Medical intervention must be considered as an integral component of the Department of Health (DoH) Mental Health Strategy 2021-31, which will set out a new vision for mental health in Northern Ireland, as well as 29 high-level actions to take forward significant strategic change over the next decade

In March 2021, Pharmacy Forum NI responded to the DoH public consultation on its draft ten year Mental Health Strategy designed to improve mental health outcomes for people in Northern Ireland. The Forum’s overriding message related to the worrying omission of medical intervention and we have requested that the issue be addressed during the next stage of strategy development. The Forum’s view has been shared by other NI health and social care stakeholders and the regional Mental Health Medicines Optimization Group which also responded to the consultation.

WHO findings: pharmacological intervention is a core element of mental health treatment

Referring to findings from the world health report 2001 – Mental Health: New Understanding, New Hope published by the World Health Organization (WHO), the Forum’s response highlighted the following:

  • Mental health medicines ‘often provide the first-line treatment, especially in situations where psychosocial interventions and highly skilled professionals are unavailable’…’Consequently, strategies to promote more appropriate use of medicines need to involve those who prescribe medicines (physicians, nurses, other health care providers), those who dispense medicines (community and hospital pharmacists) and those who use medicines or supervise its proper intake (patients, care givers, family members) (World Health Organization, 2005).’
  • Point 1.2 of the Preface of the WHO document ‘Pharmacological treatment of mental disorders in Primary care’ states; ‘The World Health Organization (WHO) reviewed evidence for effective treatment of mental disorders, and concluded that a combined psychosocial and pharmacological approach is likely to yield the best results.’

Additionally, while it is well recognised that CBT, talking therapies and other psychological therapies are an effective strategy for non-psychotic disorders, empirical data suggests that medicinal intervention is still the most effective option for psychotic disorders.

The Forum’s response continued with clear argument that pharmacological intervention is a core element of mental health treatment and asked it be accounted for in the final strategy and action plan. This is important now more than ever as underlined by the WHO statement of 14 May 2020: “it is crystal clear that mental health needs must be treated as a core element of our response to and recovery from the COVID-19 pandemic”.

A coordinated approach with pharmacy at the forefront

In view of Northern Ireland’s increasingly deteriorating mental health and wellbeing, the Forum added in its response that input of all key health service providers is needed if government wants to have the best chance to reverse the current trend:

Pharmacy must be at the forefront of efforts as part of a coordinated approach. We are among the most accessible of health professional group – as the pandemic has proven – and the public will continue to turn to pharmacists as a trusted source of advice. Above all and fundamentally, our profession’s clinical knowledge on medicines use is, and will continue to be a crucial component of the treatment of those requiring care for mental health conditions.

The Department of Health is aware that the pharmacy profession is undergoing it’s largest shift in training in a generation to a much more clinically focused role, expanding our role as non-medical prescribers in a very significant way. That development and expertise needs to be accounted in the region’s mental health service delivery.

Given our place within the primary care model as highly skilled, often patient facing and highly accessible HCPs, and as the experts in medicines, the department’s ten year plan must ensure the role of the pharmacist is identified in a more meaningful way in order to support people with mental health problems and ultimately to contribute to the achievement of the outcome identified by the NIE Programme for Government  that ‘We all enjoy long, healthy active lives’.

Download Pharmacy Forum NI Response to DoH Consultation on the Draft Mental Health Strategy 2021-31