In an effort to enhance patient adherence and seek early intervention for mental health conditions, Medication Support Services (MSS) now extends its support to cover antidepressant medications. Despite patients with severe and persistent mental health issues often being prescribed new medications, none of the 16 areas covered by MSS address mental health conditions.
Encouragingly, in 2021, the College of Psychiatric Pharmacists was tasked with providing clinical support for the development of the antidepressant section of this service—I am a member of the working group. While the reasons for the significant delay in including antidepressants remain unclear, we aim to ensure its effective support for patients and pharmacists, going beyond symbolic inclusion.
Building Pharmacists’ Confidence
To ensure flexibility and appropriate patient follow-up, adjustments to service standards are necessary. One of the primary concerns surrounding the introduction of antidepressants into MSS is the lack of confidence among pharmacists when consulting with patients about depression. The fear that patients may open up about self-harm and suicidal feelings creates a challenge for pharmacy staff, highlighting the need to support patients while acknowledging the difficulty for staff.
Recent studies indicate that pharmacists lack confidence in dealing with mental health patients, and their knowledge is not significantly higher than that of the general public. There is room for improvement in providing assistance to pharmacists.
The introduction of MSS has been met with hesitancy, and despite the working group’s efforts in building confidence, more work is required. It is crucial to ensure that pharmacists approach discussions about antidepressants with the same confidence as they would discussions about antihypertensive or anticoagulant medications.
Controversy Surrounding Antidepressants
Pharmacists’ confidence has not been aided by the explosive growth in antidepressant prescriptions, controversies surrounding their efficacy, and increasing evidence of withdrawal. The situation indicates that pharmacists need to support new patients taking antidepressants, especially as patients express doubts about the appropriateness and long-term effects of their treatment, particularly since the pandemic.
These concerns highlight the need for pharmacy staff to enhance their knowledge in this area. Rather than allowing these gaps to impede crucial conversations, they should drive us towards more robust training and education around mental health. With the development of antidepressant Medication Support Services, we hope to leverage existing resources and bridge these gaps. Once these discussions become a part of everyday practice, we can address a broader range of mental health issues.
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