http://morethanmeds.com

This is more than just another website with links and resources. It’s more than one or two folks with a really good idea to share. It’s also asking pharmacists to do more than they’ve ever been asked to do before.

It’s a paradigm change in the approach to mental health.

As pharmacists, when we tackle our studies in school, CNS is either loads of fun in 3rd year, or frustrating as hell. Diagnoses that don’t fit patterns, therapies that aren’t well-understood, and a general absence of neat black-and-white boundaries to confine decision-making. It would be great if we could measure objective targets for mental health: ‘You’ve been on citalopram for 6 weeks now and this blood test says your libido level is up to eleventeen mmol/L from a low of forty-threeve”. Alas, all cases are subjective and unique, requiring discussion, education, and support for the journey to improved mental-health. Medications that were once seen as ‘the answer’ are now better recognized for what they are: complements to a patient-centred approach.

A good friend of mine offers a counter-point that deserves mentioning. On the topic of objective metrics, he says:

“Of course I’d argue that for other areas of medicine people look to the surrogates too quickly, being fooled by them as being accurate indicators of “clear sailing” (a good blood test) or doom (a bad blood test). With medications for mental illness it is what the patient experiences that matters. We can get feedback from the suitability of treatment pretty quickly, from symptom management, progress toward personal goals and recovery, treatment tolerance and side effects, etc. You can’t get that from a statin or diabetes medication. You can only hope that you are the one to see the measurable benefit vs. all the others who took it and didn’t need to, or took it and still had the thing they were trying to avoid.”

Having said that, pharmacists are often the first point of contact when patients are seeking help with their experiences and may provide opportunity for early intervention. A recent article in the Capital Beat – June 2013 (http://www.cdha.nshealth.ca/media-centre/news/more-meds-pharmacists-and-communities-partner-better-mental-health) outlined the MoreThanMeds project. Dr. Andrea Murphy, one of the co-founders of the project, captures the opportunity by stating, “Pharmacists are often underused or are not working to their full scope of their practice when providing services for individuals living with mental illness. (They) are well positioned to help individuals with lived experience of mental illness, and especially those who often have difficulty getting the right care at the right time.”

<…the right care at the right time…> This phrase really makes you think. Those with longstanding mental illness will report feeling ostracized, or judged, or helpless. Depending on the day, there may be a brief window of opportunity for an individual to be receptive to conversation. Many days this may not be the case, however knowing the pharmacist is available can help build up that trust.

I’m only beginning this journey, but so far it’s been extremely rewarding to scope out community mental health resources from a consumer point of view. I can’t wait to share my experiences with other pharmacists; we can be much bigger part of the collaborative mental health team in the communities we serve.

I aspire to be More Than…a conventional community pharmacist when it comes to mental health support for patients and families…much more.

Disclaimer: The views and opinions expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of any agency, employer or affiliation.