Community Pharmacy

Push to expand the role of pharmacies in depression screening

Lorcan Gormley’s struggle with mental illness peaked when he was studying pharmacy at Trinity College Dublin.

He had suffered from depression, extreme mood swings and self-destructive behaviour since he was a young boy living in Donegal, but growing up in rural Ireland in the 1990s, his condition went undiagnosed.

It culminated in two suicide attempts when he was in his early 20s. In 2012, at the age of 23, he was given a name for his condition: borderline personality disorder.

Gormley, now 30, is the managing pharmacist at McMeel’s Pharmacy in Skerries, Co. Dublin. He believes Ireland’s mental health services are lagging, and wants community pharmacists to play a greater role in depression and mental health screening.

“A pharmacist is much more accessible than a doctor,” Gormley said. “We can’t diagnose, but we can identify people with symptoms who might need a referral and help those who are suffering unnecessarily.

“There shouldn’t be any shame or stigma associated with mental illnesses. These are illnesses that have a certain set of outcomes and they can be treated. We’ve made a lot of strides in Ireland and we’re much better than we used to be, but there’s still a long way to go.”

Gormley would like to see the Irish Pharmacy Union lead a campaign that aims to break down the taboos associated with mental illnesses such as depression, and promote pharmacists as front-line healthcare professionals who are capable of providing help and referring patients to specialists.

“It’s an area that the IPU could be very useful in,” he said. “People should be encouraged to talk about mental health and to talk to their pharmacist. Depression is the one thing that people can be most hesitant to seek help for, so making that initial step is really important. The public need to realise that the help and knowledge and resources are there for them in the pharmacy.”

Gormley said pharmacists were well placed to screen patients for depression, and while it does already happen informally across the country, a targeted campaign would help promote the service to the general public.

“We know there’s a stigma around mental health,”

“People don’t want to be seen as having a mental illness. But as pharmacists we have to assess how serious the problem is when someone comes in feeling unwell. Are they just having a bad day, like we all do? Or are there persistent symptoms that warrant further referral?”

he said.

Gormley said many people who come into his busy seaside pharmacy with a prescription for antidepressants were often reluctant to take the medication. “There’s a real perception that if you’re on them you’re not trying hard enough or that you’re weak,” he said.

“I always go and talk to patients when I’m dispensing antidepressants. I tell my story – to young men in particular – to let them know that I’m not broken, that this is something you can overcome. I tell them I have a mental illness, I tell them I was on antidepressants, that I nearly checked out six years ago. I tell them it can happen to anybody. I tell them that I’ve been there, and that it’s OK. I feel like I have to be open about it so it’s not something that’s just happening behind closed doors.”

Pharmacists already monitor and review patients taking antidepressant medications, but there is a growing push around the world for pharmacies to take on a more formal role in mental health screenings. Advocates say every visit to a community pharmacy is an opportunity to educate patients about the mental health resources available to patients.

The Irish Pharmacy Union said running a depression awareness campaign was “not on the list of our immediate campaigns” but could be considered in the future.

The Pharmaceutical Society of Ireland said it was unable to provide information on the number of pharmacists who have undertaken further study in mental health, but the regulator said pharmacists’ unique skills and expertise equipped them to maximise the benefits of medicine, and minimise the potential for patient harm.

“Provision of information by pharmacists to their patients about the appropriate and most effective use of medicines, and care as to interactions of certain medicines, is a vital part of the pharmacist-patient relationship, and a pharmacist’s professional role,” PSI spokeswoman Louise Canavan said.

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