Module 2, Advanced mental health services Flashcards
What is the prevalance of mental illness?
- highest in young adults (16-24 years) & declines with age
- people with mental illness suffer psychological distress & higher rates of disability than people without mental illness
What are some s&s common to most mental illnesses?
- anxiety
- nervousness
- inhability to experience pleasure
- lack of motivation
- lethargy
- self isolating
- more irritable
- more negative
- failure to keep appointments
- feelings of hopelessless, despair & worthlessness
- forgetfulness
What mood disorders would pharmacists commony deal with at the primary care level?
- mood disorders
- depressive disorders
- bipolar disorders
What anxiety disorders would pharmacists commonly deal with at the primary health care level?
- PTSD
- social phobia
- agarophobia
- general anxiety disorders
- panic disorder
- obsessive compulsive disorder
What are the most common mental health disorders?
- Anxiety-related disorders and then followed by mood disorders such as depression
- More than half of australians experiencing anxiety and depression reamin untreated
What is the issue with mental health medication?
- Consumers expressed dissatisfaction with lack of education about medication
- Consumers need more autonomy and involvement in decision making
- Need for increased disclosure about medication particularly regarding risks and alternative therapies
Who is the first point of contact for people with mental health concerns?
- general practitioner
What is the role of pharmacists in mental health issues?
- Dispensing and supply of medicines, ensuring medicine safety and efficacy
- Stages supply of psychotropics
- Medication adherence support, monitoring compliance to prescribed therapy
- Monitoring and managing medicine-related adverse events
- Mental health promotion
- Supply of early detection and intervention
- Triaging and referrals to other health professionals or mental health care team
What is the mental healthcare framework?
- Articulates the expertise of pharmacists and the roles they do and can fulfil as partners in mental health care
- Intended to be used as the basis for exploring future pharmacist roles as partners in mental health care to enhance mental health care service delivery to australian consumers and carers
What do pharmacists do in medication adherance support?
- we utilise existing services and tools such as:
- Meds Check
- HMRs/RMRs
- DAA
- Clinical interventions
- Stages supply
- Primary healthcare
- Community services support
- working with others
What is mental health stigma?
- stigma is a problem of:
- knowledge–> ignorance
- attitutudes–> prejudice
- behaviour–> discrimination
- What impact does it have?
- stops people from accessing tx
- impacts adherance to tx, early tx discontinuation
- leads to social withdrawal, low self esteem, poor self care, substance abuse
- hinders a perosns recovery process
- discrimination in the workplace and social situations
- limits opportunities
- difficulties obtaining housing & emplyment
Clozapine scenario… Andy drinks about 6 cups of coffee a day. He wants to change to decaffeinated coffee. What do you recommend?
- caffeine is a weak CYP1A2 inducer- thus removing this may increase clozapine levels
- competitive inhibition also occurs- stopping caffeine increases clozapine metabolism and decrease plasma levels
- any change in caffeine intake should be in discussion with his Dr
- may need increased monitoring & change of dose
- recommend to taper down caffeine gradually
- monitoring of signs and symptoms
Clozapine scenario… So, what if Andy is also a smoker? Would you advise him to stop smoking? If he does stop smoking, what advice would you provide?
- 80% of people with schizophrenia smoke, and usually heavily
- cardiovascular disease is the major cause of morbidity and mortality in these people
- ensure that clozapine prescriber is aware of cessation attempt and prepared to regularly monitor and reduce clozapine dose…
Clozapine scenario… Andy comes to you for a cold remedy. He says he’s caught the ‘flu bug’ that’s been doing the rounds recently. How would you respond?
- further questioning- have him expand on the symptoms
- blood test results? neutropenia- referall point
- concerns are towards low white cell counts and risk of infection due to weakened immune system
- also have concerns towards myocarditis and risk of aspiration
- if satisfied that it is a cold, could give symptomatic relief such as decongestat nasal spray, paracetamol
Clozapine scenario… Andy wants to visit his cousin in Darwin. He’ll be away for 6 weeks. He wants to know if you can give him an extra pack of tablets ‘to see him through’, What do you advise?
- refer to clozapine coordinator
- cannot supply more than 28 days at a time
- need to arrange for extra blood tests as tests needs to be every 4 weeks
- check community pharmacies that could supply in NT
- check other legislative requirements
