Abstract
BACKGROUND: Given the growing prevalence of mental illness in the U.S. and the number of people receiving psychiatric medications, pharmacists are in a unique position to engage willing participants in mental health care. However, most existing training programs fail to address barriers related to patient acceptability of pharmacists as mental health support professionals. OBJECTIVE: We aimed to: (a) determine whether veterans and non-veterans find it acceptable to speak with community pharmacy staff about mental health and suicidal behaviors, and (b) identify barriers that may prevent individuals in either group from engaging in mental health conversations with pharmacy staff. METHODS: A formative qualitative study using semi-structured interviews was conducted to assess the acceptability of discussing mental health and suicidal behaviors with community pharmacists among pharmacy consumers. To capture a cross-section of the community, including individuals with a higher prevalence of mental health conditions, both veterans (n=10) and non-veterans (n=22) were recruited. Results were analyzed using a thematic analysis approach. RESULTS: Key facilitators to improve patient comfort to discuss mental health with their pharmacists include developing patient-pharmacist relationships, ensuring privacy, improving the physical pharmacy environment, and enhancing pharmacist mental health training. Commonly, participants desired pharmacists to treat them as individuals, remain calm, listen, and provide gentle suggestions without forceful tones. Increasing awareness of pharmacists' roles in mental health through signs, posters, and social media campaigns may result in improved patient interactions. Additionally, participants encouraged pharmacists to build partnerships with mental health providers to integrate pharmacists into the mental health care continuum. CONCLUSION: The present study underscores the complex dynamics surrounding mental health conversations between community pharmacists and patients. Among participants in North Carolina, reluctance to engage pharmacists in mental health discussions stemmed largely from limited rapport and unfamiliarity with pharmacists, concerns about privacy, and the perception that pharmacy environments were not always conducive to sensitive conversations. With targeted training, environmental adjustments, and active partnerships with mental health professionals, pharmacists could more confidently address mental health-related concerns, thus becoming more trusted resources in patient care.