Providing personalized patient care; how independent pharmacies can address mental health  

Why pharmacists?

Retail pharmacists have a unique opportunity to make a significant impact on the mental health of their patients.USA Today analysis of Medicaid data showed that mental health-related prescriptions rose further in 2022, up 12% from 2019, outpacing the less than 1% growth in overall prescriptions ⁱⁱⁱ.

As a pharmacist, you are in the unique position of interacting with patients face-to-face, on a very personal level and on a regular basis without the need to schedule appointments. And, it’s proven that your personalized care as an independent pharmacist builds a level of trust with patients. In fact, according to a consumer research study we conducted last year, 52% of people turn to their pharmacist as their trusted source for advice. But building trust within the mental health space can be challenging; it is imperative to watch for changes in the physical demeanor of a patient as a warning sign of mental health issues. 

Bridging the gap between diagnosis and treatment

 
As an independent pharmacist you know your customers on a personal level and understand their personal struggles. This makes you perfectly equipped to treat a patient in the most vulnerable position in his or her mental health.

“Being in regular contact with their patients allows independent pharmacists to easily recognize any changes in behavior or personality, which could be indicative of underlying mental health issues,” Good Neighbor Pharmacy Director Zackary Levine, PharmD, explains, adding, “This creates an advantageous position for early intervention and providing the necessary support and resources to ensure patients receive the care they need.”

Counseling on the medications utilized for mental health and walking a patient through how to administer and explaining the importance of adherence, is important. 

Dr. Levine points out, “In years past it was not common for pharmacists to administer long acting injectables to patients in a retail setting; however, in recent years this is becoming a lot more common.”

That said, treating patients with mental health disorders – especially anxiety – can be tricky. For example, trypanophobia, the fear of getting poked with a needle, is a certain type of anxiety-driven phobia that can impact in-pharmacy care, such as immunization delivery, testing and administering long-acting injectables, which are services pharmacist can provide to patients to address this fear.

Here are some tips from Dr. Levine on how to create a welcoming environment for anxious patients:

• Ensure that the physical location is inviting and comfortable – a calm and clean atmosphere, soothing background music playing throughout the store, comfortable seating areas, and appealing lighting are all examples on how a pharmacy can create a welcoming environment.
• Provide private consultation areas for one-on-one conversations between the pharmacist and the patient to build trust. “During the conversation if I were to determine products were needed from over the counter, I would walk the patient to the product, help them select the product(s), and then bring them to the register to checkout myself. This is a strong way to show care for the patient and build a trusting relationship,” he says.
• Train and coach the staff on a regular basis to be empathetic, understanding, and non-judgmental during every patient interaction. Fostering a culture of compassion, respect, and confidentiality can go a long way in making patients feel comfortable and supported in your store.

Additionally, AmerisourceBergen’s Director of Clinical Pharmacy Services Gold Eneyo, PharmD. suggests ensuring your team attends training on caring for patients with mental illness. In addition to caring for these patients, she also recommended attending training from the association of autism and neurodiversity to successfully provide care for patients who may be neurodivergent. 

"Pharmacies who attend these trainings are given strategic tools to care for these patients. This population is often overlooked or requires a little more time and care, and pharmacists equipped with the skills and tools to serve this population open up a new untapped patient base," she explains, adding, "To help reduce barriers to administration and missed doses, pharmacies should consider offering administration of long-acting anti-psychotic injectable medications to their patients. However, this is dependent on applicable state laws and regulations governing the administration of injectable products by licensed pharmacists."

Understanding revenue opportunities

Pharmacists can also offer specialized services such as mental health screenings, assessments, and referrals to mental health professionals when needed. Collaborating with healthcare providers to develop comprehensive treatment plans for patients with mental health issues creates better holistic care for the patient and strengthens the pharmacy’s relationships with the local providers. 

Educational outreach is key to success

To raise awareness among patients, especially those already seeking information and guidance in managing their mental health conditions, Dr. Levine suggests offering educational programs, workshops, and support groups focused on mental health topics, saying, “By diversifying their services and expertise in the field of mental health, pharmacists can not only improve patient outcomes but also create new revenue streams for their practice.”

Some suggested approaches include:

• Offering informative materials like brochures, pamphlets, posters, and flyers in the pharmacy. These materials can spotlight prevalent mental health conditions, their symptoms, and the resources available for support. By providing easy access to this information, patients can educate themselves without feeling hesitant to ask for help.
• Utilizing digital platforms such as social media, websites, and email newsletters to share educational content, resources, and tips on mental health to reach a wider audience and promote ongoing awareness. Collaborating with local mental health organizations, support groups, or healthcare providers to co-host educational initiatives can also strengthen the impact of educational efforts within the community.
• Proactively engaging in one-on-one conversations with patients during medication consultations or counseling sessions to discuss mental health topics, address any concerns, and provide personalized guidance. 

“Overall, by proactively engaging patients in conversations about mental health, providing accessible information and resources, and fostering a supportive environment, independent pharmacies can play a crucial role in raising awareness and promoting mental health literacy among their patient population,” Dr. Levine says.

Dr. Eneyo agrees, suggesting offering onsite screening tools like the PHQ-9 test. Pharmacists can start by integrating two or three questions at every visit to gauge a patient’s mental health status. This might help the pharmacist and patient understand the link between medication utilization (adherence) and a patient’s current mental status and help get them care when needed.

She emphasizes that pharmacists as healthcare providers in the community have a unique opportunity to help identify patients in need of mental health assessment early and connect them to a provider through referral system. 

“This is not currently a paid service, but pharmacists have been left out of the mental health space with reimbursement. With the connection, loyalty, and trust pharmacists have developed with patients in their communities, they can make a difference in the time to provide care and improve patient outcomes,” she says.

^{i. Mental Health Disorder Statistics. Johns Hopkins Medicine. Accessed May 10, 2024. https://www.hopkinsmedicine.org/health/wellness-and-prevention/mental-health-disorder-statistics
ii. About Mental Health. CDC.gov. Accessed May 7, 2024. https://www.cdc.gov/mentalhealth/learn/index.htm
iii. Mental health crisis fuels the post-pandemic rise in medication use. A USA TODAY analysis of Medicaid data.Accessed May 23, 2024. https://www.usatoday.com/story/news/investigations/2024/02/29/mental-health-related-prescriptions-rise-post-covid/72310337007/}