Mental Health Curricula at Schools of Pharmacy in the United Kingdom and Recent Graduates' Readiness to Practice
Rutter, Paul, Taylor, Denise, Branford, Dave, American Journal of Pharmaceutical Education
Mental illnesses are common and vary from those that impact people severely throughout their lives, to those that are less severe and have a lesser impact. What sets mental illnesses apart from other diseases though is their societal impact. For example, the societal cost of anxiety in the United States exceeded $42 billion during the 1990s, (1) and mental health disorders are known to be associated with significantly higher impairment than chronic medical disorders. (2) Each year an estimated 38% of the European population experiences a mental disorder, the most frequent of which are anxiety disorders (14.0% of population), insomnia (7.0% of population), major depression (6.9% of population), somatoform (6.3%), attention deficit hyperactivity disorder (ADHD) (5%) in the young, alcohol and drug dependence (>4% of population), and dementia (1%-30%, depending on age). (3) Health care providers commonly prescribe medications for people with mental health problems, and may prescribe multiple medications over an extended period of time for those with severe mental health problems.
Most medicines used to treat mental illness are associated with side effects, which can result in patient nonadherence or cause long-term health problems. (4-6) Also, many medicines are only partially effective or only effective against some aspects of the illness but not others. These factors make selecting the best medication a key issue for pharmacists and psychiatrists and may require trying several alternative medications to find the ideal treatment regimen for a patient. The need for pharmacists to be well educated about mental health conditions and their treatments is therefore important. (7) However, only limited research on mental health curricula has been conducted and only one 1990 study explored the undergraduate mental health curriculum in UK schools of pharmacy. (8) Branford found that teaching of mental health care in the then 16 schools of pharmacy varied widely, although lectures on the primary uses of psychiatric drugs and the clinical presentation of illnesses were covered by most schools. A 2007 study of US colleges and schools revealed that a wide range of mental health conditions were taught in the pharmacy curriculum, although the time devoted to the different conditions varied considerably. (7) Given that UK mental health services have dramatically changed since the work of Branford, moving from predominantly hospital-based care to tailored local community care, (9-10) and that studies have shown that pharmacy students have stigmatizing views regarding mental health illnesses (11-13) the authors felt that reassessment of mental health teaching in UK schools of pharmacy was needed.
This study aimed to provide up-to-date information on undergraduate pharmacy mental health education and training offered by UK schools and to gauge how well graduates are prepared to manage mental health patients. In order to capture the whole of mental health education provision in pharmacy schools, this study used a broad definition of mental health that included areas that many educators may categorize differently, for example conditions that may be treated as neurological (eg, epilepsy and Parkinson disease) rather than as mental illness.
The authors used a mixed methods approach in this study: semi-structured telephone interviews with pharmacy educators and an electronic self-administered survey of graduates. The content of the interview was developed by one of the authors in conjunction with The College of Mental Health Pharmacy, senior employed mental health pharmacists, and academic pharmacists. Questions were open-ended and explored curriculum content and delivery.
The lead pharmacy practice (those responsible primarily for clinical teaching) academic at each UK school of pharmacy (n = 26) was contacted by phone and asked to identify the faculty member at the school who had responsibility for coordinating mental health teaching. …