How Pharmacies Can Better Support Employees Living with Serious Mental Illness

Pharmacies, whether community-based, hospital-affiliated, college-run, or in other settings, are high-pressure workplaces where employees are expected to juggle multiple responsibilities—such as dispensing medications, administering immunizations, handling patient interactions and, increasingly, performing clinical services like point-of-care testing. These demands have only grown since the COVID-19 pandemic, leading to widespread burnout among pharmacists and technicians.¹ For employees living with serious mental illness (eg, bipolar disorder or schizophrenia), the pharmacy work environment can be especially challenging.

Burnout, stigma, and insufficient mental health support are persistent issues across many professions, and pharmacy is no exception; however, there are real, concrete steps that pharmacy employers can take to foster a more inclusive, supportive workplace.

The Reality of Burnout in Pharmacy Workplaces

Image credit: tadamichi | stock.adobe.com

Burnout among pharmacists isn’t new, but the pandemic transformed a chronic issue into a full-blown crisis.¹ Staffing shortages and mounting responsibilities have left pharmacists stretched thin, with little room to breathe. In many community pharmacies, staffing shortages make it nearly impossible for pharmacists to take breaks, often necessitating working through lunch because there isn’t enough coverage to close. Unfinished tasks can pile up from one day to the next, contributing to an endless cycle of exhaustion.

The good news is that this issue isn’t without solutions. Addressing burnout isn’t just about employee well-being; it’s about ensuring safer, higher-quality patient care. In any workplace, elevated levels of employee burnout can lead to a higher rate of errors. In this profession or across health care, mistakes can have consequences related to the outcomes we all strive for.

Many employers have introduced wellness initiatives in an effort to support their teams, but these efforts don’t always fully address the workload and resource challenges that contribute to burnout. Conversations about self-care and resilience are valuable, but to be truly effective, they must be paired with meaningful changes in workplace policies. Beyond internal workplace improvements, public understanding of pharmacists' responsibilities is also crucial.

A recent National Association of Boards of Pharmacy task force report highlighted the need to educate patients on the services pharmacists provide, helping to set realistic expectations and reduce unnecessary stress. The task force recommended a broad coalition of professional pharmacy organizations develop a public service announcement to better inform the public about pharmacists' workloads and contributions.² Such efforts could ease some of the external pressures that contribute to burnout, creating a more sustainable work environment. If pharmacies want to create a healthier work environment, reevaluating staffing levels, workloads, and job expectations can help ensure that wellness isn’t just a talking point, but instead, a sustained priority.

The Persistent Stigma of Serious Mental Illness in Pharmacies

The challenges facing the pharmacy profession have been well-documented.³ Compared to workers in other industries, health care workers have a higher prevalence of any mental illness.⁴ Those working in this environment while living with serious mental illness face additional layers of complexity. While societal conversations around mental health have improved, serious mental illnesses, such as bipolar disorder and schizophrenia, remain deeply stigmatized, even within health care.⁵ Pharmacists routinely dispense medications that help people with these conditions manage their symptoms, yet, stigma can still prevent pharmacy employees from seeking help for themselves. In pharmacy workplaces, employees may fear that disclosing a serious mental illness could lead to judgment, misunderstanding, unwanted scrutiny, or even professional consequences, discouraging them from seeking help when they need it.⁶

Effective treatment options for serious mental illnesses exist. As experts in pharmacotherapy, pharmacists are trained in and knowledgeable about the clinical impact of a wide range of medications, including oral treatments as well as long-acting injectables; however, stigma continues to be a major barrier, not just to treatment, but to open conversations about mental health in pharmacy workplaces.

Mental illness should be treated like any other diagnosable, treatable health condition. When a pharmacist calls out sick with the flu, no one questions it. But when someone needs time off for their mental health, they often feel pressure to conceal the real reason. Instead of saying, “I need a mental health day,” they say, “I’m not feeling well.” Not because they want to, but because they may fear how it will be perceived. A study conducted in the UK showed how common mental disorders are the leading cause of workplace absences.⁷ There shouldn’t be a difference between waking up with the flu and waking up unable to get through the day because of a mental health condition. In either instance, appropriate treatment provides an optimal path to recovery, particularly when complemented by psychosocial and interpersonal support.

Medical professionals should, in theory, be the most understanding, but oftentimes, they reinforce this stigma. For those of us who work in health care, we have all likely experienced the unspoken expectation that we should be tough enough to push through any perceived personal struggles. The belief that medical professionals must always be composed, always capable and always in control makes it even harder for those struggling to admit they need help. In pharmacy school, students are taught to be resilient, adaptable, and efficient, but rarely are they taught that prioritizing their own mental health is just as important as caring for their patients. This “tough it out” culture starts early and follows many professionals throughout their careers, reinforcing the stigma that seeking help is a sign of weakness.

In my workplace, mental health struggles are openly acknowledged and accepted. I work in a psychiatric hospital where everyone—from pharmacists, to technicians, to clinicians—understands that mental health challenges are just a part of life. When one of us is going through something, we talk about it, we share, and we support each other. No one feels the need to hide what they’re dealing with; but I know that many workplaces don’t operate this way. In too many places, the expectation is still to stay silent, to push through, and to pretend everything is fine, even when it’s not. If pharmacy employers want to support their staff, they need to take the lead in normalizing mental health conversations. Employees should feel just as comfortable taking a needed day for a mental illness as for a physical one. Without real structural change, stigma will persist, and pharmacy employees will continue to feel unsupported.

The Role of Mental Health First Aid in Pharmacy Training

If pharmacies are serious about supporting mental health, Mental Health First Aid (MHFA) should be a standard requirement, just like CPR. A 2018 survey of 225 community pharmacists revealed that 77% were not aware of MHFA training, and only 6% had completed it. Seven years later and MHFA training is still not universally adopted across pharmacy education and practice.⁸ Pharmacists are trained to handle medical emergencies, yet most receive no formal education on recognizing or responding to mental health crises. This gap leaves employees unprepared to support struggling colleagues or intervene when a patient is in distress.

MHFA equips pharmacists with the tools to recognize early warning signs of suicide, psychosis, and mania. More importantly, they teach pharmacists how to respond appropriately. Right now, some pharmacy schools require this training, but many do not. That inconsistency needs to change. Every pharmacist should know how to recognize when a coworker is struggling, how to ask the right questions and what steps to take next.

Pharmacists also need better awareness of crisis resources like 988, the mental health emergency hotline. Too many people—even within health care—don’t even know it exists. If a patient or colleague is in crisis, pharmacists should immediately know how to connect them with help.

It would send a strongly supportive message to the industry if pharmacy licensing boards and accreditation bodies took the lead in requiring MHFA as part of continuing education. Doing so would issue a clear stance that mental health is equally important as physical health and would ensure that pharmacists aren’t expected to "figure it out" when a crisis arises but are actively prepared to help. Just as pharmacists have been trained to administer vaccines—something that wasn’t routine years ago—MHFA should become a standard part of pharmacy education and workplace training. Additionally, large pharmacy chains and independent pharmacies alike should incorporate this training into their onboarding process.

Making this a mandatory part of professional development would ensure that pharmacists are equipped to handle mental health crises, with real-world implications and practical effect. For example, in a recent co-teaching session, a psychiatrist colleague noted that some of the most impactful calls he receives are from pharmacists alerting his office when a patient appears to be struggling. Enhancing training in the identification of mental health symptoms and effective triage not only bolsters pharmacists’ confidence, but also fosters clearer communication with provider offices, ultimately leading to improved patient outcomes.

How Pharmacies Can Support Employees with Serious Mental Illness

There are policies that pharmacy employers can proactively incorporate to foster a workplace culture that supports employees with serious mental illness. As previously mentioned, employees should feel that employer-sponsored personal time may be appropriately taken for mental or physical illness, and that either need is legitimate without fear of judgment or professional repercussions.

Beyond allowing time for medical appointments or personal recovery, pharmacies can strengthen their commitment to mental health by ensuring meaningful support through standard employee benefits. Employee Assistance Programs are an important starting point, providing initial counseling sessions and resources; however, for employees managing serious mental health illnesses, short-term support may not be enough. Expanding access to ongoing mental healthcare—whether through additional counseling sessions, specialized provider networks, or comprehensive wellness programs—can make a lasting impact and help close the gap for the millions of adults and youth in the US who still lack parity in insurance coverage for mental health and substance use services. Currently, approximately 10% of adults and 8.5% of youth with private insurance still do not have mental health coverage,⁹ underscoring the urgent need for more equitable access to care.

Mental health benefits are a valuable resource, but true well-being is also shaped by workload and workplace expectations. When employees face unrealistic demands, chronic understaffing and relentless pressure, even the best wellness initiatives can only go so far. Recognizing when workloads may be contributing to burnout, and proactively addressing those challenges, can make a meaningful difference. By ensuring staffing levels are adequate and expectations are sustainable, pharmacies can create an environment where employees feel supported both mentally and professionally. While many of the challenges facing the profession extend beyond individual businesses, each employer has an opportunity to foster a healthier, more balanced workplace.

Reducing stigma, improving mental health benefits, and addressing workload concerns all need to happen simultaneously. For employees to thrive, employers must consider how workplace expectations, resources, and support systems contribute to overall well-being. Prioritizing mental health alongside physical health fosters a sustainable workplace—one that benefits employees, enhances patient care, and strengthens the profession as a whole.

REFERENCES

1. Coelho E, Amaral AP, Rocha C, Cruz R, Brito-Costa S. Burnout in Pharmacy professionals during COVID-19 outbreak. Acta Biomed. 2022;93(6):e2022281. Published 2022 Dec 16. doi:10.23750/abm.v93i6.13386

2. National Association of Boards of Pharmacy. Report of the Task Force on Pharmacist and Pharmacy Personnel Mental Health and Well-Being. NABP; April 2024. Available at: https://nabp.pharmacy/wp- content/uploads/Report-of-the-Task-Force-on-Pharmacist-and-Pharmacy-Personnel-Mental-Health-and-Well-Being.pdf

3. Wash A, Moczygemba LR, Brown CM, Crismon ML, Whittaker TA. A narrative review of the well-being and burnout of U.S. community pharmacists. J Am Pharm Assoc. 2024;64(2):337-349. doi:10.1016/j.japh.2023.11.017.

4. Skillman SM, Snyder CR, Frogner BK, Patterson DG. Mental and Physical Health Status of U.S. Health Care Workers: Results from the National Health Interview Survey. Center for Health Workforce Studies, University of Washington; 2024.

5. Knaak S, Mantler E, Szeto A. Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthc Manage Forum. 2017;30(2):111-116. doi:10.1177/0840470416679413

6. Brohan E, Henderson C, Wheat K, Thornicroft G. Workers' perspectives on workplace disclosure of serious mental illness: a qualitative study. J Occup Rehabil. 2012;22(4):451-460. doi:10.1007/s10926-012-9366-4.

7. Gray NS, Davies H, Brad R, Snowden RJ. Reducing sickness absence and stigma due to mental health difficulties: a randomised control treatment trial (RCT) of a low intensity psychological intervention and stigma reduction programme for common mental disorder (Prevail). BMC Public Health. 2023;23(1):1324. Published 2023 Jul 10. doi:10.1186/s12889-023-16200-x

8. McKee J, Mospan CM, Benfield M, Gillette C, et al. A call for community pharmacists to complete mental health first aid training. J Am Pharm Assoc. 2019;59(2):167-169. doi:10.1016/j.japh.2018.12.012.

9. Mental Health America. The state of mental health in America. Mental Health America. Published 2024. Accessed February 26, 2025. https://mhanational.org/issues/state-mental-health-america