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Bridging the Gap: How Pharmacists Can Expand and Transform Mental Health Services

This expansion of their role goes beyond traditional dispensing duties, positioning pharmacists as an essential bridge between patients and the broader health care system.

Current practice paradigms in mental health care emphasize the necessity for a more integrated approach to the delivery of services, highlighting the evolving role of pharmacists as pivotal players in the mental health landscape. With the growing importance of mental health awareness, pharmacists are increasingly recognized for their accessibility and potential to contribute significantly to mental health care. Their expertise in pharmaceutical sciences and therapeutics enables them to guide patients on the safe use of psychiatric medications, monitor for potential drug interactions, and advise them on side effects, thereby playing a critical role in the treatment and management of mental health conditions.¹ This expansion of their role goes beyond traditional dispensing duties, positioning pharmacists as an essential bridge between patients and the broader health care system, enhancing the delivery of mental health care and promoting a more holistic approach to patient wellness.

PTSD Mental health concept, Psychologist sitting and touch hand young depressed asian man for encouragement near window with low light environment.Selective focus

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Despite significant progress in recognizing the importance of mental health, the US health care system often struggles to meet the demand for mental health services. Traditionally, pharmacists are viewed primarily as dispensers of medications, but they carry the potential to contribute greatly to mental health care. They are uniquely positioned to offer support through medication management and patient education. This evolving role not only enriches the traditional perspective of pharmacists but also represents a critical step forward in addressing the pressing challenges of mental health access for patients. For example, mental health screening in the community setting has been viewed as beneficial to patients with perinatal depression and thoughts of self harm.²

Furthermore, pharmacists would be pivotal in early detection of mental health symptoms and facilitating referrals to mental health professionals.³ This expanded role leverages pharmacists' accessibility and expertise in medication management and fills a critical gap in the health care system by offering a more integrated and accessible approach to mental health support. This evolution from a traditional to a more dynamic role in mental health care reflects a broader shift towards a holistic and patient-centered approach in services delivery.

Pharmacists' accessibility makes them easily available to patients in need. In community settings, pharmacists typically operate without appointment schedules, offering patients convenient access to advice on health issues and preventive care often without the need to first consult their general practitioners. Pharmacists could hence serve as an initial point of contact for patients in need of mental health support. Despite the stigma surrounding depression, which often deters patients from seeking treatment, there is a notable trend of patients openly confiding in community pharmacists about suicidal ideation, plans, and attempts.⁴ This highlights the significant role pharmacists play in providing a supportive and accessible avenue for mental health concerns.

Research further indicates that pharmacists have been effective in identifying individuals at high risk of depression, conducting assessments, and facilitating referrals to other health professionals, as appropriate,³ thus integrating pharmacists into suicide prevention frameworks. Importantly, however, additional mental health training crucial to ensuring the health and safety of patients.

In clinical practice, pharmacists have been proactive in supporting patients' mental health in a variety of ways.⁵ For instance, a study revealed that regular meetings between pharmacists and psychiatrists to implement benzodiazepine guidelines resulted in a significant reduction in daily dosage among the incarcerated.⁶ These collaborative efforts highlight the essential contribution of pharmacists in enhancing medication management and improving mental health outcomes across various health care environments.

Continued expansion of pharmacists’ mental health roles will face challenges. The foremost issue revolves around limited training opportunities, exacerbated by time constraints and regulatory limitations on practice. Current literature reveals that creating a mental health educational program for community pharmacy personnel is necessary.⁷ Demonstrating the effectiveness of such programs through evidence-based practices would be crucial for gaining recognition and support from regulating bodies, ultimately solidifying the importance of mental health in pharmacy education and practice.

About the Authors

Ariana Paras, Jamila Beckford, and Audrey White are all PharmD candidates at the Touro University College of Pharmacy in Vallejo, California.

Shane Desselle, PhD, is Associate Dean for Research, Department Chair, and professor at the Touro University College of Pharmacy in Vallejo, California.

In regard to education, addressing mental illness and suicide prevention is a significant focus in public health worldwide. The absence of these topics from pharmacy curricula may be a result of a broader lack of emphasis on public health education within pharmacy programs.⁸ This gap underscores the need for a more comprehensive approach to incorporating mental health topics into pharmacy. However, provided there's adequate training, regulatory support, and resource allocation, the future promises a pivotal expansion of pharmacists' mental health role. Empowered pharmacists will be well-positioned to provide essential services such as medication management, patient education, and bridging the gap between physical and mental health services, ultimately enhancing global mental health outcomes.

The evolving landscape of mental health care emphasizes the pivotal role of pharmacists in improving patient outcomes and addressing critical gaps in health care delivery. Recognized for their accessibility and expertise, pharmacists are increasingly positioned as integral members of interdisciplinary care teams, bridging the divide between patients and the broader health care system. Despite progress, significant challenges persist in pharmacy education and government recognition. If these factors are addressed, the future holds promise for pharmacists who wish to expand their mental health roles and facilitate connections between physical and mental health services.

Resources
1. Bell JS, Rosen A, Aslani P, Whitehead P, Chen TF. Developing the role of pharmacists as members of community mental health teams: perspectives of pharmacists and mental health professionals. Res Social Adm Pharm. 2007;3(4):392-409. doi:10.1016/j.sapharm.2006.10.005
2. Strowel C, Raynes-Greenow C, Pham L, et al. Perinatal depression screening in community pharmacy: exploring pharmacists’ roles, training, and resource needs using content analysis. Int J Clin Pharm. 2023;45(5):1212-1222. doi:10.1007/s11096-023-01647-0
3. Rubio-Valera M, Chen TF, O’Reilly CL. New roles for pharmacists in community mental health care: a narrative review. Int J Environ Res Public Health. 2014;11(10):10967-10990. doi:10.3390/ijerph111010967
4. Murphy AL, O’Reilly CL, Ataya R, et al. Survey of Australian and Canadian community pharmacists’ experiences with patients at risk of suicide. Psychiatr Serv. 2020;71(3):293-296. doi:10.1176/appi.ps.201900244
5. Richardson TE, O’Reilly CL, Chen TF. A comprehensive review of the impact of clinical pharmacy services on patient outcomes in mental health. Int J Clin Pharm. 2014;36(2):222-232. doi:10.1007/s11096-013-9900-y
6. Lerat MC, Cabelguenne D, Lassia J, Meunier F, Zimmer L. Impact of pharmacist and clinician dual intervention on prescribed benzodiazepines in prisoner patients: a retrospective study. Fundam Clin Pharmacol. 2011;25(6):762-767. doi:10.1111/j.1472-8206.2010.00902.x
7. May A, Fowler JL, Knox K, et al. Review of community pharmacy staff educational needs for supporting mental health consumers and careers. Community Meant Health J. 2014;50(1):59-67. doi:10.1007/s10597-012-9580-4
8. El-Den S, Collins JC, Chen TF, O’Reilly CL. Pharmacists’ roles in mental healthcare: past, present, and future. Pharm Pract (Granada). 2021;19)3):2545. doi:10.18549/PharmPract.2021.3.2545

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