Saturday, February 2, 2019

#Lets Keep Talking - How Pharmacists can be Mental Health Champions

On January 30th, Bell Media held its annual #Let’s Talk event, an initiative meant to move mental health forward in Canada by fighting stigma, improving access to care, supporting research and promoting positive workplace mental health. While this year’s event has ended, I wish to continue the conversation and discuss how pharmacy professionals can work towards providing optimal mental health care. 

Quick Facts on mental illness and addiction in Canada:1,2,3

In any given year, 1 in 5 people in Canada will personally experience a mental health problem or illness.
  • Mental and physical health are linked. People with a long-term medical condition such as chronic pain are much more likely to also experience mood disorders. Conversely, people with a mood disorder are at a much higher risk of developing a long-term medical condition.
  • The disease burden of mental illness and addiction in Ontario is 1.5 times higher than all cancers put together and more than 7 times that of all infectious diseases. This includes years lived with less than full function and years lost to early death.

Being one of the most accessible health care providers, those in the pharmacy profession -pharmacists, technicians, and students - are well situated to address the key concerns that are faced by individuals who experience mental illnesses and addiction. Pharmacy professionals can improve patient care and reduce the stigmatization of those living with mental health illnesses through simple changes that can be seamlessly incorporated into everyday practice.

1) Use people-first language:
Firstly, what is people-first language? The definition can be derived from the term itself, people-first language refers to the individual first and the condition second. The concept behind utilizing people-first language is that the mental or physical health condition is only one aspect of a person’s life and not the defining characteristic. Although it may be at first awkward rephrasing to include people-first language, use of such syntax is important. Not only does it challenge the existing tendencies of the public to view and treat individuals with mental health illnesses in dehumanizing ways, but it also helps individuals with mental illnesses feel respected as human beings rather than labelled as “abnormal” or “dysfunctional”.4

For example:
Use “s/he has a diagnosis of schizophrenia” or “s/he has schizophrenia” rather than saying “s/he is schizophrenic”.

When referring to individuals who are diagnosed with substance use disorders, use terms like “s/he has an alcohol use disorder”, in place of “s/he is an alcoholic” and avoid the terms “abuser” or “abuse”. It has been shown that these terms can evoke automatic negative thoughts about individuals with substance-related problems.By using more neutral terms to lessen stigma surrounding alcohol and other drug use disorders, individuals with these conditions may be more likely to seek help, stay in treatment, and achieve long-term remission.

2) Promote community supports and resources:
 Community pharmacists may the most visible part of the healthcare system and an accessible source of local information. Pharmacy professionals are valuable not only for their expertise but also for directing people to other healthcare providers or services and programs. They can leverage their skills in engaging patients, and their position as one of the most trusted healthcare professionals to provide appropriate signposting for members of the community who may benefit from local mental health and wellness services and resources.

Having information on local mental health and wellness services displayed in a prominent place can be a simple way for pharmacists and pharmacy technicians to promote access to mental health services. To best address the specific needs of the community, it may be beneficial to incorporate healthcare services that are specifically designed for a particular population subgroup; for example, community pharmacies located near university/college campuses may wish to incorporate information on campus resources available for students.

A good starting step towards building the list of resources may be to visit the website for the local Canadian Mental Health Association branch.

Of course, individual efforts are only the starting point to change the landscape of mental health support in Canada, and as a professional body, we can advocate for the development and implementation of pharmacist-delivered interventions in mental health care. In the face of growing demand and continued pressure on mental health services, it is crucial to mobilize the pharmacy professional body to address and lessen the gaps in mental health and addictions systems across the country.

  1. Mental Health Commission of Canada. Accessed 09/07/2015.
  2. Ratnasingham et al. (2012). Opening eyes, opening minds: The Ontario burden of mental illness and addictions. An Institute for Clinical Evaluative Sciences / Public Health Ontario report. Toronto: ICES.
  3. Patten et al. (2005). Long-term medical conditions and major depression: strength of association for specific conditions in the general population.Canadian Journal of Psychiatry, 50: 195-202.
  4. Jensen ME, Pease EA, Lambert K, Hickman DR, Robinson O, McCoy KT, Barut JK, Musker KM, Olive D, Noll C, Ramirez J. Championing person-first language: a call to psychiatric mental health nurses. Journal of the American Psychiatric Nurses Association. 2013 May;19(3):146-51.
  5. Kelly JF, Dow SJ, Westerhoff C. Does our choice of substance-related terms influence perceptions of treatment need? An empirical investigation with two commonly used terms. Journal of Drug Issues. 2010 Oct;40(4):805-18.