Improving mental health is a priority and the focus of national strategy in Scotland. This policy document describes how pharmacists can improve care for people with mental health conditions and makes six recommendations to enable enhanced roles for pharmacists.
Access to pharmacological and non-pharmacological therapies is critical to the effective and safe management of mental health conditions, yet timely access could be improved. Conversely, it is recognised that people are prescribed medicines for some conditions, e.g. anxiety and depression, for longer than is necessary and this must change.
Increasing numbers of pharmacists working within mental health services and GP practices are using prescribing skills to manage conditions by initiating, reviewing and reducing medication as part of the multidisciplinary team.
Many of the medicines used to treat mental health conditions are complex and associated with acute and chronic health risks and therefore require frequent blood and physical health monitoring, e.g. clozapine and lithium. Side effects vary from mild and short term to long-term and significant for some medicines. Improvement is required in monitoring and follow up to avoid and minimise the impact of medicines on physical health.
Pharmacists’ expertise in medicines could be better harnessed through new approaches to minimise and manage these risks in order to deliver safer care for people with mental health conditions. We have listened to our members, patients, patient representatives, pharmacy teams and other health care professionals and have gathered evidence of best practice and set out recommendations in this policy document that will make a real difference to improving care if implemented.
The expertise, clinical knowledge and accessibility of pharmacists across the NHS should be better used within multidisciplinary teams to support people with mental health conditions to help them live longer and healthier lives.
One in three adults in Scotland experience mental health conditions in their lifetime. People with a life-long mental health condition are likely to die 15-20 years prematurely because of poor physical health, 1 much of which is preventable with improved patient care and risk management.
The Scottish Government’s Mental Health Strategy 2017- 2027 has a vision of a Scotland where people can get the right help at the right time, expect recovery, and fully enjoy their rights, free from discrimination and stigma.
RPS Scotland has undertaken a review of pharmacy involvement in mental health and believes that better use of the pharmaceutical care* expertise and skills of pharmacists, better resourcing of existing services and commissioning of new models of care could help to realise the aims and ambitions of the strategy.
Our policy recommendations are aimed at key stakeholders tasked with implementing Scotland’s mental health strategy and primary care transformation, and individual practitioners who have collective responsibility for ensuring they provide the best possible pharmaceutical care for people with mental health conditions.
Pharmaceutical care is a holistic practice which aims to provide the right patient with the right medicines in the right dose at the right time for the right reasons to achieve agreed outcomes. Medicines should have an active indication and be as effective and as safe as possible.