Future models for mental health pharmacy

Future models for mental health pharmacy

Increasingly, secondary care mental health services are moving towards a brief intervention model with expectation of follow-up in the community by any one of an assortment of community-based teams. For those admitted to crisis teams or acute wards discharge back to more homely settings will be at the first opportunity and with only partial treatment.

As described earlier, full response to treatment may take some time but the sedative effective of medicines may allow early discharge of a still largely unwell person back into the community. Except for the period as an inpatient, the supply of medicines will almost exclusively come from the community pharmacy. Traditionally this supply of medicines has provided a demarcation of responsibility for the pharmacy profession.

However, with the development of clinical pharmacy, the expectation is that the community pharmacist will have a greater clinical responsibility for the medicines provided and the patient with mental health problems may access four services that relate to medicines and where enhanced pharmacy services could have a direct impact on the medicines prescribed. These are:

1. the community pharmacy

2. the GP

3. the community mental health team

4. the acute/crisis services of the MHT or equivalent.

In addition to the current hospital-based services, what might work better is dedicated mental health specialist pharmacists or technicians using one of the following models:

·      employed by community pharmacy chains whose role is to achieve the above in liaison with secondary care

·      employed by GP practices who, in addition to undertaking roles relating to mental health within the GP practice, develop the role of the community pharmacies that service the practice

·      employed by MHT community teams who, in addition to undertaking roles relating to mental health within the community team, develop the role of the community pharmacies that service the team’s catchment area.

Whatever model develops, the requirement for well-trained mental health pharmacists and technicians to ensure medicines are used well in mental health and LD and to provide support for patients with their medicines will remain.