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The Mental Health Crisis in Community Pharmacy; Less Talk, More Action Needed

I could have predicted what the Royal Pharmaceutical Society's 'Workforce Wellbeing Survey' results revealed this week but it doesn’t make it any easier to stomach.

Over 60% of respondents have had their mental health and wellbeing impacted by work

80% were at a high or very high risk of burnout

Over 50% have considered a career change

These figures are shocking but are sadly reflective of a sector that is being pushed to the brink. Staff shortages, medicines shortages, decreasing funding and an increase in paperwork and service provision are a perfect storm for stress, overwhelm, burnout and depression. It cannot be denied; the community pharmacy sector (and pharmacy as a whole) is in a mental health crisis.

Since I started to openly discuss my own experiences of mental ill health earlier this year I have been inundated by fellow pharmacists contacting me, usually in tears, telling me about how they have contemplated suicide, how my story is their story, how they don’t speak out for fear of being hauled in front of a Fitness to Practice committee or worse, struck off the register altogether. And these are just the ones who are brave enough to approach me. This survey just proves how many more there are out there, suffering in silence and too scared to admit to themselves and others, what is happening to them.

I get it. I’ve been there. It’s a dark and lonely place. You’re not always sure where to turn and you think that no one will really understand but instead, judge you for being the one who ‘can’t cope’. Well, if this survey proves anything it’s that there are many out there that can’t cope. It’s actually the norm. And it can’t carry on.

Why are stress levels so high in pharmacy?

Every profession struggles with a risk of burnout but not necessarily at this level. We need to start with asking the uncomfortable questions like WHY are we pharmacists under so much stress? Why do we take it upon ourselves to run everything in the dispensary, why do we not delegate better? Why can we not trust our staff to look after those tasks that really don’t need a pharmacist, telling ourselves that it’s easier (and quicker) to do it ourselves than train someone else to do it?

Make no bones about it, being a community pharmacist is tough. It’s isolating and involves long days, sometimes angry patients, incessant ringing phones, never-ending acute scripts that can end up elsewhere if the patient isn’t acknowledged within seconds and calls to source even the most basic of medicines.

Most pharmacists are trying to keep their heads above water and on top of the volume and constant firefighting. There is little time to even consider their own wellbeing or that of their staff. So, what can be done about it? A lot, actually. But this isn’t a problem that is going to be resolved easily or overnight.

Whilst a national mental health service for pharmacists would be a great start and give pharmacists who are suffering with ill mental health much needed support, it doesn’t tackle the cause.

Causes of stress; lack of training/development?

It’s about time that we not only shed a light on the issue of mental ill health among our profession but also look at how we can go about addressing it and how we can actually start to prevent it, before the crisis gets worse and patient safety is (further) compromised.

For instance, one of the biggest causes of stress amongst pharmacists is trying to manage being pulled in many different directions and prioritise effectively. We are not taught in the MPharm how to run businesses or how to be effective leaders. As someone who has had to learn both of those skills during her career, I can attest to that fact. These are skills that are currently learnt on the job and it can be hugely stressful trying to be the responsible pharmacist and be a motivational leader of people and of a business. Pharmacists are predominantly taught disease/therapy management and patient care and whilst some universities have started to incorporate some ‘softer skills’ courses it doesn’t go far enough.

Employers also have a duty of care to continually develop their teams and ensure that their mental wellbeing is being looked after. Healthy mental practices and leadership skills can be taught but how many employers actually invest the time and resources in ensuring their pharmacists and teams are best equipped to deal with the pressures of daily dispensary life? How many employers actively seek to develop their staff on the ground to become better leaders or to help the team best utilise their strengths? As someone who now delivers leadership training with a focus on healthy mental practices, I can confidently say that the best teams are those that spend time analysing and working on how they operate and then maximise each other’s strengths. This could mean having a non-pharmacist manager who can focus on operations or upskilling junior staff to take on more responsibility or even employing one of the team to handle emails, social media and digital marketing for the business.

Whatever it looks like, it will be different depending on each individual business. The important thing is that staff are given some protected time to review processes and then figure out how best to work together as a team to ensure maximum buy-in and engagement. It is well documented that the best idea can sometimes come from the lowest common denominator; they just need the chance to contribute and be incentivised effectively.

The future

Working on some of these causes instead of just focusing on the problem could reduce the impact on mental health but we also need to provide effective stress management/coping strategies and get the whole team involved in this from the C suite right down to the most junior staff.

Understanding and practising emotional intelligence is key to this and is another skill that can be taught to help improve workplace culture. Yet, very few in our sector have ever been trained to employ this vital skill effectively.

So, we can continue to raise the issue of mental health within pharmacy so that it is better understood and ‘normalised’ to some degree. We can encourage supportive working environments so that employees feel able to open up and ask for help when they are starting to suffer with their mental health, without fear of recrimination or judgement. But if we really want to make an impact on these shocking figures, we have to identify the weaknesses in our sector and correct them NOW.

This will involve time. This will involve investment. But, if we don’t, we risk losing our talented pharmacists and support staff to other sectors and other professions.

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