New national mental health medicines report shows more needs to be done to support patients.
More than 40% of Australian mental health facilities do not have any pharmaceutical handover at discharge, a new report has found.
It also found antidepressants were involved in 31% of medicine-related deaths due to overdose, and antipsychotics in 17% of medicine-related deaths due to overdose.
The sixth edition of the Pharmaceutical Society of Australia’s Medicine Safety series, the Medicine Safety: Mental Health Care report was released last week and highlights opportunities for pharmacists to better support Australians using medicines to treat mental health conditions.
This includes improving access to care and investing in quality use of medicines services at critical points of care.
The PSA’s national president Dr Fei Sim said the “evidence presented in this report shows that, as a nation, we need to do better”.
“Wherever medicines are used there is a risk of medicine misadventure, which is exactly what this report has found,” she said.
“We know that the prevalence of mental ill health is on the rise, and more people are using medicines to manage a mental health condition.
“Too often we hear of people stopping treatment altogether because of the effects of these medicines, because they make them unwell. This is where we believe there is significant opportunity for investment in pharmacist services to help support the safe and effective use of medicines.”
Dr Sim said people using medicines in their mental health care needed better access to the expertise of pharmacists at all stages of management – in hospitals, in community pharmacies, in private clinics and across the whole spectrum of care.
“Our recommendations focus on addressing specific gaps in the provision of comprehensive health care and challenge the ‘set-and-forget’ paradigm that people using mental health medicines too often experience,” she said.
“From implementing a mental health screening program in community pharmacies, to formalising transition of care pharmacist services to reduce the risk of medicine-related harm when transferring from hospital to home, pharmacists can and should be part of a collaborative, multidisciplinary and person-centred approach to mental health care.
“This is about ensuring patients have the support they need to get the most out of their medicines safely and effectively.”
Other key findings of the report include:
- People with severe mental health conditions have poorer physical health than the general community and have a 12 to 16-year shorter life expectancy.
- 18% of Australians use medicines to treat a mental health condition.
- Only 45% of Australians seek any professional help for mental health conditions. The report says this “highlights significant opportunity for pharmacists in early intervention and referral”.
- One in four Australians are taking a medicine that would not be recommended for them based on the individual genetic variation of their drug metabolising enzymes.
- Medicine changes are frequent in mental health facilities with an average of 10 changes per admission, although more 40% of mental health facilities did not have any pharmaceutical handover at discharge.
The PSA used the report to make nine recommendations to ensure equitable access and improved support for people with mental health conditions to use medicines that they need safely and effectively.
These include funding mental health first aid and health care training; implementing a community pharmacy mental health screening program; funding and promoting community pharmacy dose administration aid and staged supply services; and implementing six-monthly medication management reviews for people in mental health medicines.
The full report and recommendations are available here.
Federal Assistant Minister for Mental Health and Suicide Prevention and Assistant Minister for Rural and Regional Health, Emma McBride commended the PSA on the report.
“This is a timely report on the importance of medication safety in mental health given the prevalence of common mental health disorders and the medications often prescribed as part of treatment and care,” she said.
“The report also highlights the vital role pharmacists play – across settings – to improve safety and importantly reduce harm.
“As a pharmacist who worked in acute adult inpatient services, I know this report will be influential as we work together to improve patient care.”
The Medicine Safety: Mental Health Care report and PSA’s recommendations are available here.
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