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Azita Alipour, PharmD, BCPP, BCGP, CTTS
Assistant Professor – Psychiatric Pharmacy
Marshall B. Ketchum University, College of Pharmacy

Morgan L. Karrels and Amanda L. Colistro
PharmD Candidates, Class of 2020 
Midwestern University, College of Pharmacy-Glendale
Faculty: Dr. Alyssa M. Peckham, PharmD, BCPP

According to the National Alliance on Mental Illness (NAMI), one in five Americans are living with mental illness or a substance use disorder and less than half of those who need help, get help. The reasons can be multifactorial, which may include stigma associated with mental illness. As pharmacists working on the front-lines of patient care, we are trained in pharmacy school on triage for “self-care” for a wide variety of ailments. Although we treat the physical, there seems to be a lack of training around the triage of psychiatric and substance abuse conditions as well as resources available for help.

Mental Health First Aid (MHFA) can help bridge this gap with training on how to recognize symptoms of mental health problems and how to offer and provide initial help and guidance toward supportive help for a person who may be experiencing a mental health-related crisis or problem. Through this 8 hour training program and its active learning exercises, the student develops these skills and experience a decrease in stigma associated with mental illness.

MHFA provides the tools needed to identify someone who may be experiencing a serious mental health issue and how to properly provide them the help they need. The course focuses on several topics such as major depressive disorder, suicidal ideation, various anxiety disorders, psychosis, substance use disorders, eating disorders, and more. MHFA training, while beneficial for everyone, is particularly useful for health care professionals who may regularly encounter patients with mental health diagnoses but may lack specialized mental health training. Of note, the course is not meant to train learners to diagnose or provide treatment, but rather focuses on providing support, offering resources, and recognizing when the level of care must be elevated.

The CPNP Foundation made MHFA training available at the 2018 CPNP Annual Meeting in Indianapolis. Two students, Morgan Karrels and Amanda Colistro from Midwestern University, shared a few of their experiences.

"Mental Health First Aid provided us with a greater sense of confidence to help and treat patients living with a mental illness. We learned about guidelines for communicating with someone in a crisis and applied this knowledge by working through different cases. Attending this training further solidified our desire to become pharmacists specializing in mental health and made us aware of the unique needs of our patients. Additionally, it inspired us to work with our campus administrators to bring MHFA training to our University in hopes that all of our pharmacy students and other healthcare professionals have the opportunity to become certified."

Seeing the utility for pharmacist trainees and the great response from those like Morgan and Amanda who have been previously certified, I started implementing MHFA at the Marshall B. Ketchum University College of Pharmacy this past summer. With the intent to offer MHFA every year at the college, I became trained as an instructor. 

The next step was deciding where in the curriculum to include MHFA. Class size and pharmacy curriculum structure were major factors of consideration. MHFA limits the maximum class size at 30 students, with prior approval needed if an instructor will exceed the limit. The course must also be in the following formats: one 8-hour day or two 4 hour days or four 2 hour days, not more than two weeks apart. Given the limitations in the size of the class and the hours needed for the course, MHFA is offered as a one-unit elective at my college of pharmacy (COP) in the summer for students entering their third year of pharmacy school. The elective has a cap at 30 students, and we charge the students a minimal fee to cover the cost of the required MHFA manual for each student.

About a quarter of the third year class took the course which was very well received. The timing of the elective worked out well as it was offered right before they started their psychiatry therapeutics block and was a good introduction to psychiatry. I highly recommend that MHFA is made available in all colleges of pharmacy.

References:

  1. https://www.nami.org/stigmafree
  2. https://www.pharmacytimes.com/publications/directions-in-pharmacy/2015/october2015/mental-health-first-aid-as-a-skill-set-for-community-pharmacy-personnel
  3. https://www.mentalhealthfirstaid.org/become-an-instructor/certification-process/
  4. www.cpnp.org
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