Page 59 - Retail Pharmacy Assistants - October 2020

C ovid-19 has not been easy on the nation’s mental health, and it’s not as though it was looking too good before the advent of the pandemic, with one in five surveyed Australians reporting they had a mental or behavioural condition in 2017-2018. This is according to the ‘Australia’s health 2020’ report, with Scientia Professor Henry Brodaty from UNSW Medicine, an advisory board member of the Australian Institute for Health and Welfare, saying the expectation is that the impact of Covid-19 will lead to further increasing this proportion. “So, it’s more important than ever to publicly acknowledge mental health and those that work in the sector through the Australian Mental Health Prize,” he said, referring to the annual award to an Australian who has made outstanding contributions to either the promotion of mental health, or the prevention or treatment of mental illness. With the efforts of mental health experts and teams around Australia being acknowledged, including Swinburne University’s contributions, pharmacists are ideally placed to offer valuable support services. This work has been aided by the signing of the 7CPA in mid-June, delivering $1.2 billion in ongoing funding for patient-focused pharmacy programs that will provide greater access to pharmacists and support the safe and quality use of medicines for all Australians. Changes to medicines management programs in the agreement enable the maintenance of a cycle of care approach, including patient follow-up, to support quality and safe use of medicines, particularly for older Australians, as well as an opportunity for significant policy reforms, particularly in the areas of aged care and mental health. According to Mark Webster, owner of Stay Well Pharmacy in Christchurch, New Zealand, pharmacists and their assistants are ideally aligned at the frontline to help people with mental health challenges or spikes. Mr Webster tells Retail Pharmacy Assistants that people are “really” struggling through the pandemic “in various degrees”. “I think sometimes it just comes down to asking a patient ‘how are you feeling today?’ and ‘how have you been getting through this rough time?’ “It’s not just about asking ‘how are you generally?’ because we’re preprogramed to respond with ‘I’m fine’. “Crises affect people’s immune systems and hypothalamic-pituitary- adrenal axis, which centres around the fight-or-flight response, so there’s a lot to it, but just asking the right questions can be massively therapeutic in combination with recommended supportive nutrition.” Mr Webster anticipates that in the coming months a “massive level” of undiagnosed post-traumatic stress disorder will be evident. “It’s not just about those people who’ve lost their jobs or lost their companies,” he said, “but also the people who’ve had to stay housebound for weeks, and people like myself that still have to work under massively different conditions. It’s all taking its toll. “And while pharmacy teams are ideally suitable to be in the frontline, they might not always be equipped in terms of the next step of referring people correctly. “I’m concerned that if people are referred to GPs then treatment could be an antidepressant or the like, which I don’t believe is the answer for many of these conditions.” MENTAL HEALTH 57 Mental health not a straightforward business Greg Murray, Professor of Psychology at Swinburne University, tells Retail Pharmacy Assistants that mental disorders have varying degrees of severity, but that their influence is far reaching on patients and families concerned. “Pharmacies are in a prime position to engage and support people with mental health problems, because they can just drop in without an appointment,” he said. “The stigma of mental health issues drops away here because people go to see pharmacists for many reasons, with mental health being just one of them. “Their role is also prime because doctors and psychiatrists who prescribe mental health medication often just don’t have the time to answer all the questions a patient may have. In fact, the GP or the psychiatrist may not even be able to help the person clarify what their questions are.” Medication framework Professor Murray says it’s important that patients are prescribed a framework for thinking about their medication. He says questions that come to the fore include: • What type of medication is this? • How does it compare to other medication? • What are the possible interactions with other medications? • What are the pros and cons of taking this medication? • What’s the evidence for this medication? • How common are its side effects? • Does everyone with bipolar disorder take lithium or do some people have mixed feelings about it? “Even a question and answer session wouldn’t be adequate,” he said. “What’s required is an extended discussion, with GPs and psychiatrists not even having enough time for a question and answer session.” Multiple medications Professor Murray says multiple medications accompany “serious” mental disorders, which is an area that the university focuses on. Patients with schizophrenia and other psychotic disorders, bipolar disorder and severe depression are typically on TO PAGE 58 “It’s not just about those people who’ve lost their jobs or lost their companies, but also the people who’ve had to stay housebound for weeks, and people that still have to work under massively different conditions. It’s all taking its toll.” Meanwhile, to support Victoria as it contends with further Covid-19 restrictions, the federal government announced an additional $31.9 million in funding for 15 mental health clinics across the state, and to further expand available mental health support services. The funding will establish the dedicated mental health clinics at existing health centres in the community, providing access to on-site support and referrals through a multidisciplinary team of mental health workers including psychologists, mental health nurses, social workers, and alcohol and drug workers. Six of these clinics will be in regional areas. RETAIL PHARMACY ASSISTANTS • OCT 2020