MENTAL HEALTH
The extent of mental health issues in Scotland is unfortunately no different to the rest of the world, with many people being affected by these diseases in some way. For example, in the year ending March 2012, over 19,000 Scots were admitted to mental health hospitals across the country, with 55% of these being readmissions (highlighting the chronic nature of these conditions). The main conditions with which these patients suffered included mood disorders, alcohol/drug misuse, schizophrenia, and neurotic disorders, however many others have been implicated in signifi cant numbers. As with many medical conditions, there is a difference in how the sexes are affected – in Scottish men, alcohol and drug related problems are the largest issue, followed by schizophrenia, in women, mood disorders were the most common5
are investigated a bit more, it looks like there is some good news, with GP consultations regarding anxiety and depression decreasing since the start of the decade – however, this is more likely due to improved coding and diagnosis of conditions, rather
than a decrease in the prevalence of these illnesses, and as such, it is important that continued headway be made in how such conditions are dealt with. This is reinforced by the fact that there were 830 suicides in Scotland in 2012 (equivalent to 15.6 people per 100,000) - a number which desperately needs to be reduced, and at an urgent pace 5
. . If the fi gures from Scotland
DIAGNOSING A MENTAL HEALTH CONDITION Before a patient can receive treatment for their condition, it is critical that their condition be diagnosed accurately, and in the correct manner for the individual patient. As we’ve discussed earlier, there are many mental health conditions, some more common than others, which all present in different ways, and require differing approaches to treatment. It makes sense then, that these conditions need to be identifi ed as early as possible, to expedite the recovery of the patient, and prevent unnecessary treatments being suggested as the result of inaccurate diagnosis.
Unsurprisingly, it’s not possible
to go into all of the diagnostic techniques and criteria here, however, pharmacists should endeavor to be aware of the types of test which are carried out to identify the patient’s condition, so that they can provide advice, support and encouragement to patients who are concerned about their mental health.
In many cases, diagnosis of these conditions can be ascertained by questioning of the patient, normally via a questionnaire of some sort. Particular types of feelings are identifi ed and quantifi ed, and from this, a diagnosis can often be made. Some common mental health diagnoses and their associated symptoms are provided in Table 2.
Pharmacists should also be aware of where these diagnostic criteria come from, so that they can inform their patients if needed, and so that they can learn more about how these conditions vary in their diagnosis. The American Psychiatric Association (APA) is regularly regarded as a highly trusted source of information, and is responsible for the publication of
documents such as the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual, currently in its fi fth edition, is used by many medical practitioners who specialise in the area of mental health and its diagnosis, and as such may be useful for pharmacists who wish to gather more information about these conditions and how they are classifi ed. Moreover, a thorough knowledge of how these conditions are diagnosed, will allow pharmacists to play a bigger role in the management of their patients, and also promote interprofessional working, which could greatly benefi t patients, and improve outcomes.
TREATING MENTAL ILLNESS As most pharmacists are probably aware, the treatment of mental disorders is normally more complex than the treatment of other exclusively physiological conditions such as hypertension, asthma or hypothyroidism, and this can be for a number of reasons – fi rstly, there is still a lack of full understanding of the pathology of mental illness, and secondly, an agreed strategy for the treatment of certain conditions is still
“ I’m bUy i n g a n othe r pha rma c y, so I
n ee d a n a d v Is e r with a pr o v e n formu L a”
Metha, pharmacy owner, Brighton
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