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El-Den S, Birkness K, Pham L, Murphy A, Moles RJ, O'Reilly CL, Raynes-Greenow C, Chen TF, Raduescu C, Gardner D, Carter SR. Development and validation of measures of pharmacists' acceptability and willingness to screen for perinatal depression. Res Social Adm Pharm 2024; 20:995-1005. [PMID: 38972786 DOI: 10.1016/j.sapharm.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 06/06/2024] [Accepted: 06/28/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND While pharmacists' roles in mental healthcare are expanding, research exploring pharmacists' acceptability and willingness to provide mental health services is limited. This study developed and validated theory-driven measures of pharmacists' acceptability and willingness to screen for perinatal depression in community pharmacy settings. MATERIALS/METHODS Items were developed using published literature and the Theoretical Framework of Acceptability (TFA), then content validated using consensus methods with experts who completed the content validity index (CVI). The revised items were disseminated to pharmacists in Australia. Responses were analysed descriptively. Exploratory factor analyses (EFA) were used to explore the factorial structure and generate scales. Multivariate regression analysis was conducted to explore predictors of willingness. RESULTS A 58-item questionnaire was developed, encompassing the 7 domains of the TFA and an eighth domain (willingness). The average CVI was 0.92, domain range (0.88-0.96). The universal CVI was 56/58. Expert feedback informed item revision, creation and deletion. Pharmacists' responses (n = 157) to the final 42-item questionnaire indicated overall acceptance and willingness to conduct PND screening. However, perceived knowledge was lacking. The EFA resulted a two-factor solution (1 = acceptance; 2 = self-efficacy). The measurement scales created had good internal consistency. In multivariate regression analysis, 'Acceptance' (Beta = 0.949 (0.760-1.103)) and 'Self-Efficacy' (Beta = 0.107 (0.036-0.174)) were significant predictors of 'Willingness' and the model predicted 77 % of the variation in 'Willingness'. CONCLUSIONS Psychometrically-sound measures of pharmacists' acceptability and willingness to screen for PND have been developed with stakeholder input. The questionnaire can be used for standardised measurement of these constructs across studies.
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Affiliation(s)
- Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | | | - Lily Pham
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Andrea Murphy
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | | | - Timothy F Chen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Corina Raduescu
- The University of Sydney Business School, The University of Sydney, Sydney, NSW, Australia.
| | - David Gardner
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
| | - Stephen R Carter
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
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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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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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Bhugra D, Liebrenz M, Ventriglio A, Ng R, Javed A, Kar A, Chumakov E, Moura H, Tolentino E, Gupta S, Ruiz R, Okasha T, Chisolm MS, Castaldelli-Maia J, Torales J, Smith A. World Psychiatric Association-Asian Journal of Psychiatry Commission on Public Mental Health. Asian J Psychiatr 2024; 98:104105. [PMID: 38861790 DOI: 10.1016/j.ajp.2024.104105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/22/2024] [Accepted: 05/31/2024] [Indexed: 06/13/2024]
Abstract
Although there is considerable evidence showing that the prevention of mental illnesses and adverse outcomes and mental health promotion can help people lead better and more functional lives, public mental health remains overlooked in the broader contexts of psychiatry and public health. Likewise, in undergraduate and postgraduate medical curricula, prevention and mental health promotion have often been ignored. However, there has been a recent increase in interest in public mental health, including an emphasis on the prevention of psychiatric disorders and improving individual and community wellbeing to support life trajectories, from childhood through to adulthood and into older age. These lifespan approaches have significant potential to reduce the onset of mental illnesses and the related burdens for the individual and communities, as well as mitigating social, economic, and political costs. Informed by principles of social justice and respect for human rights, this may be especially important for addressing salient problems in communities with distinct vulnerabilities, where prominent disadvantages and barriers for care delivery exist. Therefore, this Commission aims to address these topics, providing a narrative overview of relevant literature and suggesting ways forward. Additionally, proposals for improving mental health and preventing mental illnesses and adverse outcomes are presented, particularly amongst at-risk populations.
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Affiliation(s)
- Dinesh Bhugra
- Institute of Psychiatry, Psychology and Neurosciences, Kings College, London SE5 8AF, United Kingdom.
| | - Michael Liebrenz
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
| | | | - Roger Ng
- World Psychiatric Association, Geneva, Switzerland
| | | | - Anindya Kar
- Advanced Neuropsychiatry Institute, Kolkata, India
| | - Egor Chumakov
- Department of Psychiatry & Addiction, St Petersburg State University, St Petersburg, Russia
| | | | | | - Susham Gupta
- East London NHS Foundation Trust, London, United Kingdom
| | - Roxanna Ruiz
- University of Francisco Moaroquin, Guatemala City, Guatemala
| | | | | | | | | | - Alexander Smith
- Department of Forensic Psychiatry, University of Bern, Bern, Switzerland
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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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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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Gorton HC, Berry HJ, O'Reilly CL, Gardner D, Murphy AL. Does video e-learning improve pharmacy teams' attitudes and preparedness towards suicide prevention? EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100370. [PMID: 38058359 PMCID: PMC10696119 DOI: 10.1016/j.rcsop.2023.100370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 12/08/2023] Open
Abstract
Background Evidence on the role of pharmacy teams in suicide prevention is growing. To support pharmacy teams, a video e-learning was produced by the Centre for Pharmacy Postgraduate Education (CPPE) involving an 'on-the-sofa' style group interview with people with personal and professional experience of suicide and suicide research. Objective The objective was to measure any change in attitudes and preparedness for suicide prevention, following a video e-learning produced for pharmacy staff. Methods People working in any sector of pharmacy in England and who accessed the training video were invited to complete a pre- and post- training questionnaire, between September 2019 and March 2021. Question types included demographics, experiences, attitudes as measured by the Attitudes to Suicide Prevention (ASP) scale, and preparedness. Descriptive statistics were used to summarize demographics and experience and paired t-tests were used to compare pre- and post- questionnaire responses. Results Both questionnaires were completed by 147 people. Most worked in community pharmacy (88%) and were pharmacists (64%) or pharmacy technicians (20%). Attitudes to suicide prevention improved significantly (pre:31.20 (SD 6.04); post:28.40 (SD 6.50), p < 0.0001) after watching the video, as did self-reported preparedness. Conclusions Pharmacy teams' self-reported attitudes and preparedness for suicide prevention improved after watching this suicide awareness video compared to baseline. Suicide awareness training tailored to pharmacy teams may be valuable, but the longitudinal impact of any suicide prevention training requires further exploration.
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Affiliation(s)
- Hayley C. Gorton
- School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Hayley J. Berry
- Centre for Pharmacy Postgraduate Education (CPPE), University of Manchester, Manchester, UK
| | | | - David Gardner
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- College of Pharmacy, Dalhousie University, Halifax, Canada
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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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9
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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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10
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McKeirnan KC, MacCamy KL, Robinson JD, Ebinger M, Willson MN. Implementing Mental Health First Aid Training in a Doctor of Pharmacy Program. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100006. [PMID: 37597905 DOI: 10.1016/j.ajpe.2023.01.001] [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: 08/15/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVE In this study, we aimed to describe the implementation of Mental Health First Aid (MHFA) training as a required curricular component in a Doctor of Pharmacy (PharmD) program; and analyze the impact of MHFA training on student pharmacist's perceptions of stigma, comfort, confidence, and willingness to intervene when someone is experiencing a mental health issue. METHODS Student pharmacists completed an all-day MHFA training as a required element of the PharmD curriculum during the spring of 2022. Pre- and post-survey was completed by students during the in-person training. Questions included items from the Opening Minds to Stigma Scale for Healthcare Providers; question, persuade, refer gatekeeper training for suicide prevention; and questions developed by the authors to assess the impact of the training on participant-reported stigma, confidence, and willingness to provide care to those potentially experiencing a mental issue. RESULTS A total of 235 student pharmacists completed the MHFA training. A statistically significant reduction of stigma was seen for 9 of the 15 statements from Opening Minds to Stigma Scale for Healthcare Providers. Additionally, all responses related to comfort and willingness to provide care and confidence improved significantly after completing MHFA. CONCLUSION MHFA training was implemented as a mandatory requirement for all student pharmacists in the didactic portion of a PharmD program. This training led to reduced stigma around mental illness and improved confidence, comfort, and willingness to intervene among student pharmacists.
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Affiliation(s)
- Kimberly C McKeirnan
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
| | - Kathryn L MacCamy
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
| | - Jennifer D Robinson
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
| | - Michael Ebinger
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA
| | - Megan N Willson
- Washington State University College of Pharmacy and Pharmaceutical Sciences, Spokane, WA, USA.
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Carpenter DM, Stover AN, Harris SC, Anksorus H, Lavigne JE. Impact of a Brief Suicide Prevention Training with an Interactive Video Case Assessment on Student Pharmacist Outcomes. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100093. [PMID: 37380269 DOI: 10.1016/j.ajpe.2023.100093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/20/2022] [Accepted: 03/07/2023] [Indexed: 06/30/2023]
Abstract
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.
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Affiliation(s)
- Delesha M Carpenter
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA; Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua, NY, USA.
| | - Amanda N Stover
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Suzanne C Harris
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Heidi Anksorus
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Jill E Lavigne
- Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua, NY, USA; Wegmans School of Pharmacy, St John Fisher College, Rochester, NY, USA
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12
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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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13
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McGrath RL, Verdon S, Parnell T, Pope R. Australian physiotherapists' perceived frequency of contact with clients experiencing distress: A cross-sectional survey. Physiother Theory Pract 2023:1-18. [PMID: 37128766 DOI: 10.1080/09593985.2023.2204962] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 03/16/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Previous research suggests physiotherapists' perceived frequency of contact with clients experiencing psychological distress is common; however, there is significant variation in the frequency of such contact. OBJECTIVE The study aimed to 1) investigate Australian physiotherapists' perceived frequency of contact with clients experiencing various forms of psychological distress; 2) identify potential factors that predict perceived frequency of contact; and 3) explore physiotherapists' beliefs regarding their role and self-reported capability to identify and assess psychological distress. METHODS A nationwide online survey of 340 Australian physiotherapists was conducted, and the data were analyzed using descriptive analysis and regression analysis. RESULTS Physiotherapists' perceived frequencies of contact with psychologically distressed and severely distressed clients expressed as proportions of all clients seen each week were 36.1% and 15.6%, respectively. Factors related to the clinical setting were stronger predictors of the perceived frequency of contact (Cohen's f2 = 0.16) than factors related to the physiotherapists themselves (Cohen's f2 = 0.03). Despite believing that identifying psychological distress was within their scope of practice, the physiotherapists in the study felt that assessing and managing this distress fell outside or on the boundary of their scope of practice. CONCLUSION Australian physiotherapists frequently encounter clients they perceive to be experiencing psychological distress. Future research into physiotherapists' capability to assess and respond to client psychological distress, using non-self-reported measures, is required.
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Affiliation(s)
- Ryan L McGrath
- Department of Rural Health, The University of Melbourne, Shepparton, Australia
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, Australia
- Allied Health Education and Research Unit, Goulburn Valley Health, Shepparton, Australia
| | - Sarah Verdon
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, Australia
| | - Tracey Parnell
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, Australia
| | - Rodney Pope
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, Australia
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14
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Stover AN, Lavigne JE, Carpenter DM. A Scoping Review of Suicide Prevention Training Programs for Pharmacists and Student Pharmacists. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:ajpe8917. [PMID: 35012944 PMCID: PMC10159549 DOI: 10.5688/ajpe8917] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/05/2022] [Indexed: 05/06/2023]
Abstract
Objective. This scoping review updates a 2018 review of suicide prevention training programs for community and student pharmacists. Five scholarly databases were searched for articles published between January 2018 and December 2020. Articles were excluded if they did not describe an educational or training program for pharmacists or student pharmacists, did not explicitly include suicide, focused solely on attitudes, or did not provide sufficient detail to evaluate program content. The quality of each study was examined using a quality assessment tool.Findings. Seven studies met inclusion criteria. Most trainings (86%) were delivered live with interactive or role play scenarios to promote verbal and behavioral skill practice. About half (57%) assessed changes in knowledge, and fewer programs (29%) assessed changes in communication. All assessed participants' ability to identify suicide warning signs and included referral resources. Six studies were assessed for quality, of which 67% had a rating of good and 33% were rated as fair.Summary. Given the increase in suicide rates nationally, it is likely that pharmacists will encounter a patient in need of suicide prevention services. Since 2018, seven new suicide prevention training programs for community and student pharmacists have been reported, which demonstrates growing interest in suicide prevention training in the pharmacy profession. When integrated in Doctor of Pharmacy (PharmD) curricula, trainings may help prepare the pharmacy workforce for encounters with patients in crisis. The impact of training on self-efficacy and communication skills warrants additional attention. Variation between programs should be evaluated to understand which instructional methods best prepare pharmacy professionals to engage in suicide prevention.
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Affiliation(s)
- Amanda N Stover
- University of North Carolina, Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | - Jill E Lavigne
- St John Fisher College, Wegmans School of Pharmacy, Rochester, New York
- Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua, New York
| | - Delesha M Carpenter
- University of North Carolina, Eshelman School of Pharmacy, Chapel Hill, North Carolina
- Center of Excellence for Suicide Prevention, Department of Veterans Affairs, Canandaigua, New York
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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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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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18
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El-Den S, Pham L, Anderson I, Yang S, Moles RJ, O'Reilly CL, Boyce P, Raine KH, Raynes-Greenow C. Perinatal depression screening: a systematic review of recommendations from member countries of the Organisation for Economic Co-operation and Development (OECD). Arch Womens Ment Health 2022; 25:871-893. [PMID: 35849215 PMCID: PMC9492701 DOI: 10.1007/s00737-022-01249-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/21/2022] [Indexed: 11/02/2022]
Abstract
Perinatal depression (PND) screening recommendations are made by national, state-based and professional organisations; however, there is disagreement regarding screening timing, provider responsible, screening setting, screening tool as well as the follow-up and referral pathways required post-screening. This systematic review aimed to identify, describe and compare PND screening recommendations from member countries of the Organisation for Economic Co-operation and Development (OECD). Publications were identified through systematically searching PubMed, Google and the Guidelines International Network (GIN). Recommendations regarding PND screening endorsement, timing, frequency, responsible provider, tools/assessments and follow-up and referral were extracted. Twenty-one publications, including guidelines, from five countries were included. Most made recommendations in support of PND screening using the Edinburgh Postnatal Depression Scale. Details differed regarding terminology used, as well as frequency of screening, follow-up mechanisms and referral pathways. A broad range of health providers were considered to be responsible for screening. This is the first review to identify and compare PND screening recommendations from OECD member countries; however, only online publications published in English, from five countries were included. Heterogeneity of publication types and inconsistency in definitions rendered quality assessment inappropriate. While most publications generally endorsed PND screening, there are exceptions and the associated details pertaining to the actual conduct of screening vary between and within countries. Developing clear, standardised recommendations based on current evidence is necessary to ensure clarity amongst healthcare providers and a comprehensive approach for the early detection of PND.
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Affiliation(s)
- Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Lily Pham
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Isobel Anderson
- The University of Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Shan Yang
- The University of Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Philip Boyce
- The University of Sydney School of Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- The Westmead Institute for Medical Research, Sydney, NSW, 2145, Australia
| | - Karen Hazell Raine
- The University of Sydney School of Nursing, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- College of Nursing and Midwifery, Charles Darwin University, Darwin, NT, 0909, Australia
| | - Camille Raynes-Greenow
- The University of Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
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Dulellari S, Vesey M, Mason NA, Marshall VD, Bostwick JR. Needs assessment and impact of mental health training among doctor of pharmacy students. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:729-736. [PMID: 35809902 DOI: 10.1016/j.cptl.2022.06.003] [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: 01/17/2021] [Revised: 03/02/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Mental illness is extremely prevalent, yet many pharmacy students get little exposure to mental health training. The majority of studies assessing mental health training and Mental Health First Aid (MHFA) are focused on undergraduate programs. This study critically evaluated the impact of MHFA on pharmacy students' knowledge, confidence, and perceptions as they pertain to mental health, as well as the appropriateness of MHFA as a training course for pharmacy students. METHODS There were two parts to this study: (1) a pre-/post-survey that assessed the impact of MHFA on pharmacy students as well as the appropriateness of MHFA for students at this level of education and training and (2) a college-wide survey that assessed the impact of mental health training of any type on confidence in mental health-related skills and the perceived usefulness of mental health training for pharmacy students. RESULTS Participants of the MHFA portion of the study demonstrated a statistically significant improvement in knowledge of mental health-related topics and confidence to interact with someone experiencing mental illness (P < .05) after completing the MHFA course. Perceptions of mental illness did not improve significantly following a single training. The college-wide survey (N = 275) revealed a significantly higher confidence level among students who had previously completed any mental health training program compared to those who had not (P < .05). CONCLUSIONS MHFA training significantly increased students' knowledge and confidence in approaching and interacting with persons experiencing mental illness.
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Affiliation(s)
- Suada Dulellari
- University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI, United States.
| | - Melissa Vesey
- University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI, United States.
| | - Nancy A Mason
- University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI, United States.
| | - Vincent D Marshall
- University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI, United States.
| | - Jolene R Bostwick
- University of Michigan College of Pharmacy, 428 Church Street, Ann Arbor, MI 48109-1065, United States.
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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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21
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Pothireddy N, Lavigne JE, Groman AS, Carpenter DM. Developing and evaluating a module to teach suicide prevention communication skills to student pharmacists. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:449-456. [PMID: 35483810 DOI: 10.1016/j.cptl.2022.02.002] [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: 02/07/2021] [Revised: 01/13/2022] [Accepted: 02/27/2022] [Indexed: 06/14/2023]
Abstract
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.
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Affiliation(s)
- Nithya Pothireddy
- UNC Eshelman School of Pharmacy, 301 Pharmacy Ln, Chapel Hill, NC 27599, United States.
| | - Jill E Lavigne
- St. John Fisher College Wegmans School of Pharmacy, 3690 East Ave, Rochester, NY 14618, United States.
| | - Aleah S Groman
- St. John Fisher College Wegmans School of Pharmacy, 3690 East Ave, Rochester, NY 14618, United States.
| | - Delesha M Carpenter
- UNC Eshelman School of Pharmacy, 220 Campus Drive, Karpen Hall, CPO 2125, Asheville, NC 28804, United States.
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Pham L, Moles RJ, O’Reilly CL, Carrillo MJ, El-Den S. Mental Health First Aid training and assessment in Australian medical, nursing and pharmacy curricula: a national perspective using content analysis. BMC MEDICAL EDUCATION 2022; 22:70. [PMID: 35093037 PMCID: PMC8800543 DOI: 10.1186/s12909-022-03131-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Suicide is among the leading causes of death among people aged 15 to 29 worldwide. Healthcare professionals interact with people at risk of suicide regularly, yet mental health and crisis first aid training is lacking in curricula. Mental Health First Aid (MHFA) training teaches crucial communication and crisis first aid skills and is increasingly recognised as integral to healthcare education. This study aimed to explore the extent of, as well as barriers and enablers to MHFA training delivery and assessment in Australian medical, nursing and pharmacy curricula. METHODS All accredited Australian medical, nursing and pharmacy program providers were identified through Australian Health Practitioner Regulation Agency and National Boards websites and invited to participate in a semi-structured interview. A purpose-designed interview guide explored if and how MHFA training was delivered and assessed in curricula, as well as perceptions of and barriers and enablers to MHFA training. Interview recordings were transcribed verbatim, allowing for deductive content analysis to compare MHFA training provision across programs. RESULTS Of 75 invited program providers, 36 (48%; 13 medical, 13 nursing and 10 pharmacy) participated, of which 15 representatives (42%; six medical, two nursing and six pharmacy) reported providing MHFA training to students. Differences in mandating training, year level of students completing training, type of training delivered and source of MHFA instructors were identified. Barriers to MHFA implementation included perceived adequacy of existing curricula, lack of funding and time, while facilitators included perceived benefit and availability of funding. CONCLUSION MHFA training is provided to more than one third of medical, nursing and pharmacy students in Australia. Increased funding may facilitate the integration of MHFA as a minimum standard of mental health training for future healthcare professionals. Further research exploring the effectiveness of MHFA in improving behaviours and its impact on patient outcomes is warranted. TRIAL REGISTRATION This study was approved by the University of Sydney Human Research Ethics Committee [Project number: 2020/087].
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Affiliation(s)
- Lily Pham
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, A15 Pharmacy and Bank Building, Science Rd, Camperdown, NSW 2006 Australia
| | - Rebekah Jane Moles
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, A15 Pharmacy and Bank Building, Science Rd, Camperdown, NSW 2006 Australia
| | - Claire Louise O’Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, A15 Pharmacy and Bank Building, Science Rd, Camperdown, NSW 2006 Australia
| | - Mary Joy Carrillo
- School of the Arts and Media, Faculty of Arts and Social Sciences, The University of New South Wales, Robert Webster Building G14 Room 312, Kensington, NSW 2052 Australia
| | - Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, A15 Pharmacy and Bank Building, Science Rd, Camperdown, NSW 2006 Australia
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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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El-Den S, Collins JC, Chen TF, O'reilly CL. Pharmacists' roles in mental healthcare: Past, present and future. Pharm Pract (Granada) 2021; 19:2545. [PMID: 34621456 PMCID: PMC8456342 DOI: 10.18549/pharmpract.2021.3.2545] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Mental illnesses cause significant disease burden globally, with medicines being a major modality of treatment for most mental illnesses. Pharmacists are accessible and trusted healthcare professionals who have an important role in supporting people living with mental illness. This commentary discusses the role of pharmacists in mental healthcare, as part of multidisciplinary teams, the current evidence to support these roles, and the training, remuneration and policy changes needed to recognize these roles and embed pharmacists as core members of the mental healthcare team.
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Affiliation(s)
- Sarira El-Den
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney. Sydney, NSW (Australia).
| | - Jack C Collins
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney. Sydney, NSW (Australia).
| | - Timothy F Chen
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney. Sydney, NSW (Australia).
| | - Claire L O'reilly
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney. Sydney, NSW (Australia).
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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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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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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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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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Robinson JD, Johnson N, Brand-Eubanks DC, Kim AP. A call to action: Community pharmacists to address COVID-19-related behavioral health concerns. J Am Pharm Assoc (2003) 2020; 61:e75-e77. [PMID: 33303338 PMCID: PMC7720695 DOI: 10.1016/j.japh.2020.11.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/19/2020] [Accepted: 11/13/2020] [Indexed: 11/27/2022]
Abstract
Owing to the extended nature and worldwide exposure of the coronavirus disease (COVID-19) pandemic, it is likely that the presence and impact of behavioral health conditions will increase. For example, it is anticipated that individuals living with a major depressive disorder could reach as high as 60% of the population owing to the ongoing disruption from COVID-19. In 2017, the annual rate of individuals experiencing a major depressive episode was only 7.1%. Pharmacists, specifically community pharmacists, are well positioned to provide needed intervention and triage services to individuals living with, and struggling with, a mental health condition. Pharmacists, therefore, need additional training and support to be effective in serving the community in this way.
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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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Lutz S, Heberling M, Goodlet KJ. Patient perspectives of pharmacists prescribing HIV pre-exposure prophylaxis: A survey of patients receiving antiretroviral therapy. J Am Pharm Assoc (2003) 2020; 61:e75-e79. [PMID: 33069595 DOI: 10.1016/j.japh.2020.09.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/31/2020] [Accepted: 09/26/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Groundbreaking new laws granting community pharmacists the authority to prescribe human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) medications have the potential to substantially expand PrEP access in high-risk communities. However, whether patients will be accepting of pharmacists as PrEP providers is underexplored within the literature. OBJECTIVES To assess patient perspectives of pharmacist PrEP prescribing and identify potential barriers to acceptance of pharmacist-prescribed PrEP. METHODS Adult patients currently receiving antiretroviral therapy for HIV prophylaxis or treatment at a specialty pharmacy were surveyed telephonically from January 2020-April 2020. A 4-point Likert scale was used to measure perceptions in addition to open-ended questions. RESULTS The participation rate was 87.5%. Of the 49 included patients, 100% agreed/strongly agreed that pharmacists were knowledgeable about medications, but they were less likely to strongly agree that pharmacists were knowledgeable about HIV drugs (14.3% vs. 75.5% for other drugs, P < 0.001). Most (93.9%) of the patients agreed/strongly agreed that they would feel comfortable seeking a pharmacist for PrEP information or HIV testing. With respect to PrEP prescribing, 16.3% disagreed that they would feel comfortable having a pharmacist prescribe their first fill of PrEP, preferring to speak to their physician or expressing concerns that pharmacists have inadequate training. All patients expressed a desire for additional HIV/PrEP training requirements for pharmacists before allowing them to prescribe PrEP. A portion of the respondents (18.4%) expressed concerns that the increased availability of PrEP would lead to persons becoming lax about barrier protection. However, 100% of the patients agreed/strongly agreed that having pharmacist-prescribed PrEP would benefit their community. CONCLUSION Patients receiving antiretroviral therapy reported overall favorable perceptions of pharmacist PrEP prescribing; however, some concerns relating to pharmacists' level of training in HIV exist. This may be ameliorated through increased pharmacist education, including how to counsel patients seeking PrEP on behavioral risk reduction.
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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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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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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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Shams S, Hattingh HL. Evaluation of mental health training for community pharmacy staff members and consumers. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2020. [DOI: 10.1002/jppr.1634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Sara Shams
- Pharmacy Guild of Australia Queensland Branch Spring Hill Australia
| | - Hendrika Laetitia Hattingh
- School of Pharmacy and Pharmacology & Quality Use of Medicines Network Griffith University Gold Coast Australia
- Department of Pharmacy Gold Coast Health Southport Australia
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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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Boukouvalas E, El-Den S, Murphy AL, Salvador-Carulla L, O'Reilly CL. Exploring Health Care Professionals' Knowledge of, Attitudes Towards, and Confidence in Caring for People at Risk of Suicide: a Systematic Review. Arch Suicide Res 2020; 24:S1-S31. [PMID: 30856366 DOI: 10.1080/13811118.2019.1586608] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Health care professionals are paramount to the prevention and management of suicidal thoughts and behaviors. Confidence in caring for people at risk of suicidal thoughts and behaviors is influenced by knowledge of and attitudes towards suicide. This systematic review aimed to explore health care professionals' knowledge of and attitudes towards suicide, as well as, their confidence in caring for people at risk of suicidal thoughts and behaviors. A systematic search of 4 electronic databases over 10 years was conducted. Following retrieval of 1,723 abstracts, 46 primary research publications were included, involving both cross-sectional (n = 27) and intervention study designs (n = 19). Knowledge of, attitudes towards, and confidence in caring for people at risk of suicidal thoughts and behaviors were explored among primary health care professionals, specialists, and health care students. The influence of training and education, type of health care professional, country of practice, and prior experience with suicide were highlighted among included studies. Health care professionals' knowledge of, attitudes towards and confidence in caring for people at risk of suicide are complex, interrelated constructs that shape their behaviors and may impact patient outcomes. Suicide training and education is necessary within health care curricula and as part of health care professionals' continuing professional development.
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Keating D, McWilliams S, Hynes C, Purcell A, Clarke M, Strawbridge J. Patients and Caregivers Helping to Shape the Undergraduate Pharmacy Mental Health Curriculum. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2019; 83:7138. [PMID: 31871345 PMCID: PMC6920638 DOI: 10.5688/ajpe7138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 01/31/2019] [Indexed: 06/10/2023]
Abstract
Objective. To develop a model system for involving patients and caregivers in curriculum development of mental health education in an undergraduate pharmacy program. Methods. Purposive recruitment was used to convene a focus group of nine people with experience in using mental health services from either the patient or caregiver perspective. Group members were asked about their experience with using pharmacy services and their suggestions for enhancement of the undergraduate curriculum. Thematic analysis was conducted independently by two researchers. Results. Patients and caregivers believed that pharmacists could contribute to the care of people who experience mental health conditions by supporting shared decision making, providing information, actively managing side effects of psychotropic medication, and conducting regular medication review. Subjects suggested that the pharmacy undergraduate curriculum should introduce mental health from the beginning, include self-care for students, integrate mental and physical health education, and enhance students' communication skills. The curriculum should include broader issues relevant to mental health beyond the use of medication, such as stigma, the recovery approach, and interprofessional cooperation. These changes could support graduates in engaging proactively with people experiencing mental health difficulties. Conclusion. Involving patients and caregivers in the design of an undergraduate pharmacy curriculum in mental health resulted in a more person-centered and student-centered approach to mental health education at our university. Ultimately, the changes made to the undergraduate curriculum will improve the ability of pharmacy graduates to better meet the needs of patients.
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Affiliation(s)
- Dolores Keating
- Saint John of God Hospital, Stillorgan, Co Dublin, Ireland
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Stephen McWilliams
- Saint John of God Hospital, Stillorgan, Co Dublin, Ireland
- University College Dublin, School of Medicine and Medical Sciences, Dublin, Ireland
| | - Caroline Hynes
- Saint John of God Hospital, Stillorgan, Co Dublin, Ireland
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Audrey Purcell
- Saint John of God Hospital, Stillorgan, Co Dublin, Ireland
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Clarke
- University College Dublin, School of Medicine and Medical Sciences, Dublin, Ireland
- DETECT Early Intervention in Psychosis Service, Blackrock, Co Dublin, Ireland
| | - Judith Strawbridge
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland
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Witry MJ, Neblett K, Hutchens S, Catney C. When a patient talks about suicide: Adding a social worker led session on the pharmacist's role in suicide prevention to the PharmD curriculum. CURRENTS IN PHARMACY TEACHING & LEARNING 2019; 11:585-591. [PMID: 31213314 DOI: 10.1016/j.cptl.2019.02.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 01/11/2019] [Accepted: 02/18/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND PURPOSE Suicide is the tenth leading cause of death in the US. Frontline health professionals like pharmacists can be trained to intervene with patients displaying warning signs of suicide. The purpose of this activity was to introduce student pharmacists to suicide prevention concepts. EDUCATIONAL ACTIVITY AND SETTING A social worker on faculty at the school of social work and a pharmacy practice faculty member collaborated to deliver a 50-min didactic session to first year students on the role of pharmacists in suicide prevention. The session included: (1) suicide statistics and public health signiifcance, (2) protective factors, risk factors, and warning signs of suicidal ideation, (3) strategies for asking about suicidal ideation, including practice asking about suicide, (4) resources and referrals, and (5) brief case scenarios and student questions. FINDINGS An electronic survey was administered to 108 students and 83 responses (76.9%) were received. The results suggested the topic was new to most students and was relevant to their role as pharmacists. Most students (91%) reported that the session increased their confidence in asking about suicide for someone displaying warning signs. Student comments on the survey were generally positive with students requesting additional exposure to scenarios. Pharmacy programs may benefit from collaborating with social work or mental health professionals to deliver basic suicide intervention training tailored to pharmacy. SUMMARY A social worker-led session about suicide prevention was positively received by first year student pharmacists.
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Affiliation(s)
- Matthew J Witry
- University of Iowa College of Pharmacy, Department of Pharmacy Practice and Science, Division of Health Services Research, 115 South Grand Avenue, Iowa City, IA 52242, United States.
| | - Keri Neblett
- University of Iowa School of Social Work, Iowa City, IA 52242, United States.
| | - Sonja Hutchens
- University of Iowa College of Pharmacy, Iowa City, IA 52242, United States.
| | - Christine Catney
- University of Iowa College of Pharmacy, Iowa City, IA 52242, United States.
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Murphy AL, O'Reilly CL, Ataya R, Doucette SP, Martin-Misener R, Rosen A, Gardner DM. A survey of Canadian and Australian pharmacists' stigma of suicide. SAGE Open Med 2019; 7:2050312118820344. [PMID: 30728964 PMCID: PMC6350138 DOI: 10.1177/2050312118820344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 11/26/2018] [Indexed: 11/16/2022] Open
Abstract
Background There is limited information available regarding community pharmacists' stigma of suicide. Pharmacists regularly interact with people at risk of suicide and stigmatizing attitudes may impact care. Objective To measure community pharmacists' stigma of suicide. Method Pharmacists in Canada and Australia completed an online survey with the Stigma of Suicide Scale-Short Form. Data were analysed descriptively and with univariate and multivariate analyses. Results Three hundred and ninety-six pharmacists returned completed surveys (Canada n = 235; Australia n = 161; female 70%; mean age = 38.6 ± 12.7 years). The rate of endorsement of stigmatizing terms was low overall. Canadian and Australian pharmacists differed (p < 0.05) for several variables (e.g. age, friend or relative with a mental illness, training in mental health crisis). Pharmacists without someone close to them living with a mental illness were more likely to strongly agree/agree with words describing those who die by suicide as pathetic, stupid, irresponsible, and cowardly. Those without a personal diagnosis of mental illness strongly agreed/agreed with the terms immoral, irresponsible, vengeful, and cowardly. More Australian pharmacists strongly agreed/agreed that people who die by suicide are irresponsible, cowardly, and disconnected. Independent variables associated with a higher stigma were male sex, Australian, and negative perceptions about suicide preventability. Conclusion Community pharmacists frequently interact with people at risk of suicide and generally have low agreement of stigmatizing terms for people who die by suicide. Research should focus on whether approaches such as contact-based education can minimize existing stigma.
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Affiliation(s)
- Andrea L Murphy
- College of Pharmacy, Dalhousie University, Halifax, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Claire L O'Reilly
- School of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Randa Ataya
- College of Pharmacy, Dalhousie University, Halifax, NS, Canada
| | - Steve P Doucette
- Research Methods Unit, Nova Scotia Health Authority, Halifax, NS, Canada
| | | | - Alan Rosen
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia.,Illawarra Institute for Mental Health, University of Wollongong, Wollongong, NSW, Australia
| | - David M Gardner
- College of Pharmacy, Dalhousie University, Halifax, NS, Canada.,Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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Community pharmacists' experiences and people at risk of suicide in Canada and Australia: a thematic analysis. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1173-1184. [PMID: 29936597 DOI: 10.1007/s00127-018-1553-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To explore Canadian and Australian community pharmacists' practice experiences in caring for people at risk of suicide. METHODS We conducted a thematic analysis of 176 responses to an open-ended extension question in an online survey. RESULTS Four themes were identified and include referrals and triage, accessibility for confiding, emotional toll, and stigma. Subthemes included gatekeeping the medication supply, sole disclosure, planning for end of life, concerns of support people, assessing the validity of suicidality, gaps in the system, not directly asking, ill-equipped, resources in the pharmacy, relying on others to continue care, and attention seeking. CONCLUSIONS Community pharmacists are caring for patients at risk of suicide frequently, and often with patients seeking the help of pharmacists directly. Pharmacists engage in activities and actions that would be considered outside of the traditional dispensing roles and provide support and intervention to people at risk of suicide through collaboration and other mechanisms. Further research to determine appropriate education and training and postvention supports is required.
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Confidence and attitudes of pharmacy students towards suicidal crises: patient simulation using people with a lived experience. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1185-1195. [PMID: 30155558 DOI: 10.1007/s00127-018-1582-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/20/2018] [Indexed: 01/30/2023]
Abstract
PURPOSE Health care professionals, including pharmacists, have the potential to recognise and assist those at risk of suicide. The primary aim of this study was to assess the impact of utilising people with a lived experience of mental illness as simulated patients on final year pharmacy students' attitudes toward and confidence in caring for people at risk of suicide after first receiving Mental Health First Aid (MHFA) training. METHODS A parallel group repeated measures design was used. People with a lived experience of mental illness enacted patients experiencing a mental health crisis, including possible suicidal ideation. Following MHFA training, the first group directly participated in the simulation, the second group observed, and the final group had no exposure to the simulation. Validated surveys measuring student attitudes and confidence were conducted at three time points; pre and post MHFA, and then at 2-4 weeks follow-up. RESULTS Full datasets of survey responses were received from 34/40 direct participants (85%), 104/146 observers (71%) and 50/66 comparison students (76%). Mean confidence scores significantly improved for all groups post MHFA training (p < 0.05). At follow-up, all 8 confidence items for the direct participant and observer group maintained significance from baseline to post intervention (p < 0.05). Mixed results in relation to attitudes towards suicide were evident at each time point and among each participant group. CONCLUSIONS Utilising people with a lived experience of mental illness as simulated patients has a positive effect on sustaining pharmacy student confidence in discussing suicidal behaviour post MHFA training. The inconsistency in attitudes towards suicide suggests that attitudes are complex in nature, involving multiple dynamic influences.
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