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Letters to the Editor
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Mental health
A spectrum of specialisms
From Ms C. L. Feetam, MRPharmS
Peter Pratt (PJ, 5 March, p269) urges the profession to support pharmacists
who choose a specialism and stresses that it is time to reconsider the
status of mental health as a single specialty within the profession.
Such specialist recognition is now beginning outside the profession but
there remain barriers closer to home.
Advertisements for mental health pharmacists often bear no mention of
any specialist knowledge or experience required or even the opportunity
for further training once in post. Managers expect inexperienced pharmacists
to service psychiatric units with no psychiatric support other than attendance
at a weekend course entitled “An introduction to psychiatry”,
if they can get a place. Such service provision is often via an inadequate
and under-funded service-level agreement.
The UK Psychiatric Pharmacy Group has been in existence for over 25 years
and has 500 members. The
College of Mental Health Pharmacists, the academic
and practice subgroup of the UKPPG, now has 25 members, fully accredited
as specialist mental health pharmacists by academic achievement and experience
in the specialty, as evidenced by portfolio and viva voce. Members of
the UKPPG have been involved in the construction of all National Institute
for Clinical Excellence guidance to date involving mental health. Fifty
students a year enrol on the postgraduate distance learning certificate
in psychiatric therapeutics offered from Aston University, with nine
students soon to take the final examination for the diploma in psychiatric
pharmacy.
Medicines management has been identified as one of the greatest risks
by many mental health trusts. The situation will not change without improved
recruitment, a better career structure to include consultant pharmacists
in mental health and independent pharmacist prescribers plus the necessary
resources to effect change.
Mental health pharmacy bridges the gap between primary and secondary
care — many of us work with few if any inpatient facilities. It
interfaces with social services as well as the criminal justice system
and the probation service. It is not one but a spectrum of specialisms.
The needs of an older adult mental health service are different from
a child and adolescent or forensic service. Community mental health teams;
substance misuse, assertive outreach, home treatment and early intervention,
to name but a few, all have pharmaceutical needs and present different
challenges with respect to medicines management.
It is time mental health pharmacy was seen for what it is by policy makers,
politicians, our fellow pharmacists and those who educate the pharmacists
of the future. It is a rewarding, challenging and different area of practice.
Celia Feetam
President, College of Mental Health Pharmacists
Need for specialist pharmacists should be formally recognised
From Mr G. Diamond, MRPharmS
I agree with Peter
Pratt (PJ, 5 March, p269) that there needs to be a
degree of specialism in pharmacy disciplines. In the US a body called the “Board
of Pharmaceutical Specialties” exists to validate specialist practice
in Canada and North America.
Perhaps, the Royal Pharmaceutical Society should investigate this issue
further. In the case of mental health, my partner has just completed a
BSc in Mental Health Nursing. His experience in engaging with pharmacists
in mental health trusts has been positive and he has been impressed by
their knowledge and expertise.
There is no doubt that mental health and its multidisciplinary team approach
differs from generic pharmacy. I believe that a psychiatric pharmacy postgraduate
qualification exists and the Centre for Pharmacy Postgraduate Education
distance learning programme is informative, too.
I think we need to start formally recognising the need for specialist pharmacists.
Certainly, specialisms are the way forward for pharmacists both in community
and hospital. For example, geriatric long-term care is an ideal specialism
for community settings. Pharmacists like myself, after 20 years on the
Register, would see this as an opportunity to reinvigorate themselves in
the pharmacy profession.
Gerry Diamond
Manchester |
The
Pharmaceutical Journal