The recent school shooting in Oregon has sparked a familiar conversation about mental illness in the United States.
 
In the aftermath of the tragedy, several 2016 presidential candidates—including Dr. Ben Carson, former Governor Mike Huckabee, and Donald Trump—attributed the shooting and others like it to the perpetrators’ mental illnesses.
 
These comments were met with ire from critics such as John Oliver, host of HBO’s “Last Week Tonight,” who rebuked the candidates for their eagerness to attribute gun violence to mental illness.
 
“The vast majority of mentally ill people are nonviolent, and the vast majority of gun violence is committed by non-mentally ill people. In fact, mentally ill people are far likelier to be the victims of violence rather than the perpetrators,” Oliver said during the show’s October 4, 2015, episode, citing a study from the Annals of Epidemiology and 2 other studies from the American Journal of Public Health. “The fact that we tend to only discuss mental health in a mass shooting context is deeply misleading.”
 
The misguided association between mental illness and violence has become commonplace among many Americans, according to Lisa W. Goldstone, MS, PharmD, BCPS, BCPP, an assistant professor at the University of Arizona College of Pharmacy.
 
“Violence and mental illness have become linked in many minds,” Dr. Goldstone told Pharmacy Times. “While there’s some increasing acceptance of disorders such as depression or anxiety due to greater awareness, there’s still a lot of stigma surrounding illnesses like schizophrenia and substance-use disorders.”
 
Pharmacists and other health care professionals are not free from these misconceptions, and this could potentially have a detrimental effect on their patients’ health, Dr. Goldstone added.
 
“I would say that the vast majority of pharmacists do not intentionally try to perpetuate these stigmas, but if they’re not particularly familiar with certain mental illnesses, they may treat these patients differently or be afraid to interact with them,” she said.  “If this happens, then patients may not be adequately treated for their other illnesses.”
 
Dr. Goldstone suggested that this problem results from a lack of adequate education or exposure to patients with mental health issues, and she advised pharmacy schools to provide students with greater opportunities to interact with mentally ill patients.
 
Perhaps the most important step pharmacists can take towards eliminating stigmas associated with mental illness is to examine the ways in which they think and speak of their patients.
 
“I teach my students that there should be no ‘ics’ among patients, that we shouldn’t define them as schizophrenics or alcoholics,” Dr. Goldstone explained. “We need to think of all of them as patients with diseases rather than diseased people, and refrain from using language or derogatory terms that would suggest otherwise.”
 
While she acknowledges that pop culture can often perpetuate stereotypes about mental health, she also believes it can influence the public’s awareness of the issue. She pointed to the recent Last Week Tonight segment as an example of how popular figures can address the stigmas associated with mental illness in a positive way.
 
“Mental health is a really tough topic for many to discuss, so it was very encouraging to see Oliver intermix humor into a very serious discussion without being derogatory or inappropriate,” she stated.
 
Dr. Goldstone emphasized that the segment should ultimately serve as a launching pad for a larger conversation about mental health and the way it is perceived.
 
“In the pharmacy profession, we need to make mental health a priority and put a greater emphasize on it when discussing chronic disease management,” Dr. Goldstone said. “Pharmacists can make a big difference in shaping attitudes towards disease states in their communities, and it would be good for us to advocate as a profession to ensure that we’re serving our patients with mental illnesses and providing them with the treatment that they need.”

The International Pharmaceutical Federation plans to publish a new report highlighting the pharmacist's role in treating patients with mental illnesses and filling gaps in mental health care in recognition of World Mental Health Day on October 10.