Amary Mey

Mental health consumer and caregiver perceptions of stigma in Australian community pharmacies

Background: The stigma of mental illness can be a barrier to effective medication management in the community pharmacy setting. This article explored mental health consumers’ or caregivers’ experiences of stigma in Australian community pharmacies. Materials: Semi-structured interviews and focus groups were conducted with a purposive sample of consumers or caregivers (n = 74). Interview transcripts were analysed using a general inductive approach. Discussion: Stigma presented a barrier to effective mental health management. Self-stigma impeded consumers’ community pharmacy engagement. Positive relationships with knowledgeable staff are fundamental to reducing stigma. Conclusions: Findings provide insight into the stigma of mental illness in community pharmacies.

Review of community pharmacy staff educational needs for supporting mental health consumers and carers

Development of a mental health education package for community pharmacy staff should be informed by mental health consumers/carers’ needs, expectations and experiences, and staff knowledge, skills and attitudes. This review (1) explored research on community pharmacy practice and service provision for mental health consumers/carers, and (2) identified validated methods for assessing staff knowledge, skills and attitudes about mental illness to inform the development of a training questionnaire. A literature scan using key words knowledge, skills, attitudes, and beliefs combined with community pharmacy, pharmacist, and pharmacy support staff, and mental illness, depression, anxiety was conducted. A small number of studies were found that used reliable methods to assess pharmacists’ training needs regarding mental illness and treatment options. There was little published specifically in relation to depression and anxiety in community pharmacy practice. No studies assessed the training needs of pharmacy support staff. A systematic analysis of pharmacy staff learning needs is warranted.

Privacy and confidentiality: perspectives of mental health consumers and carers in pharmacy settings

The study aims to explore within the community pharmacy practice context the views of mental health stakeholders on: (1) current and past experiences of privacy, confidentiality and support; and (2) expectations and needs in relation to privacy and confidentiality.

Australian mental health consumers' and carers' experiences of community pharmacy service.

Many Australians with anxiety or depression experience issues accessing pharmacological treatment even though community pharmacies are remunerated to supply subsidized medicines and provide medicine management services.

Trust and Safe Spaces: Mental Health Consumers’ and Carers’ Relationships with Community Pharmacy Staff

BackgroundTrusting relationships between mental health consumers and health care providers are critical in the management and recovery process. Although community pharmacy staff are well placed to form relationships with mental health consumers and carers, little is known about the existence, nature or significance of consumer–staff relationships.ObjectivesThe aim of this study was to explore mental health consumers’ and carers’ perceptions of community pharmacy services, and describe the nature of their relationships with pharmacy staff.MethodsFocus groups and semi-structured interviews were conducted with a convenience sample of 74 mental health consumers or carers who self-selected into the study. Thematic analysis was undertaken to explore participants’ perspectives.ResultsPositive experiences of pharmacy services were perceived to encourage consumers’ and carers’ trust in pharmacists and promote relationship development. This was enhanced when participants felt that elements of patient-centred care were part of the pharmacy services provided. Although some participants perceived community pharmacy to have a limited role in mental health, those who had established relationships highlighted the current role of pharmacists in their care, and appeared to welcome further extensions of pharmacists’ role in mental health.ConclusionsTrusting relationships between consumers and carers and community pharmacy staff were deemed to be important in mental health care and contributed to consumers’ and carers’ views of pharmacy as a safe health care space. Community pharmacy services that included core elements of patient-centred care appeared to facilitate relationship formation and associated benefits. Education and training is needed for community pharmacy staff to improve mental health knowledge and promote positive engagement with consumers and carers.

Education and training for community pharmacists in mental health practice: how to equip this workforce for the future

Purpose – The purpose of this paper is to explore the potential approaches to continuing education and training delivery for community pharmacists to equip them to support mental health consumers and carers with illnesses such as depression and anxiety. Design/methodology/approach – Review of national and international literature about community pharmacists’ roles, beliefs and attitudes towards mental health, continuing education delivery for the workforce and training recommendations to equip pharmacy workforce. Findings – Training involving consumer educators was effective in reducing stigma and negative attitudes. Interactive and contextually relevant training appeared to be more effective than didactic strategies. Narratives and role-plays (from the perspective of consumers, carers and health professionals) are effective in promoting more positive attitudes and reduce stigma. Flexible on-line delivery methods with video footage of expert and consumer narratives were preferable for a cost-effective pro...

Motivations and Barriers to Treatment Uptake and Adherence Among People Living with HIV in Australia: A Mixed-Methods Systematic Review

In Australia, approximately 30% of people diagnosed with HIV are not accessing treatment and 8% of those receiving treatment fail to achieve viral suppression. Barriers limiting effective care warrant further examination. This mixed-methods systematic review accessed health and social sector research databases between November and December 2015 to identify studies that explored the perspective of people living with HIV in Australia. Articles were included for analysis if they described the experiences, knowledge, attitudes and beliefs, in relation to treatment uptake and adherence, published between January 2000 and December 2015. Quality appraisal utilised the Mixed Methods Appraisal Tool Version 2011. Seventy-two studies that met the inclusion criteria were reviewed. The interplay of lack of knowledge, fear, stigma, physical, emotional and social issues were found to negatively impact treatment uptake and adherence. Strategies targeting both the individual and the wider community are needed to address these barriers.ResumenEn Australia, aproximadamente el 30% de las personas diagnosticadas con VIH no están accediendo al tratamiento; el 8% de los que han recibido el tratamiento no logran alcanzar niveles de supresión viral total. Las barreras que limitan la prestación de una atención médica integral y eficaz, necesitan ser examinadas detenidamente. Se realizó una revisión sistemática de los estudios que exploraron la perspectiva de las personas viviendo con VIH en Australia. Se utilizaron métodos mixtos para acceder a bases de datos de investigación en salud y del sector social entre noviembre y diciembre de 2015. Los artículos que se incluyeron para el análisis debían describir experiencias, conocimientos, actitudes y creencias, en relación a la adopción del tratamiento y adherencia al mismo, publicados entre enero de 2000 y diciembre del 2015. La evaluación de la calidad de los artículos utilizó la herramienta de evaluación de métodos mixta, versión 2011. Se revisaron setenta y dos estudios que cumplieron los criterios de inclusión. Las interacciones entre la falta de conocimiento, miedo, estigma, así como problemas físicos, emocionales y sociales produjeron un impacto negativo en la adopción y adherencia al tratamiento. Se necesitan estrategias dirigidas a los individuos, así como a la comunidad en general para hacer frente a estas barreras.

Development of a phenomenologically derived method to assess affective learning in student journals following impactive educational experiences

Abstract Background: Assessment of affective learning (AL) is difficult but important, particularly for health professional students, where it is intimately linked to the development of professional values. This study originally aimed to determine whether an emotionally impactive, extended, multimethod, interprofessional simulation experience enhanced the AL of senior medical students, compared to conventional seminars and workshops alone. This necessitated the development of a method to assess for the presence and quality of AL. Methods: We developed a “double hermeneutic” method, derived from Smith’s Interpretative Phenomenological Analysis, to identify examples of AL, according to Krathwohl’s hierarchy (“receiving,” “responding,” “valuing,” “organization,” “characterization”), in the journals of students from each arm of a randomized educational trial. Three assessors rated the highest level of AL seen in each journal and then we compared ratings from the two study arms. Results: A total of 135 journals were available for assessment (81 Intervention, 54 Control). The method proved to be effective in identifying and characterizing examples of uniprofessional and interprofessional AL. The median level identified in Intervention journals (“valuing”) was significantly higher than Control journals (“responding,” p < 0.0001). Conclusions: The method described provides a means to assess affective learning among health professional students. An extended, immersive simulation experience appears to enhance affective learning.

What’s the attraction? The role of performance enhancement as a driver of recreational drug use

ABSTRACT Introduction: Despite the risks involved, the use of drugs for recreational purposes is prevalent and generally well accepted. However, there is sparse research to explore the drivers of this phenomenon. Method: Semi-structured interviews were conducted with lay field observers of the recreational drug scene. The data were analyzed using ground theory to provide a framework for understanding motivators underpinning recreational drug use. Two ascribed benefits underpinned recreational drug use: 1) improved social connectedness and 2) enhanced performance. This paper reports on the relationship between drug use and performance enhancement. Results: Recreational drugs were used with the aim of enhancing performance in a number of ways, including to improve endurance, appearance, confidence, and personality. The majority of participants reported that drug taking offers personal and social benefits that outweighed the risks. Discussion and conclusions: In contrast to much of the literature, this study found that people perceived recreational drug use to have a range of positive effects that they wanted to take advantage of. This important finding adds to our understanding of the “pulling power” of drugs. Ultimately, the study highlights a need to rethink the preoccupation in drug strategies with negative physical, mental, and social outcomes as this would seem to be disconnected from actual experience and may result in a credibility gap for prevention education.

What’s the attraction? Social connectedness as a driver of recreational drug use

ABSTRACT Background: Licit and illicit drugs are commonly used for recreational purposes, with users viewing them as a relatively safe and acceptable leisure activity. This study proposes key drivers for better understanding the attractions of recreational drugs and factors that underwrite their popularity. Method: In-depth interviews were conducted with key informants whose roles were to share their experiences and to act as field observers of the complex scenarios and contexts that constitute the recreational drug scene in Gold Coast Region of Australia. Data were analyzed using a grounded theory approach. Results: Recreational drug use takes place in complex social settings and entails extensive codes and practices. Two ascribed benefits underpinned recreational drug use: (1) improved social connectedness and (2) enhanced performance. This paper reports on the relationship between recreational drug use and social connectedness. Discussion and conclusions: Enhanced social connectedness seems to contribute to the attractiveness and acts as a potent force underpinning recreational drug use. This research suggests that harm mitigation strategies must speak to a wider audience as well as address the social attraction of drugs because focusing on younger populations and antisocial features does not seem to reflect reality for recreational users.