When a patient talks about suicide: Adding a social worker led session on the pharmacist's role in suicide prevention to the PharmD curriculum

Pharmacist-social worker interprofessional relations and education in mental health: a scoping review

Background

One in eight patients is affected by a mental health condition, and interprofessional mental health teams collaborate to improve patient care. While pharmacists and social workers are recognized as mental health team members, there is a lack of literature describing interprofessional relations and education between these professions, especially as it pertains to mental health. The purpose of this review was to identify and characterize reports describing pharmacist-social worker interprofessional relations and education within mental health.

Methodology

To address this knowledge gap, this scoping review was conducted to collect and characterize reports published between January 1, 1960 and August 18, 2023 describing pharmacist-social worker interprofessional relations and education within the field of mental health. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines were followed. Ovid MEDLINE, CINAHL, and Social Work Abstracts were searched using keywords "pharmacy student," "pharmacist," "social work student," "social worker," and "social work." Reports were included if they were published in English and interprofessional relations or education occurred directly between (student) pharmacists and social workers.

Results

Three hundred twenty records were identified and three records were included: one cross sectional study, one qualitative educational project, and one case report. Each record suggested positive patient and/or educational outcomes developing from pharmacist-social worker interprofessional relations and education. In clinical practice, pharmacist-social work teams identified mental health risk factors, reduced 30-day readmissions, and improved post-discharge telehealth care. In the classroom, a social worker improved pharmacy students' confidence assessing patient suicidal ideations.

Conclusions

This scoping review identified needs and areas for future research: pharmacist interprofessional education with Master of Social Work and Doctor of Social Work degree students, transitional care and mental health outcome measure reporting using evidence-based outcomes, and development of scholarly teaching projects utilizing higher-level educational frameworks beyond learner reactions.

Suicide prevention curriculum development for health and social care students: Protocol for a scoping review

Suicide has become a serious public health concern and international research has shown that the majority of individuals who die by suicide had receive healthcare in the year prior to their death. This presents an opportunity for suicide prevention by strategically training healthcare students in suicide prevention knowledge and skills. The objective of this scoping review is to identify literature that describes the design, development, implementation and/or evaluation of suicide prevention training for healthcare and/or social care students in higher education settings. Studies will only be considered eligible for inclusion if they describe the design, development, implementation and/or evaluation of suicide prevention curricula being delivered to healthcare or social care degree students in higher education. Quantitative, qualitative, and mixed method studies published between 2011 and 2023 (inclusive) and in the English language will be considered eligible. This scoping review will be conducted according to the PRISMA guidelines for scoping reviews (PRISMA-ScR). The developed search strategy will be implemented across six databases: PubMed, ERIC (Education Resources Information Center), PsycINFO, Embase, CINAHL and Web of Science. Several grey literature sources will also be consulted. Further potential results will be located by hand-searching the reference lists of included articles. The search strategy will include variations of the terms: 'student', 'suicide prevention' and 'education'. The search will be limited to titles, abstracts, and keywords in databases that allow it. Two reviewers will complete the screening using the predefined inclusion criteria. A third reviewer will resolve any conflicts during the screening and eligibility appraisal processes. Results will be presented in the form of tabulated results and an accompanying narrative summary, describing key findings and context related to learning outcomes, methodologies employed and implementation of the identified programmes.

Impact of a Brief Suicide Prevention Training with an Interactive Video Case Assessment on Student Pharmacist Outcomes

OBJECTIVE

To determine whether a brief suicide prevention training with an interactive video case (Pharm-SAVES) improves student pharmacists' suicide prevention knowledge and self-efficacy.

METHODS

Student pharmacists (N = 146) from 2 United States universities completed the 75-minute Pharm-SAVES training in September 2021. Suicide prevention knowledge and self-efficacy were measured via an online pre-test and post-test, and a post-test interactive video case assessed self-efficacy to engage in SAVES steps (recognize Signs, Ask about suicide, Validate feelings, Expedite a National Suicide Prevention Lifeline [NSPL] referral, and Set a follow-up reminder). Paired samples t tests compared pre-test and post-test scores (alpha = 0.05). Three months later, students indicated if they had used Pharm-SAVES in practice.

RESULTS

Mean knowledge and self-efficacy significantly improved from pre-test to post-test. The interactive video case assessment revealed that students were least confident asking about suicide, moderately confident referring to or calling the NSPL on behalf of patients, and most confident following up with patients. Three months later, 17 (11.6%) students reported that they had recognized someone with suicide warning signs (S in SAVES). Among them, 9 (52.9%) reported asking the person with warning signs if they were considering suicide (A in SAVES), 13 (76.5%) validated feelings (V in SAVES), 3 (9.4%) called the NSPL for the patient, and 6 (35.3%) referred to the NSPL (E in SAVES).

CONCLUSION

Pharm-SAVES increased student pharmacists' suicide prevention knowledge and self-efficacy. Within 3 months, more than 10% had used Pharm-SAVES skills with at-risk individuals. All Pharm-SAVES content is now online and available for asynchronous or synchronous instruction.

Developing and evaluating a module to teach suicide prevention communication skills to student pharmacists

INTRODUCTION

This study aimed to determine whether a brief educational intervention for student pharmacists about individuals who exhibit suicide warning signs improves knowledge and confidence to recognize suicide warning signs, ask about suicide, validate feelings, and expedite referrals.

METHODS

This longitudinal, observational study was conducted with student pharmacists from two pharmacy schools in 2019. Students completed a suicide prevention module adapted from the Veteran Administration's S.A.V.E. suicide prevention gatekeeper training program (completion rate 67%). The module included a video case of an individual who exhibits suicide warning signs, a brief didactic lecture, and a role-play practice session. Text responses were coded by three independent raters. Students completed a multiple-choice pretest and posttest to assess knowledge and confidence. Paired samples t-tests were calculated to examine changes in students' knowledge and confidence scores.

RESULTS

Students' (N = 139) confidence and knowledge in recognizing and managing suicide warning signs improved significantly. There was improvement in how many students directly asked about suicide and expedited a referral. Most students (86%) reported planning to incorporate what they learned into practice.

CONCLUSIONS

In two schools of pharmacy, a brief suicide prevention module was implemented and adapted to the community pharmacy setting, which improved pharmacy students' knowledge and confidence to interact with an individual who exhibits suicide warning signs. S.A.V.E. teaches students how to communicate with an individual in crisis in a way that can be integrated into a busy pharmacy workflow, which may be why students planned to incorporate it into practice.

Student pharmacist personal and work experiences with people displaying warning signs of suicidal ideation

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.

Evaluation of participant reluctance, confidence, and self-reported behaviors since being trained in a pharmacy Mental Health First Aid initiative

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.