Mental, Behavioral Health Issues Call for Creative Solutions

What if pharmacists could help prevent suicide? One Iowa pharmacy may have done just that. Kate Gainer, PharmD, executive vice president and CEO of the Iowa Pharmacy Association (IPA) shared her story during a presentation focused on creative mental and behavioral health solutions at the National Association of Chain Drug Stores Total Store Expo, held August 27 to 29 in Boston, Massachusetts, alongside Erin Shaal, PharmD.

“I [asked] a pharmacist to administer the [Patient Health Questionnaire-9] in a pharmacy in central Iowa. The results were that the patient was suicidal....Before the patient left the pharmacy, the pharmacist was able to contact a case manager... and get them on the phone as the patient was walking out the door. And the pharmacist was able to provide follow-up and make sure that that care linkage existed.”

In an ideal world, all pharmacists would be able to spot similar situations and provide appropriate care. In a country where 52.9 million individuals are living with mental illnesses, more solutions for screening for mental health—and helping patients cope—are desperately needed.

During their session, Shaal and Gainer presented a handful of creative solutions during their session that can help combat the current mental health crisis while providing the most acute care to patients struggling with mental illness.

Screening Questionnaires

Shaal, vice president, pharmacy procurement, specialty and patient care at Albertsons Companies, pointed out that questionnaires are a quick and easy way to measure a patient’s health. Pharmacists can use questionnaires to help identify mental or behavioral health issues that a patient is facing — and a simple questionnaire, administered when a patient is in the pharmacy for another service, can alleviate the stigma and create an avenue for a conversation about mental health.

Upstream Intervention

The goal of upstream intervention is fighting the problem at the source; in other words, working to figure out why so many individuals are facing mental health issues in the first place.

At the University of Iowa, medical students created an “upstream clinic” focused on social determinants of health (SDOH). Students working at the clinic would provide an SDOH questionnaire to patients to determine whether there were any needs related to food, transportation, legal services, or family issues not being addressed that could be affecting their health.

Using the results of the questionnaire, clinic staff were able to determine what kinds of help patients needed, other than the medical help they were at the clinic for. Staff then went on to fill those gaps by providing food, transportation, legal services, and much more.

Mental Health First Aid and Trauma-Informed Care

Just as CPR is needed if someone is having a heart attack, mental health first aid is needed when someone is having a mental health crisis. Mental health first aid is training to identify, understand, and respond to someone dealing with a mental health issue. Perhaps most important is that like CPR, this training isn’t just for pharmacists and pharmacy staff members; widespread mental health first aid training can help all of us take care of each other, Gainer pointed out.

Similarly, the goal of trauma-informed care is addressing patients or clients with the notion that they may be dealing with some form of trauma. Using the right language, and having the right tools under their belt, can help pharmacists more effectively communicate with patients who are dealing with trauma.

In the fight against the current mental health crisis, pharmacies and pharmacists help patients identify and cope with their mental and behavioral issues, it may just require a little bit of creative problem solving.

“I think that pharmacists should play a role in advocacy and support, and really be that front line,” Gainer said. “And recognition of the fact that there’s additional sources out there for them. There’s additional resources, there’s different health, there’s different education, that you don’t necessarily have to do it alone.”