Home' Australian Pharmacist : Australian Pharmacist Nov 2013 Contents Australian Pharmacist November 2013 I © Pharmaceutical Society of Australia Ltd.
healthcare and consequently increase the
pharmacist’s level of competence to meet
those demands.5 Consumers have high
expectations of the health advice pharmacy
should provide and pharmacists have a
positive attitude to delivering public health
services but feel less confident in this role.6
Improved training and education can
significantly reduce stigma, improve the
health practitioner’s attitudes and improve
their ability to support clients with mental
illness.7 Mental health clients perceive
pharmacy positively and equally when
compared to other health providers but the
greatest value was the approachability and
ease of access.8
Rural and urban
It is well established that farmers in rural areas
pose the highest risk of suicide in Australia.
Many reasons for this have been suggested
but the true nature is not yet fully understood.
It is believed that the main issues contributing
to higher stress levels are the downturn in
financial viability of many farms in Australia
and a lack of employment opportunities.
Farmers generally have poorer health and
fewer health services to support them in their
rural environment compared to urban areas.
There is a link between physical and mental
health issues where changes in work practices
have lead to a more sedentary life contributing
to obesity, diabetes and other chronic illness.
This, coupled with the stoic nature of rural
men promotes a cycle of negative health
outcomes (Figure 1).1
Tools to prompt a conversation
Pharmacists are trained to engage with their
clients and often are seen as less threatening
than other health care providers. To help open
a dialogue, consider the following:
• Engaging in health promotion.
• Having conversations with your clients
and understand their problems and health
• Establish a rapport with them and their
family (it is often the family members that
will identify a problem).
• Foster a good relationship with the local GP
so information passage is encouraged.
• Consider a mental health first aid
course to improve your confidence and
understanding of the issues.
• Encourage HMRs, which are useful in
identifying undiagnosed or poorly treated
The rural male population is at risk of
many chronic and acute illnesses. There is
a clear link between their general health
and mental health. This compounded with
the stresses of an increasingly complex
business model. Further, lack of services
can lead to mental health problems greater
than those experienced in the urban
setting. The stoic nature of men working
in a rural environment and a ‘she’ll be
right’ attitude provide a barrier to health
care. The farmer in this case study would
benefit from open dialogue and support
from family and friends. He should be
encouraged to see his GP and restart his
medication, particularly as current privacy
laws require consent from the client before
you can approach the GP unless they are
at risk of serious harm. Providing him with
a better understanding of depression and
information may encourage him to review
his treatments options.
1. Miller K, Burns C. Suicides on farms in South Australia.
Australian Journal of Rural Health, 2008;16(6):327.
2. Alston M. Rural male suicide in Australia. Social science &
3. Maslen CL, Rees L, Redfern PH. Role of the community
pharmacist in the care of patients with chronic schizophrenia
in the community. International Journal of Pharmacy Practice,
4. Landers M, Blenkinsopp A, Pollock K. Grime J. Community
pharmacists and depression: the pharmacist as intermediary
between patient and physician. International Journal of
Pharmacy Practice, 2002;10(4):253–65.
5. National Competency Standards Framework for Pharmacist
in Australia, National Competency Standards Framework for
Pharmacist in Australia. 2010.At: www.psa.org.au/download/
6. Eades CE, Ferguson JS, O’Carroll RE. Public health in community
pharmacy: a systematic review of pharmacist and consumer
views. BMC public health, 2011;11(1):582.
7. O’Reilly CL, Bell S, Kelly P, Chen T. Impact of mental health first
aid training on pharmacy students’ knowledge, attitudes and
self-reported behaviour: a controlled trial. The Australian and
New Zealand journal of psychiatry, 2011;45(7):549–57.
8. Black E, Murphy AL, Gardner DM. Community pharmacist
services for people with mental illnesses: preferences,
satisfaction, and stigma. Psychiatric services ( Washington, D.C .),
Increased BMI &
Figure 1. Cycle of negative health outcomes
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