Mental health: "it is a subject where most pharmacists [or pharmacy] students have no more knowledge than the general public"

BACKGROUND

Mental health is a global health priority, and pharmacists have a valuable role in improving outcomes in all sectors of practice. This study sought to explore pharmacy students' views on teaching and learning of mental health and future practice.

METHODS

An anonymous online questionnaire was distributed to pharmacy students in the UK and Ireland in February 2020 via the Qualtrics™ platform and 232 students responded. The questionnaire was originally intended to explore the provision of Mental Health First Aid (MHFA) teaching and the quantitative analysis has been previously reported. Students were invited to comment on their views about MHFA. The open-ended question: 'Do you have any other comments about mental health teaching and learning in the MPharm degree?' was also included. The rich free-text data were analysed, and themes identified.

RESULTS

Three major themes were identified: (i) Mental Health is important; (ii) Pharmacist roles and (iii) So, Teach me. A fourth theme, Stigma, crosscut all the themes.

CONCLUSIONS

Pharmacy students appreciate the importance of mental health care. The majority recognise the role of the pharmacist in providing person-centred care and the potential to enhance this role. Students are keen to learn more, and acquire the confidence and skills to contribute in the future. They would like an integrated approach and have more opportunities to learn from patients. Addressing stigma is an important consideration for educators.

Developing mental health education: “It is a subject where most pharmacists [or pharmacy] students have no more knowledge than the general public”

Introduction

With one quarter of people in the UK reporting a mental health problem, pharmacists have a vital role in mental health care. We previously explored pharmacy students’ views on the value of Mental Health First Aid (MHFA) training in preparing them to provide mental health care. (1) Within the questionnaire, students were given opportunity to discuss their experiences of mental health teaching and learning. The large amount of rich data generated lent itself to separate qualitative analysis.

Aim

To understand the main themes in pharmacy students’ reflections on mental health and pharmacy.

Methods

An anonymous, online questionnaire was distributed in February 2020.The original aim was to establish the attitudes and experiences of pharmacy students (n=232) in the UK and Ireland in relation to Mental Health First Aid Training (MHFA). Students across all year groups in the MPharm were invited, and 70% of respondents were in year 3 or 4. Students from eighteen universities responded, of which 80% were female. (1) Participants were also asked open questions to enable explanation and further expansion on their answers both about MHFA and about mental health and pharmacy generally. Comments ranged from short phrases to full paragraphs. These data were analysed by two authors (HG and HM), following Thematic Analysis as outlined by Braun and Clarke (2) and adopting an interpretivist approach. Authors read and re-read open comments to develop understanding of the main themes discussed when students reflected on MH teaching, their own learning and the anticipated value of this in professional practice. To ensure rigour, the authors initially undertook their analysis separately and then agreed on the themes which best described the data. A third author, JS, reviewed the coding, agreed the proposed themes and revised subthemes.

Results

The identified themes were i) Mental health is important; ii) Pharmacists’ role and iii) So, teach me. Overall, students identified that ‘mental health is extremely important and often overlooked’. Most identified that pharmacists have a central role in mental health support and that mental health ‘needs to have a more important place in pharmacy than it does at the moment’. Students highlighted ‘concern[s] about communicating with mental health patients’ and managing ‘difficult situations’. They wanted to learn more about mental health and wanted this embedded across curricula. There was a fourth, crosscutting theme: stigma. Participants acknowledged the existence of stigma but felt it was reducing. Data included examples of othering, referring to people with mental illness as ‘them’ not ‘us’.

Conclusion

This study is the most contemporary, pan-university study of mental health in MPharm curricula in recent times. The potential for bias, given participants elected to engage in a questionnaire about MHFA was something borne in mind during analysis. Pharmacy students identified mental health to be an important aspect of health, where stigma still exits. Students recognised their potential future contribution in mental healthcare. It requires focus in pharmacy degrees which could ultimately support increasing pharmacists’ involvement in mental health.

References

(1) Gorton, H.C., Macfarlane, H., Edwards, R. et al. UK and Ireland survey of MPharm student and staff experiences of mental health curricula, with a focus on Mental Health First Aid. J of Pharm Policy and Pract14, 73 (2021). https://doi.org/10.1186/s40545-021-00364-1

(2) Braun V, Clarke V. Successful Qualitative Research: A Practical Guide For Beginners. London: Sage; 2013.

UK and Ireland survey of MPharm student and staff experiences of mental health curricula, with a focus on Mental Health First Aid

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.

Mental health curricula and Mental Health First Aid in the MPharm

Introduction

Improving mental health care is an international priority, and one that is championed by the Royal Pharmaceutical Society. (1) In the course of their work, pharmacists frequently encounter people with mental health problems. The extent to which mental health is taught on the undergraduate pharmacy degree in the UK and Ireland, and the inclusion of Mental Health First Aid (MHFA) training, has not be described recently.

Aim

We aimed to determine how mental health teaching is embedded into the MPharm and students’ perception of their own preparedness to help people with their mental health. We explored if and how MHFA training is included, and students’ experience of, or desire to complete this.

Methods

We conducted an anonymous, online questionnaire of UK and Ireland MPharm students, distributed via networks and social media. Students were asked a series of closed questions about mental health teaching in the MPharm, and exposure to MHFA. We analysed answers using descriptive statistics. We included some open-ended questions to enable students to expand on their answers. We used this qualitative data to contextualize findings. We invited one member of staff from each university to answer a modified staff version of the questionnaire, in order to provide a curriculum overview and staff perspective on MHFA provision.

Results

232 students and 13 staff responded, from 22 universities in total. Eighty percent of student participants were female and 70% were in the third or final year of study. Three-quarters of students felt that mental health was not embedded throughout the MPharm. Eighty-percent of students stated that they were taught about neuropharmacology and 44.8% stated that their course included communicating with people about their mental health. One third of students felt 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 more preparedness than those who did not, but student numbers were small.

Conclusion

Mental health teaching remains focused on theoretical aspects, such as pharmacology, with less emphasis on practical skills, such as communication skills that might support interactions about mental health. MHFA was viewed by students as one way to enhance this. Of the small number of students who had completed MHFA, they displayed an increased self-reported preparedness. This could, however, be linked to the environmental culture of the programme rather than the training per se. MPharm programmes need sufficient focus on skills including communication and crisis response that may be required by pharmacists, alongside the fundamental scientific knowledge relating to mental health.

References

1. Royal Pharmaceutical Society. No health without mental health: How can pharmacy support people with mental health problems? London: RPS; 2018.