework was used to search, select, chart and analyse data with the assistance of personal and public involvement. MEDLINE, Embase, CINAHL, Scopus and Web of Science databases were searched. A final consultation exercise was conducted using results. Findings 37 articles were within scope. Reporting and training of SPs are inconsistent. SPs were actors, volunteers or the person with the illness experience. Real illness experience was commonly drawn on in communication interactions. People with illness experience could be directly involved in various ways, such as through conversation with an SP, or indirectly, such as a recording of heart sounds. The impact on the learner was rarely considered. Conclusion Authentic illness experiences help create meaningful person-centred simulation education. Patients and SPs may both require support when sharing or portraying illness experience. Patients' voices profoundly enrich the educational contributions made by SPs.
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Affiliation(s)
- Linda Ní Chianáin
- Centre for Medical Education, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Richard Fallis
- Medical Library, Queen's University Belfast, Belfast, UK
| | - Jenny Johnston
- Centre for Medical Education, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Nancy McNaughton
- The Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada
- University Health Network Education Scholar, Michener Institute of Education at UHN, Toronto, Ontario, Canada
| | - Gerard Gormley
- Centre for Medical Education, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
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23
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El-Den S, Moles RJ, Zhang R, O’Reilly CL. Simulated Patient Role-Plays with Consumers with Lived Experience of Mental Illness Post-Mental Health First Aid Training: Interrater and Test Re-Test Reliability of an Observed Behavioral Assessment Rubric. PHARMACY 2021; 9:28. [PMID: 33498944 PMCID: PMC7838905 DOI: 10.3390/pharmacy9010028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 11/17/2022] Open
Abstract
Mental Health First Aid (MHFA) training teaches participants how to assist people experiencing mental health problems and crises. Observed behavioral assessments, post-training, are lacking, and the literature largely focuses on self-reported measurement of behaviors and confidence. This study explores the reliability of an observed behavioral assessment rubric used to assess pharmacy students during simulated patient (SP) role-play assessments with mental health consumers. Post-MHFA training, pharmacy students (n = 528) participated in SP role-play assessments (n = 96) of six mental health cases enacted by consumers with lived experience of mental illness. Each assessment was marked by the tutor, participating student, and consumer (three raters). Non-parametric tests were used to compare raters' means scores and pass/fail categories. Interrater reliability analyses were conducted for overall scores, as well as pass/fail categories using intra-class correlation coefficient (ICC) and Fleiss' Kappa, respectively. Test re-test reliability analyses were conducted using Pearson's correlation. For interrater reliability analyses, the intra-class correlation coefficient varied from poor-to-good to moderate-to-excellent for individual cases but was moderate-to-excellent for combined cases (0.70; CI 0.58-0.80). Fleiss' Kappa varied across cases but was fair-to-good for combined cases (0.57, p < 0.001). For test re-test reliability analyses, Pearson's correlation was strong for individual and combined cases (0.87; p < 0.001). Recommended modifications to the rubric, including the addition of barrier items, scoring guides, and specific examples, as well as the creation of new case-specific rubric versions, may improve reliability. The rubric can be used to facilitate the measurement of actual, observed behaviors post-MHFA training in pharmacy and other health care curricula.
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Affiliation(s)
- Sarira El-Den
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW 2006, Australia; (R.J.M.); (R.Z.); (C.L.O.)
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24
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Witry MJ, Fadare O, Pudlo A. Pharmacy professionals' preparedness to use Mental Health First Aid (MHFA) behaviors. Pharm Pract (Granada) 2020; 18:2102. [PMID: 33294061 PMCID: PMC7699831 DOI: 10.18549/pharmpract.2020.4.2102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/25/2020] [Indexed: 11/17/2022] Open
Abstract
Background: There is a need to train healthcare professionals to provide first aid to
people experiencing a mental health crisis. Research testing the association
between Mental Health First Aid (MHFA) training and the use of MHFA
behaviors could provide evidence of program effectiveness in the pharmacy
setting. Objectives: The objectives of this study were to measure the preparedness of pharmacy
professionals to function in a MHFA role, and compare preparedness and the
use of MHFA behaviors based on demographic characteristics. Methods: Pharmacists and student pharmacists attended MHFA training under a
multi-state pharmacy initiative in 2018. An anonymous electronic survey was
administered to 227 participants using 4 contacts in May to June, 2019. The
survey evaluated if participants had recommended MHFA to others, their
preparedness to engage in MHFA behaviors (13 items), and their frequency of
performing a set of MHFA behaviors (7 items). Descriptive statistics,
bivariate analysis, and ANOVA were used to describe the sample and compare
these variables across groups. Results: The analysis was based on 96 responses (42.3%). Almost all respondents
(96%) had recommended MHFA training to others. Respondents reported
that the training program prepared them to provide a range of MHFA behaviors
for multiple mental health conditions, particularly for depression and
anxiety. Participants most often reported asking about a distressed mood and
listening non-judgmentally. Almost half of participants had asked someone if
they were considering suicide and a similar percent had referred someone
considering suicide to resources. Those reporting the highest levels of
preparedness engaged in significantly more MHFA behaviors than those with
lower levels of preparedness (p=0.017). Preparedness and use of MHFA
behaviors were not significantly associated with respondent demographic
characteristics. Conclusion: These data suggest that pharmacy professionals who had MHFA training felt
prepared to engage in MHFA and many used behaviors like asking about suicide
and making referrals since being trained in MHFA. Research is warranted to
better understand what makes someone feel maximally prepared to use MHFA
behaviors compared to lower feelings of preparedness.
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Affiliation(s)
- Matthew J Witry
- PharmD, PhD. Assistant Professor, Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa. Iowa City, IA (United States).
| | - Olajide Fadare
- BPharm. Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa. Iowa City, IA (United States).
| | - Anthony Pudlo
- PharmD, MBA. Vice President. Professional Affairs, Iowa Pharmacy Association. Des Moines, IA (United States).
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25
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Murphy AL, Jacobs LM, Gardner DM. Pharmacists' experiences with the Bloom Program application process. Can Pharm J (Ott) 2020; 154:42-51. [PMID: 33598059 DOI: 10.1177/1715163520968120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background The Bloom Program, which began as a demonstration project, is an ongoing community pharmacy-based mental illness and addictions program funded by the government of Nova Scotia. To be eligible to offer the Bloom Program, interested pharmacists were required to complete a 9-part application on behalf of their pharmacies. A process evaluation was conducted to inform future program implementation changes of program components, including the application process. Methods Qualitative interviews from 24 pharmacists were inductively analyzed to determine the challenges and opportunities in the program's application process. Results Key and impactful components of the application process included training, providing a mental health and addictions resource centre within the pharmacy and completing outreach activities with local mental health and addictions services and support organizations. The training content and format for the program was highly valued. Community outreach to local mental health and addictions resources, and other health care resources in the community, was particularly valuable in supporting patient navigation of the health care system and extending the pharmacists' networks. Components of the application process were challenging for many pharmacists but were beneficial personally and professionally. Dedicated resources (e.g., time and staffing) are required for the efficient completion of the application process. Conclusion Pharmacists viewed the Bloom Program application process as intensive yet necessary and relevant for preparing to deliver the Program. The demonstration project process evaluation was essential for elucidating the strengths of the application process and, importantly, identifying areas for improvement. Can Pharm J (Ott) 2021;154:xx-xx.
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26
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Willson MN, Robinson JD, McKeirnan KC, Akers JM, Buchman CR. Training Student Pharmacists in Suicide Awareness and Prevention. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:ajpe847813. [PMID: 32934394 PMCID: PMC7473223 DOI: 10.5688/ajpe847813] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/28/2019] [Indexed: 05/22/2023]
Abstract
Objective. To determine whether students gained knowledge, confidence, and skills in identifying and preventing suicide in patients, peers, friends, and family after receiving training in suicide prevention. Methods. Student pharmacists participated in a 3.5-hour suicide prevention training program. A pre- and post- intervention assessment and pre- and post-intervention survey were administered before and after completion of the training program. Questions were designed to assess knowledge of, comfort with, and confidence in assessing and intervening with individuals at risk of suicide. A standardized patient prescription counseling session was conducted two weeks after the training session. Videos of the counseling sessions were reviewed to determine whether student pharmacists assessed the patient for suicide risk. Additionally, a post-counseling reflection was completed asking students to reflect on incorporation of the suicide prevention training into their prescription counseling session. Results. One-hundred seventy-one student pharmacists participated in the training. Knowledge increased across all areas as evidenced by improved scores on the post-intervention knowledge assessment. Students' comfort level with asking about suicidal ideation and their confidence with intervening significantly increased from the pre- to post-intervention survey. After the training, 40% stated they knew someone who may need help and 21% said they had decided to seek help for themselves. Conclusion. The training program increased student pharmacists' knowledge of and confidence in assessing and counseling individuals considering suicide. Encouraging student pharmacists to participate in prevention training may aid future providers in preventing death by suicide.
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Affiliation(s)
- Megan N. Willson
- Washington State University, College of Pharmacy and Pharmaceutical Sciences, Spokane, Washington
| | - Jennifer D. Robinson
- Washington State University, College of Pharmacy and Pharmaceutical Sciences, Spokane, Washington
| | - Kimberly C. McKeirnan
- Washington State University, College of Pharmacy and Pharmaceutical Sciences, Spokane, Washington
| | - Julie M. Akers
- Washington State University, College of Pharmacy and Pharmaceutical Sciences, Spokane, Washington
| | - Christina R. Buchman
- Washington State University, College of Pharmacy and Pharmaceutical Sciences, Yakima, Washington
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27
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Piot MA, Dechartres A, Attoe C, Jollant F, Lemogne C, Layat Burn C, Rethans JJ, Michelet D, Cross S, Billon G, Guerrier G, Tesniere A, Falissard B. Simulation in psychiatry for medical doctors: A systematic review and meta-analysis. MEDICAL EDUCATION 2020; 54:696-708. [PMID: 32242966 DOI: 10.1111/medu.14166] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/14/2020] [Accepted: 03/23/2020] [Indexed: 05/06/2023]
Abstract
CONTEXT Most medical doctors are likely to work with patients experiencing mental health conditions. However, educational opportunities for medical doctors to achieve professional development in the field of psychiatry are often limited. Simulation training in psychiatry may be a useful tool to foster this development. OBJECTIVES The purpose of this study was to assess the effectiveness of simulation training in psychiatry for medical students, postgraduate trainees and medical doctors. METHODS For this systematic review and meta-analysis, we searched eight electronic databases and trial registries up to 31 August 2018. We manually searched key journals and the reference lists of selected studies. We included randomised and non-randomised controlled studies and single group pre- and post-test studies. Our main outcomes were based on Kirkpatrick levels. We included data only from randomised controlled trials (RCTs) using random-effects models. RESULTS From 46 571 studies identified, we selected 163 studies and combined 27 RCTs. Interventions included simulation by role-play (n = 69), simulated patients (n = 72), virtual reality (n = 22), manikin (n = 5) and voice simulation (n = 2). Meta-analysis found significant differences at immediate post-tests for simulation compared with active and inactive control groups for attitudes (standardised mean difference [SMD] = 0.52, 95% confidence interval [CI] 0.31-0.73 [I2 = 0.0%] and SMD = 0.28, 95% CI 0.04-0.53 [I2 = 52.0%], respectively), skills (SMD = 1.37, 95% CI 0.56-2.18 [I2 = 93.0%] and SMD = 1.49, 95% CI 0.39-2.58 [I2 = 93.0%], respectively), knowledge (SMD = 1.22, 95% CI 0.57-1.88 [I2 = 0.0%] and SMD = 0.72, 95% CI 0.14-1.30 [I2 = 80.0%], respectively), and behaviours (SMD = 1.07, 95% CI 0.49-1.65 [I2 = 68.0%] and SMD = 0.45, 95% CI 0.11-0.79 [I2 = 41.0%], respectively). Significant differences in terms of patient benefit and doctors' behaviours and skills were found at the 3-month follow-up. CONCLUSIONS Despite heterogeneity in methods and simulation interventions, our findings demonstrate the effectiveness of simulation training in psychiatry training.
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Affiliation(s)
- Marie-Aude Piot
- Epidemiological and Public Health Research Centre, Villejuif, France
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, Institute Mutualiste Montsouris, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Agnès Dechartres
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Pitié Salpêtrière, Département de Santé Publique, Paris, France
| | - Chris Attoe
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Fabrice Jollant
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital Center, Paris, France
- Department of Psychiatry, Nîmes Academic Hospital (CHU), Nîmes, France
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Cédric Lemogne
- University of Paris, Faculty of Health, Medicine School, Paris, France
- University of Paris, INSERM, Institute of Psychiatry and Neurosciences of Paris (IPNP), Paris, France
- AP-HP.Centre-University of Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France
| | - Carine Layat Burn
- Department of Orthopaedic Surgery, La Providence Hospital, Neuchâtel, Switzerland
- Department of Psychotherapy, Berger Psychotherapeutic Centre, Neuchâtel, Switzerland
| | - Jan-Joost Rethans
- Institute for Education and Skills Lab, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Daphne Michelet
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Pediatric Anesthesia, CHU of Reims Hôpital Maison Blanche, Reims, France
| | - Sean Cross
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gregoire Billon
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gilles Guerrier
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Anaesthesiology, Cochin Hospital, AP-HP, Paris, France
| | - Antoine Tesniere
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Bruno Falissard
- Epidemiological and Public Health Research Centre, Villejuif, France
- Department of Public health, School of Medecine, University Paris Saclay, Villejuif, France
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28
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Wheeler AJ, O'Reilly CL, El-Den S, Byrnes J, Ware RS, McMillan SS. Bridging the gap between physical and mental illness in community pharmacy ( PharMIbridge): protocol for an Australian cluster randomised controlled trial. BMJ Open 2020; 10:e039983. [PMID: 32709657 PMCID: PMC7380878 DOI: 10.1136/bmjopen-2020-039983] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION There is a significant life expectancy gap attributable to physical comorbidities for people living with severe and persistent mental illness (SPMI) compared with the general population. Medications are a major treatment for SPMI management and physical illnesses, hence pharmacists are well positioned to support mental healthcare and comorbidities. The randomised controlled trial (RCT) aim is to evaluate effectiveness of an individualised, pharmacist led, support service for people experiencing SPMI focusing on medication adherence and physical comorbidity management, compared with standard care (a medication-management service; MedsCheck). METHODS AND ANALYSIS: PharMIbridge is a cluster RCT, whereby community pharmacies in four Australian regions will be randomised (1:1 ratio), to either Intervention Group (IG) or Comparator Group (CG). All IG and CG pharmacy staff will receive Blended-Mental Health First Aid training. Additionally, IG pharmacists will receive further training on medication adherence, goal setting, motivational interviewing, managing physical health concerns and complex issues relating to psychotropic medication. CG pharmacists will not receive additional training, and will provide standard care (MedsCheck). The primary outcome will be change in participants medication adherence for psychotropic medication over 6-months. Using mixed-effects logistic regression model and a cluster size of 48 pharmacies, a total of 190 participants will need to be recruited to each arm to find a statistically significant difference in medication adherence. Secondary outcomes will be changes in factors associated with cardiometabolic risk and quality of life, emphasising physical and psychological well-being; medication-related problems; adherence to other prescribed medication; pharmacists knowledge, confidence and ability to support people experiencing SPMI; and effects on healthcare utilisation. A within RCT-based economic evaluation comparing the intervention with standard care will be undertaken. ETHICS AND DISSEMINATION The protocol and pharmacist training programme received Griffith University Human Research Ethics Committee approval (HREC/2019/473 and HREC/2019/493 respectively). Results will be published in peer-reviewed journals and available at the Sixth Community Pharmacy Agreement website (http://6cpa.com.au/about-6cpa/). TRIAL REGISTRATION NUMBER ANZCTR12620000577910.
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Affiliation(s)
- Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Faculty of Medical and Health Sciences, Auckland University, Auckland, New Zealand
| | - Claire L O'Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Joshua Byrnes
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Sara S McMillan
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- School of Pharmacy and Pharmacology, Griffith University, Gold Coast, Queensland, Australia
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29
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Witry M, Clayden A. Student pharmacist personal and work experiences with people displaying warning signs of suicidal ideation. Ment Health Clin 2020; 10:244-249. [PMID: 32685336 PMCID: PMC7337995 DOI: 10.9740/mhc.2020.07.244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction Student pharmacists, in their roles as trainees, technicians, and peers, may interact with people displaying suicide warning signs. Providing suicide gatekeeping training to student pharmacists may prepare them to engage people at risk. Measuring the extent to which student pharmacists have encountered people displaying warning signs of suicide may help contextualize the potential importance of training student pharmacists in suicide gatekeeping. The objective was to describe student pharmacists' awareness of someone they know having attempted or died by suicide and whether they have heard statements suggesting suicide risk in their personal and work life. Methods An anonymous electronic survey was administered to 111 student pharmacists before engaging in question-persuade-refer training as part of their second-year pharmacy curriculum. Respondents were asked for demographics and if Someone ever told you something concerning where you wondered if they were thinking about suicide for both work and one's personal life. Descriptive statistics and chi-squared tests were used to compare items by gender. Results There were 111 responses to the survey for a 100% response rate. Concerning statements related to suicide were reported by 71.2% of respondents in their personal life and by 34.2% of students while at work. There were no differences based on gender. Discussion A significant proportion of student pharmacists have personal, peer, and professional exposure related to people with potential suicidal ideation. These findings emphasize the need for broad approaches for training students and pharmacists in suicide gatekeeping as a new public health role.
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Affiliation(s)
- Matthew Witry
- Graduate Student, University of Iowa School of Social Work, Iowa City, Iowa
| | - Alyssa Clayden
- Graduate Student, University of Iowa School of Social Work, Iowa City, Iowa
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30
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Arensman E, Troya MI, Nicholson S, Sadath A, Cully G, Ramos Costa AP, Benson R, Corcoran P, Griffin E, Williamson E, Eustace J, Shiely F, Browne J, Rigby J, Jeffers A, Cassidy E. Study protocol for the implementation and evaluation of the Self-harm Assessment and Management for General Hospitals programme in Ireland (SAMAGH). BMC Health Serv Res 2020; 20:590. [PMID: 32600390 PMCID: PMC7322837 DOI: 10.1186/s12913-020-05254-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 04/26/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Previous self-harm is one of the strongest predictors of future self-harm and suicide. Increased risk of repeated self-harm and suicide exists amongst patients presenting to hospital with high-risk self-harm and major self-harm repeaters. However, so far evidence-based training in the management of self-harm for mental health professionals is limited. Within this context, we aim to develop, implement and evaluate a training programme, SAMAGH, Self-harm Assessment and Management Programme for General Hospitals in Ireland. SAMAGH aims to (a) reduce hospital-based self-harm repetition rates and (b) increase rates of mental health assessments being conducted with self-harm patients. We also aim to evaluate the training on self-harm knowledge, attitudes, and skills related outcomes of healthcare professionals involved in the training. METHODS/DESIGN The study will be conducted in three phases. First, the SAMAGH Training Programme has been developed, which comprises two parts: 1) E-learning Programme and 2) Simulation Training. Second, SAMAGH will be delivered to healthcare professionals from general hospitals in Ireland. Third, an outcome and process evaluation will be conducted using a pre-post design. The outcome evaluation will be conducted using aggregated data from the National Self-Harm Registry Ireland (NSHRI) on self-harm repetition rates from all 27 public hospitals in Ireland. Aggregated data based on the 3-year average (2016, 2017, 2018) self-harm repetition rates prior to the implementation of the SAMAGH will be used as baseline data, and NSHRI data from 6 and 12 months after the implementation of SAMAGH will be used as follow-up. For the process evaluation, questionnaires and focus groups will be administered and conducted with healthcare professionals who completed the training. DISCUSSION This study will contribute to the evidence base regarding the effectiveness of an evidence informed training programme that aims to reduce repeated hospital self-harm presentations and to improve compliance with self-harm assessment and management. This study is also expected to contribute to self-harm and suicide training with the possibility of being translated to other settings. Its feasibility will be evaluated through a process evaluation.
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Affiliation(s)
- Ella Arensman
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland.
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland.
- Australian Institute for Suicide Research and Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.
| | - M Isabela Troya
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Sarah Nicholson
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Anvar Sadath
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Grace Cully
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Ana Paula Ramos Costa
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Ruth Benson
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Paul Corcoran
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Eve Griffin
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Eileen Williamson
- National Suicide Research Foundation, University College Cork, 4.28 Western Gateway Building, Cork, Ireland
| | - Joe Eustace
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland
- Health Research Board Clinical Research Facility-Cork, University College Cork, Cork, Ireland
| | - Frances Shiely
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland
- Health Research Board Clinical Research Facility-Cork, University College Cork, Cork, Ireland
| | - John Browne
- School of Public Health, College of Medicine and Health, University College Cork, Western Gateway Building, Cork, Ireland
| | - Jan Rigby
- Centre for Health Geoinformatics & Department of Geography, Maynooth University, Maynooth, Ireland
| | - Anne Jeffers
- National Clinical Programme for the Assessment and Management of Patients presenting to the Emergency Department following Self-Harm, Office of the National Clinical Advisor and Group Lead, Dr. Steeven's Hospital, Dublin, Ireland
| | - Eugene Cassidy
- Department of Psychiatry and Neurobehavioral Science, University College Cork, Acute Mental Health Unit, Cork University Hospital, Wilton, Ireland
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Witry M, Karamese H, Pudlo A. Evaluation of participant reluctance, confidence, and self-reported behaviors since being trained in a pharmacy Mental Health First Aid initiative. PLoS One 2020; 15:e0232627. [PMID: 32365115 PMCID: PMC7197798 DOI: 10.1371/journal.pone.0232627] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/17/2020] [Indexed: 11/19/2022] Open
Abstract
In the U.S., an estimated one in five individuals experience a mental illness annually which contribute to significant human and economic cost. Pharmacists serving in a public health capacity are positioned to provide first aid level intervention to people experiencing a mental health crisis. Research on pharmacy professionals (pharmacists, technicians, students) undergoing training in Mental Health First Aid (MHFA) can provide evidence of the potential benefits of such training. The objectives of this study were to 1) describe the reluctance and confidence to intervene in mental health crises of pharmacy professionals previously trained in MHFA, 2) describe their self-reported use of MHFA behaviors since becoming trained, and 3) describe participant open-ended feedback on their MHFA training. Materials and methods: An electronic survey was disseminated in May and June, 2019 using a four-email sequence to pharmacy professionals who had completed MHFA training from one of five pharmacist MHFA trainers throughout 2018. Domains included demographics, six Likert-type reluctance items, seven Likert-type confidence items for performing MHFA skills, and frequency of using a set of nine MHFA skills since being trained. Prompts collected open-ended feedback related to MHFA experiences and training. Descriptive statistics were used for scaled and multiple-choice items and a basic content analysis was performed on the open-ended items to group them into similar topics. Results: Ninety-eight out of 227 participants responded to the survey yielding a response rate of 44%. Participants reported high levels of disagreement to a set of reluctance items for intervening and overall high levels of confidence in performing a range of MHFA skills. Participant self-reported use of a set of MHFA skills ranged from 19% to 82% since being trained in MHFA. Almost half (44%) of participants had asked someone if they were considering suicide. A majority (61%) also had referred someone to resources because of a mental health crisis. Open-ended responses included positive experiences alongside important challenges to using MHFA in practice and recommendations including additional training focused on the pharmacy setting. Conclusions: Pharmacy professionals in this evaluation reported little reluctance and high confidence related to using MHFA training and reported use of MHFA skills since being trained.
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Affiliation(s)
- Matthew Witry
- Division of Health Services Research, Department of Pharmacy Practice and Science, University of Iowa College of Pharmacy, Iowa City, Iowa, United States of America
- * E-mail:
| | - Hacer Karamese
- Center for Evaluation and Assessment, University of Iowa College of Education, Iowa City, Iowa, United States of America
| | - Anthony Pudlo
- Iowa Pharmacy Association, Des Moines, Iowa, United States of America
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Mospan CM, Gillette C. Student Pharmacists' Attitudes Toward Suicide and the Perceived Role of Community Pharmacists in Suicidal Ideation Assessment. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:7588. [PMID: 32577030 PMCID: PMC7298224 DOI: 10.5688/ajpe7588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 10/14/2019] [Indexed: 05/30/2023]
Abstract
Objective. To determine first-year Doctor of Pharmacy students' attitudes toward suicide and perceptions of the role of the pharmacist in assessing patients for suicidal ideation, and whether their previous pharmacy work experience influences these attitudes and perceptions. Methods. An anonymous online survey was administered to first-year student pharmacists at one school of pharmacy in North Carolina. Measures included gender, previous community pharmacy work experience, personal contact with suicide, and score on the Attitudes Toward Suicide (ATTS) scale. Results. Seventy-three student pharmacists (75%) completed the survey. The vast majority (92%) agreed or strongly agreed that suicide was a real disease. Similarly, most students (79%) agreed or strongly agreed that pharmacists have a professional responsibility to assess for suicidal ideation. There was not a significant association between ATTS score and previous community pharmacy work experience nor the perceived pharmacist's role in assessing for suicidal ideation. Additionally, there was no association between ATTS score and personal contact with suicide. Conclusion. First-year student pharmacists, while undecided on their personal attitudes toward suicide, overwhelmingly agreed that suicide is a disease and that pharmacists have an important role in assessing patients for suicidal ideation. Pharmacy schools should implement training programs to prepare student pharmacists to identify suicidal ideation, design interventions to address student pharmacists' personal beliefs that may impact their ability to provide patient care, and provide students with adequate support skills to care for patients experiencing mental health crises.
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Affiliation(s)
| | - Chris Gillette
- Wake Forest School of Medicine, Winston-Salem, North Carolina
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Murphy AL, O'Reilly CL, Ataya R, Doucette SP, Burge FI, Salvador-Carulla L, Chen TF, Himmelman D, Kutcher S, Martin-Misener R, Rosen A, Gardner DM. Survey of Australian and Canadian Community Pharmacists' Experiences With Patients at Risk of Suicide. Psychiatr Serv 2020; 71:293-296. [PMID: 31744430 DOI: 10.1176/appi.ps.201900244] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The study's objective was to examine Canadian and Australian community pharmacists' experiences with people at risk of suicide. METHODS A survey was developed and administered online. Countries were compared by Fisher's exact and t tests. Multivariable logistic-regression analysis was used to identify variables associated with preparedness to help someone in a suicidal crisis. RESULTS The survey was completed by 235 Canadian and 161 Australian pharmacists. Most (85%) interacted with someone at risk of suicide at least once, and 66% experienced voluntary patient disclosure of suicidal thoughts. More Australians than Canadians had mental health crisis training (p<0.001). Preparedness to help in a suicidal crisis was negatively associated with being Canadian, having a patient who died by suicide, lacking training and confidence, and permissive attitudes toward suicide. CONCLUSIONS Several perceived barriers impede pharmacists' abilities to help patients who voluntarily disclose suicidal thoughts. Gatekeeper and related suicide prevention strategy training for community pharmacists is warranted.
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Affiliation(s)
- Andrea L Murphy
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
| | - Claire L O'Reilly
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
| | - Randa Ataya
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
| | - Steve P Doucette
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
| | - Frederick I Burge
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
| | - Luis Salvador-Carulla
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
| | - Timothy F Chen
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
| | - Dani Himmelman
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
| | - Stanley Kutcher
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
| | - Ruth Martin-Misener
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
| | - Alan Rosen
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
| | - David M Gardner
- College of Pharmacy (Murphy, Ataya, Gardner), Department of Psychiatry (Murphy, Kutcher, Gardner), Department of Family Medicine (Burge), and School of Nursing (Martin-Misener), all at Dalhousie University, Halifax, Nova Scotia, Canada; School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia (O'Reilly, Chen); Research Methods Unit, Nova Scotia Health Authority, Halifax (Doucette); Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory (Salvador-Carulla); Schizophrenia Society of Nova Scotia, Halifax (Himmelman); Brain & Mind Centre, University of Sydney, Sydney (Rosen); Illawarra Institute for Mental Health, University of Wollongong, Wollongong, New South Wales, Australia (Rosen); Independent Senators Group, Senate of Canada, Ottawa, Ontario, Canada (Kutcher). Dr. Kutcher was with IWK Health Centre, Dalhousie University, Halifax, at the time of this study
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El-Den S, Moles R, Choong HJ, O'Reilly C. Mental Health First Aid training and assessment among university students: A systematic review. J Am Pharm Assoc (2003) 2020; 60:e81-e95. [PMID: 32019720 DOI: 10.1016/j.japh.2019.12.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/17/2019] [Accepted: 12/22/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To explore the literature describing the delivery and assessment of Mental Health First Aid (MHFA) training among university students. DATA SOURCES The databases MEDLINE, PreMEDLINE, CINAHL, EMBASE, ERIC, and PsycINFO were searched to identify publications describing MHFA training and assessment among university students since 2000. STUDY SELECTION All studies, regardless of design, that described the delivery and assessment of MHFA training among university students, at any level, were included in this systematic review. DATA EXTRACTION The discipline and level of students; the version, length, and integration of MHFA training; and the constructs used to assess students post-MHFA training were extracted from each study. RESULTS Of the initial 1662 records, 12 were included. Eight studies were conducted in Australia, 3 in the United States, and 1 in the United Kingdom. Most students were enrolled in health care or social work degree programs across all years of their program with 4 studies involving pharmacy students. Three studies described integrating compulsory MHFA training for university students. Most studies reported on the delivery of the Standard or Adult version of MHFA training; no study reported on MHFA for Tertiary Students. Post-MHFA training, students were assessed on mental health knowledge, literacy, intentions, confidence, stigma, and skills application. Only 2 studies described assessment methods involving direct observation of behaviors, whereas the rest relied on self-reported measurements. CONCLUSION Despite the spread of MHFA to over 25 countries and the availability of tertiary student-specific training, the studies included in this systematic review were conducted in only 3 countries and mainly involved Standard and Adult MHFA training. Most assessments relied on self-reported measures. Future studies involving different versions of MHFA training, and the exploration of novel competency-based assessment methods among a diverse range of students from different countries are warranted.
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Rickles N, Wertheimer A, Huang Y. Training Community Pharmacy Staff How to Help Manage Urgent Mental Health Crises. PHARMACY 2019; 7:pharmacy7030133. [PMID: 31527455 PMCID: PMC6789501 DOI: 10.3390/pharmacy7030133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/05/2019] [Accepted: 09/07/2019] [Indexed: 11/16/2022] Open
Abstract
Nearly 44 million Americans are affected by mental illness every year. Many individuals, however, are not diagnosed and/or do not receive treatment. The present manuscript reviews the incidence of mental illness, the continuum from mental wellness to mental illness, and the role of the pharmacy staff in helping individuals manage different mental health needs. In particular, there is discussion of stigma of mental illness that those with mental health needs experience by those around them including health professionals such as pharmacy staff. One way to resolve such stigma is through training such as Mental Health First Aid (MHFA). The paper reviews key aspects of MHFA, the evidence supporting MHFA, and how MHFA relates specifically to pharmacy practice and services. A conceptual framework for MHFA and its relationship to individual factors, attitudes, behaviors, and outcomes. Lastly, a discussion is presented that briefly compares MHFA to other similar approaches to helping those in mental health crises, the limits of what is known about MHFA, and what future research might explore to better understand the outcomes of pharmacy staff providing mental health education, support, and referral to care.
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Affiliation(s)
- Nathaniel Rickles
- Department of Pharmacy Practice, University of Connecticut, Storrs, CT 06269, USA.
| | - Albert Wertheimer
- Department of Sociobehavioral and Administrative Pharmacy, Fort Lauderdale-Davie, FL 33314, USA.
| | - Yifan Huang
- Department of Pharmacy Practice, University of Connecticut, Storrs, CT 06269, USA.
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Kassir H, Eaton H, Ferguson M, Procter NG. Role of the pharmacist in suicide prevention: primely positioned to intervene. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2019. [DOI: 10.1002/jppr.1552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hiba Kassir
- School of Pharmacy and Medical Science University of South Australia Adelaide Australia
| | - Heather Eaton
- School of Nursing and Midwifery University of South Australia Adelaide Australia
| | - Monika Ferguson
- School of Nursing and Midwifery University of South Australia Adelaide Australia
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Reavley NJ, Morgan AJ, Fischer JA, Kitchener B, Bovopoulos N, Jorm AF. Effectiveness of eLearning and blended modes of delivery of Mental Health First Aid training in the workplace: randomised controlled trial. BMC Psychiatry 2018; 18:312. [PMID: 30257665 PMCID: PMC6158844 DOI: 10.1186/s12888-018-1888-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 09/17/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The aim of the WorkplaceAid study was to compare the effects of eLearning or blended (eLearning plus face-to-face course delivery) Mental Health First Aid (MHFA) courses on public servants' knowledge, stigmatising attitudes, confidence in providing support and intentions to provide support to a person with depression or post-traumatic stress disorder (PTSD). METHODS A randomized controlled trial was carried out with 608 Australian public servants. Participants were randomly assigned to complete an eLearning MHFA course, a blended MHFA course or Red Cross eLearning Provide First Aid (PFA) (the control). The effects of the interventions were evaluated using online questionnaires pre- and post-training. The questionnaires centred around vignettes describing a person meeting the criteria for depression or PTSD. Primary outcomes were mental health first aid knowledge and desire for social distance. Secondary outcomes were recognition of mental health problems, beliefs about treatment, helping intentions and confidence and personal stigma. Feedback on the usefulness of the courses was also collected. RESULTS Both the eLearning MHFA and blended MHFA courses had positive effects compared to PFA eLearning on mental health first aid knowledge, desire for social distance, beliefs about professional treatments, intentions and confidence in helping a person and personal stigma towards a person with depression or PTSD. There were very small non-significant differences between the eLearning MHFA and blended MHFA courses on these outcome measures. However, users were more likely to highly rate the blended MHFA course in terms of usefulness, amount learned and intentions to recommend the course to others. CONCLUSIONS The blended MHFA course was only minimally more effective than eLearning MHFA in improving knowledge and attitudes. However, course satisfaction ratings were higher from participants in the blended MHFA course, potentially leading to greater benefits in the future. Longer-term follow-up is needed to explore this. TRIAL REGISTRATION ACTRN12614000623695 registered on 13/06/2015 (prospectively registered).
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Affiliation(s)
- Nicola J. Reavley
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC 3010 Australia
| | - Amy J. Morgan
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC 3010 Australia
| | - Julie-Anne Fischer
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC 3010 Australia
| | - Betty Kitchener
- Mental Health First Aid Australia, 369 Royal Parade, Parkville, VIC 3052 Australia
| | - Nataly Bovopoulos
- Mental Health First Aid Australia, 369 Royal Parade, Parkville, VIC 3052 Australia
| | - Anthony F. Jorm
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC 3010 Australia
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