Community pharmacy staff interactions with patients who have risk factors or warning signs of suicide

Carpenter, Delesha M.; Lavigne, Jill; Colmenares, Evan W; Falbo, Kristin; Mosley, Sherita L.

doi:10.1016/j.sapharm.2019.05.024

Cited by 36 publications

(74 citation statements)

References 11 publications

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“…Two recent studies found that between 85% and 98% of pharmacy staff have interacted with patients at risk of suicide (Carpenter et al, 2019;Murphy, et al, 2019;Murphy, et al, 2020). With regard to responding to patients in crisis, more than 20% of pharmacy staff had patients request a lethal amount of medication and 13% had patients state intent to kill themselves (Carpenter et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Gatekeeper training needs of community pharmacy staff

Carpenter

Roberts

Lavigne

et al. 2021

Suicide & Life Threat Behav

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Objective To develop an online suicide prevention gatekeeper training program to prepare community pharmacy staff to communicate with patients who exhibit warning signs of suicide. Method A convenience sample of 17 community pharmacy staff members completed a 1‐hr semi‐structured interview during which they viewed content from an existing gatekeeper training program and provided suggestions for improvement. Once thematic saturation was achieved, interviews were digitally recorded, transcribed, and analyzed by two independent coders who reached consensus on the themes present in each transcript. Results Participants noted barriers to communicating about suicide, including lack of time and privacy, discomfort with using the word “suicide” and limited referral options. Participants wanted gatekeeper training to include local suicide prevention referral resources, take less than 30 min to complete, and incorporate 3–4 realistic role play scenarios, including a phone interaction. Conclusions Many environmental, interpersonal, and individual‐level barriers complicate pharmacy staff members’ ability to act as gatekeepers and communicate about suicide with at‐risk patients. To maximize the public health impact of pharmacy staff, skills‐based training on how to identify, communicate with, and refer at‐risk patients is needed. Gatekeeper training should model brief, realistic interactions with patients and provide pharmacy staff with local referral resources.

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Section: Introductionmentioning

confidence: 99%

“…Directly asking about suicide is considered the optimal response to individuals who express verbal suicide warning signs, yet, less than 1% of pharmacy staff members reported doing so (Carpenter et al, 2019). Suboptimal responses to patients with warning signs may be linked to lack of SP training.…”

Section: Introductionmentioning

confidence: 99%

Gatekeeper training needs of community pharmacy staff

Carpenter

Roberts

Lavigne

et al. 2021

Suicide & Life Threat Behav

Self Cite

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“…[4,[8][9][10][11] Persons experiencing mental health crises, including those with warning signs of suicide, can present to pharmacies, clinic appointments, or other pharmacy practice settings during routine interactions such as when people procure medications, seek advice over the telephone, or engage with other pharmacy services. [8,[10][11][12][13][14] Studies in pharmacy, however, cite a variety of barriers to intervening [8,10,15,16], including a lack of confidence by the pharmacist [14,17] and a need for additional training. [13,17] Pharmacists, especially those in the community-based setting, could play a key role in identifying people in mental health crises and refer them to appropriate professional help.…”

Section: Introductionmentioning

confidence: 99%

“…[8,[10][11][12][13][14] Studies in pharmacy, however, cite a variety of barriers to intervening [8,10,15,16], including a lack of confidence by the pharmacist [14,17] and a need for additional training. [13,17] Pharmacists, especially those in the community-based setting, could play a key role in identifying people in mental health crises and refer them to appropriate professional help. [10,11,14,18,19] Research suggests Mental Health First Aid (MHFA) can increase trainee knowledge, decrease reluctance, decrease stigma, and improve confidence related to intervening with persons experiencing mental health crises, including suicidal ideation.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of participant reluctance, confidence, and self-reported behaviors since being trained in a pharmacy Mental Health First Aid initiative

2020

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In the U.S., an estimated one in five individuals experience a mental illness annually which contribute to significant human and economic cost. Pharmacists serving in a public health capacity are positioned to provide first aid level intervention to people experiencing a mental health crisis. Research on pharmacy professionals (pharmacists, technicians, students) undergoing training in Mental Health First Aid (MHFA) can provide evidence of the potential benefits of such training. The objectives of this study were to 1) describe the reluctance and confidence to intervene in mental health crises of pharmacy professionals previously trained in MHFA, 2) describe their self-reported use of MHFA behaviors since becoming trained, and 3) describe participant open-ended feedback on their MHFA training. Materials and methods: An electronic survey was disseminated in May and June, 2019 using a four-email sequence to pharmacy professionals who had completed MHFA training from one of five pharmacist MHFA trainers throughout 2018. Domains included demographics, six Likerttype reluctance items, seven Likert-type confidence items for performing MHFA skills, and frequency of using a set of nine MHFA skills since being trained. Prompts collected openended feedback related to MHFA experiences and training. Descriptive statistics were used for scaled and multiple-choice items and a basic content analysis was performed on the open-ended items to group them into similar topics. Results: Ninety-eight out of 227 participants responded to the survey yielding a response rate of 44%. Participants reported high levels of disagreement to a set of reluctance items for intervening and overall high levels of confidence in performing a range of MHFA skills. Participant self-reported use of a set of MHFA skills ranged from 19% to 82% since being trained in MHFA. Almost half (44%) of participants had asked someone if they were considering suicide. A majority (61%) also had referred someone to resources because of a mental health crisis. Open-ended responses included positive experiences alongside important challenges to using MHFA in practice and recommendations including additional training focused on the pharmacy setting.

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“…A thematic analysis of responses to open-ended survey questions answered by pharmacists in Australia and Canada reported that pharmacists have a role in caring for people at risk of suicide, particularly by referral and triage, and directly supporting people with suicidal thoughts and behaviours [14]. Until now, there has been no published research on the role of community pharmacy teams in suicide awareness or prevention in the UK, and just one study globally that considers the role of the entire pharmacy team [15]. We therefore aimed to explore the current and potential role of community pharmacy teams in suicide prevention from the perspectives of members of those teams.…”

Section: Introductionmentioning

confidence: 99%

Current and potential contributions of community pharmacy teams to self-harm and suicide prevention: A qualitative interview study

et al. 2019

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BackgroundSuicide prevention is a global priority. Despite the focus on primary care in suicide prevention, little is known about the contributory role of community pharmacists and nothing about the role of the wider community pharmacy team in this area. We aimed to explore the current and potential role of community pharmacy teams in self-harm and suicide prevention.MethodsWe conducted one-to-one semi-structured qualitative interviews with community pharmacy staff (pharmacists, pre-registration pharmacists, pharmacy technicians, dispensing/pharmacy assistants, delivery drivers) in the North West of England, UK. We identified themes from the interview transcripts through an iterative process of inductive thematic analysis.ResultsWe conducted twenty-five interviews with community pharmacy staff. Many described examples of helping those who were contemplating suicide or self-harm. No participants had received suicide prevention training. We identified six themes. The first two themes (i) Relationship with Patient and (ii) Pharmacy environment were seen as facilitators, which, if supported by (iii) Training, could underpin the final three themes: (iv) Opportunities for contact, (v) Facilitated referral pathway and (v) Restricting access to means. The distinct lack of training should be overcome with evidence-informed training. Referral pathways should be clear and enable direct and accessible referral by community pharmacy teams. There are opportunities for existing pharmacy services and schemes to be adapted to maximise suicide and self-harm prevention activities. Pharmacy teams did not identify themselves to have a clear role in restricting access to medication.ConclusionsPharmacy teams already support patients in relation to self-harm and suicide, often relying on their personal experience in the absence of formal training. With the implementation of evidence-informed training and clear referral pathways, this could be done in a more effectively.

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Community pharmacy staff interactions with patients who have risk factors or warning signs of suicide

Cited by 36 publications

References 11 publications

Gatekeeper training needs of community pharmacy staff

Gatekeeper training needs of community pharmacy staff

Evaluation of participant reluctance, confidence, and self-reported behaviors since being trained in a pharmacy Mental Health First Aid initiative

Current and potential contributions of community pharmacy teams to self-harm and suicide prevention: A qualitative interview study

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