Veerpal Sandhu is a current mental health clinical pharmacist at the NELFT NHS Foundation Trust, where her role involves  analysing complex patient information to ensure optimal clinical outcomes. Prior to this, Sandhu has worked as a community pharmacist manager for nine years, where she was involved in several clinical services and projects regarding mental health. With her extensive experience and passion in both her career and voluntary work with SHOUT, a mental health charity, Sandhu has been influential as a pharmacist to remove the stigma around mental health. This article has been written by Sandhu for the BPSA Mental Health Campaign 2021 to highlight the current problems surrounding stigma in the field, as well as suggestions and steps we can actively take to protect our own mental health as future pharmacists as well as that of our colleagues. 

No health is without mental health. In present times, discussions around mental health have  become less controversial. More public figures such as the royal family, celebrities, and  footballers are becoming aware and actively advocating in campaigns of mental health  issues. Social media has also played a role in boosting this awareness. 

Stigma persists throughout all areas of the community, and healthcare is no exception. In  general, some healthcare professionals may view mental illness as incompetence,  unpredictable, dangerous for patients. We are expected to bring ourselves, our empathy,  and compassion to work each day to enable us to support both our patients and team well.  This stigma comes from guilt of letting the team and patients down and this is the main  reason for the mental health of pharmacists worsening. Some pharmacists are worried  about Fitness to Practice and being questioned by GPHC, and this means they will deny  recognising the mental health issues affecting them. The career pressure is another stigma  issue; worries around the effects of a diagnosis being on permanent GP records may hinder  pharmacists to speak to anyone in the team or to their GP. 

Another issue which makes it hard to recognise poor mental health amongst ourselves is  being perfectionists. We are constantly under pressure to be clinically perfect with accuracy  checking, the way we respond to patients, and handle the work pressure. A pre-COVID survey by the Royal Pharmaceutical Society and Pharmacist Support found that 80% of the  profession was at a high risk of burnout. With the COVID-19 pandemic, increased workload  and staff shortage has increased this percentage for the pharmacists. This leads to anxiety and stress, meaning pharmacists are often the second victims and can suffer emotional  distress and poor mental health as a result of the same incidents that can harm patients. 

This issue can be resolved in various steps, firstly by organisations implementing and  practicing an open culture of communication between the teams and colleagues. Pharmacy  teams should be equipped to handle mental health discussions and being in the profession  should not make the conversations awkward. 

Every pharmacy team should have some sort of wellbeing strategy to manage the wellbeing  of staff within the pharmacy environment. The senior colleagues should regularly check how  the team is coping and feeling with the workload and have open and productive discussions to support their colleagues in their personal or professional issues. There have been some  improvements and recognition to support pharmacists with their mental health, however  there is still a long way to go to eliminate the stigma of healthcare professionals not being  able to experience poor mental health. 

As a pharmacist, you can support your colleagues and patients by having general awareness  of how to identify the emotional distress or struggles a colleague or patient may be facing.  The stressed, upset colleague or patient who suddenly may have an anxiety attack, the little  clues to identify a change in their behaviour. A key thing to remember is to try not to  assume anything about the situation; instead, have an open and welcoming conversation.  Another important aspect of being able to support or recognise signs is having a trustworthy  relationship with your patient or colleague; the rapport you make even in the first  conversation is impactful and the key here is to be a good listener first. Pharmacists should  have good local and national signposting knowledge so that they can offer the necessary  support. 

As well as looking out for colleagues and patients, being aware of your own boundaries and  recognising when you yourself may need to seek help is immensely important as a  pharmacist. To do so, it is very important for a pharmacist to have good work ethics and to  have balance in their work and personal lives. Staying back to catch up with work or longer  hours can eventually lead to stress. Switching off is very important, and has positive effects  on mental health, stress levels, and work outcomes. 

The worry of making errors should not be part of the daily tasks; many pharmacists take this  worry home and this can lead to sleepless nights which has a domino effect on the efficiency  of work the next day, as well as attitudes towards work. It is important to have confidence  in yourself to make clinical and ethical decisions, and never to be afraid of asking for support  or help from colleagues. 

The top tip is this: As long as you can justify your actions in the best interest of the patient  and confidently explain why you took a certain decision, you should not go home worried.  On the basis of this principle, I have taken difficult decisions confidently, whilst always  following the suitable processes and procedures. 

Being able to identify the difference between burnout and stress is crucial. The stress of a  workday is temporary, but burnout occurs when you are consistently doing something  which is out of your capacity and you don’t enjoy it but force yourself. This leads to a poor  work life balance, and overall has a negative impact on the mental health of pharmacists. 

This is why it is important to be honest and open with both yourself and colleagues in the  workplace, to ensure a happier and healthier environment. 

Contacts for help: 

Pharmacist support: info@pharmacistsupport.org, 08081682233 

TEXT SHOUT 85258 

MIND: 03001233393