Mental Health First Aid Training for Pharmacists and Support Staff, Stigma Reduction in Pharmacy Settings

In an interview with Pharmacy Times, Hannah Fish, PharmD, CPHQ, discussed NCPA's Mental Health First Aid program which trains pharmacists and staff to recognize signs of mental health crises. Fish focused on how pharmacists can benefit from the training and ways to raise mental health awareness. She addressed common misconceptions about mental illness, along with strategies to reduce stigma. Pharmacists were encouraged to look out for changes in patients and start caring conversations about mental health.

Can you describe NCPA's Mental Health First Aid program, and the aim behind the program?

The Mental Health First Aid training that NCPA offers is actually created by the National Council for Mental Wellbeing. We are one entity of many that offers the course. But it's an 8-hour training program focused on helping individuals recognize the signs and symptoms of mental health crises and equipping learners with the tools to respond in those situations. The Mental Health First Aid training is really designed to equip any person, any layperson—but from NCPA standpoint, pharmacist, and our support staff to be able to recognize signs and symptoms of mental health crises. Similar to how you would get trained to provide basic life support or CPR, that's what this course aims to do for mental health issues.

Key Takeaways

Mental Health First Aid training equips pharmacists with skills to recognize signs of mental health crises and support individuals.
Reducing stigma involves mindful language use focused on recovery rather than lifelong illness.
Pharmacists and staff play an important role in mental health by asking open-ended questions, noticing changes, and providing a safe space for patients.

The Mental Health First Aid training course I love it, because it's an 8-hour program, and you learn a little bit more about specific disease states in terms of recognizing some of these mental health crises. We focus on anxiety and depression — we cover a little bit of signs of psychosis. But we also drill into some suicidal thoughts and how you can help with individuals that might be experiencing those thoughts or behaviors and really help you practice, it's really like an applicable course for you to test out and try skills. Especially around some of these really hard conversations, it's equipping you with some of the tools to be able to step up and assist in a situation. I really love the hands on nature. The courses are also in small cohorts, so you really create a bond with your other classmates, to be able to share your own personal stories if they feel comfortable. But really learn from each other and their lived experiences and their shared experiences, both personally and professionally in the workplace.

Timestamps

0:00:11 - Description of the Mental Health First Aid program
0:01:01 - How pharmacists and technicians can benefit from the training
0:01:05 - What the training covers to help respond to mental health episodes
0:02:22 - The ALGEE action plan taught in the training
0:04:17 - Ways for pharmacists to raise awareness during Mental Health Awareness Month

What does the training cover that could better prepare pharmacists when responding to a mental health episode?

Absolutely. So, in addition to learning about some of the disease states and the signs and symptoms, we equip the trainees and the learners with something called the allergy action plan. That action plan is an acronym for how you can engage if you notice that someone might be experiencing some sort of mental health crisis or signs and symptoms. That goes into how do you approach someone? How do you maintain awareness of the situation going on? It equips you with some tools about how to listen to someone that might be experiencing some signs and symptoms. And really one of the biggest focuses, so our G in the algae is giving hope and reassurance and giving information. When we think about mental health disorders or diseases, sometimes we categorize them as maybe some lifelong issues, right? We talked about how you have physical ailments. You might have a broken arm, and there's hope for recovery with a broken arm, right? It's a couple of weeks in a cast in some physical therapy. But what does that look like for mental health. So, we really focused on the giving hope piece for people that might experience mental health issues. Then our E in the algae acronym is about encouraging both professional health and self-help. So, we equip the learners also with a training to let them know who they can reach out to or what they can encourage from all sides of the spectrum in terms of elevating care if needed, or just providing some general tips for how they can take care of themselves.

So first off, NCPA is offering the Mental Health First Aid training on May 1. I encourage anyone to sign up for that program. I don't know if it'll this video make it in time to promote that, but the course I should say is offered in nearly every community across the United States. If you haven't been trained in Mental Health First Aid, look for a course near you because there might be an opportunity for you to get trained during the month of May. But what else I would suggest doing is even a simple sign on your door or on your pharmacy counter just to say certain questions like "Have you been feeling down lately? Talk to a pharmacist." Or "Ask me about your mental health. I'll be happy to talk to you about that." Something so simple is just asking those questions. Especially in community pharmacy, a lot of our technicians are the ones that are at the frontline, the first interaction that a patient may have, if it's not the pharmacist and they know their patients, they know their communities. They really experience when someone might have a change in disposition or mood or might know that someone lost a family member or a friend. They might be able to have those deeper conversations to really ask rather than how are you doing and accept the answer of being fine or okay. But really ask them to go into that a little bit more. And just broach the question of how you are really doing, we're here to talk if you need someone. Just creating that openness and being mindful that there might be those changes in situations and in their patients that they see all the time. It's sometimes just that matter of noticing and asking the question, especially during this month, and creating that awareness, but just having that hyper focus to say, how are you doing today?

As May is Mental Health Awareness Month, how can pharmacists raise awareness for individuals living with mental or behavioral health issues?

What are common misconceptions when it comes to mental health, and how can we combat those stigmas?

Oh, my goodness. So many stigmas that we'd love to talk about and combat, if you will, during this course. With mental health to begin with, and I alluded to some of it is that recovery is possible. That's one of the big misconceptions is that if you have a mental health disorder diagnosis, that you essentially have that for the rest of your life, and that's not necessarily true. As much as 1 in 5 Americans, I believe, maybe it's closer to 1 in 4 experienced some sort of mental health issue in their lifetime. But that might be one panic attack, at one point in their life during a really stressful situation. But that doesn't mean that they have panic disorder. And that doesn't mean they're going to have panic attacks for the rest of their life. I think combating that stigma around who has mental health disorders and whether that is a lifelong chronic disease that they have to deal with. I think some of the other stigmas is just the language that we use — we talk about someone being crazy, or someone being psycho. If you can really watch your terminology and how you talk about things in general, but especially around people is trying not to use those stigmatizing labels, is another way to be mindful. The other big one, too, and we talked about suicide, for example is, I talked about this in the course, is we tried to change the phraseology to say someone died by suicide, like the cause of death was a heart attack or someone died from a car accident, right? When we use the stigmatizing language of someone committed suicide that makes it sound successful, or like something to be encouraged or positive. We really just try to acknowledge where our terminology and our language can be flipped around. Using that person first language, it's someone with anxiety, not an anxious person or a depressive person. Those are some of the tips and tricks to think about and watching out for, especially during Mental Health Awareness Month.

70% of Americans with depression are in the workforce and 35 million workdays are lost every year due to mental illness. What are common symptoms that peers can identify that could lead to seeking support for the individual?

Depression can show up in a lot of different ways for various different individuals. It's really important to look at a couple of different factors. In the course we definitely talk about any changes in your thoughts, feelings, behaviors, and appearance. Anything like showing up late to work more often than not when you've previously been on time. So, that change in pattern. Someone who's normally perfectly manicured, and all of a sudden is not doing their hair, their makeup or some of those little things, those noticeable things. But sometimes even the thoughts and feelings too. If you notice someone's being more spacey while they're at work and maybe not as focused as they once were before, if they talk about being tired all the time and having low motivation — all of those different things can add up. But I would really emphasize those 4 areas. Anything that you notice that the change in their thoughts, feelings, behavior, or appearance are potentially a flag to look for, at least engaging in a conversation to see what might be going on.

One of the best things that I would say about the Mental Health First Aid course and mental health engagement in general and asking your patients and really being that front line person is that a lot of mental health disorders and signs and symptoms, while they may be outward appearing, in some cases, they're often happening in the dark. It's very isolating for some patients that are experiencing that. Not only patients but some of even our own pharmacists and our technicians that are working, who may be burnt out or under pressure and whatever it may be happening in their lifetime, right? We're in the workforce. We're humans too, right? We're taking care of patients, but we have our own issues. I would say really just emphasize asking the question about how someone is doing because if you don't ask the question, then someone's going to continue suffering in the dark and so what we want to do is shine a light on that situation.