World Mental Health day – 10 October – is a fantastic opportunity for pharmacy staff to tackle the issue of mental health stigma, encourage customers to talk about the subject and seek help, if necessary

One in four adults and one in 10 children will experience a mental health problem in any given year, according to the World Mental Health Foundation. But despite the damaging ripple effect that mental health problems have on a person’s work, relationships and wellbeing, there are still many factors which prevent people from seeking help and getting the treatment they need.

“Overall, we know that stigma does still prevent people from accessing the help they need. In fact, three-quarters of people with mental health problems receive no support at all,” says Nia Charpentier from the charity Rethink Mental Illness. 

Even those with serious mental health problems struggle to get the right help, with only 10 per cent having access to all the treatments recommended by the National Institute for Health and Care Excellence (NICE).

At the Mental Health Foundation (MHF), Cal Strode says: “We know that only 25 per cent of those experiencing mental health problems in any given year have accessed any support. This presents both a challenge and an opportunity for frontline pharmacy professionals, who are well placed to spot the signs of mental distress and encourage people to seek and access the range of support available to them.”

The most common mental health problems in the UK include anxiety (8.2 million cases), mood disorders (four million), addiction (one million), depression, panic disorder, obsessive compulsive disorder and post traumatic stress disorder.

Asking for help

Thanks to initiatives such as Rethink and Mind’s ‘Time to Change’ campaign, public attitudes towards mental health have improved by six per cent in the last three years, suggesting that people are becoming braver about seeking help. “We have seen a lot of progress in terms of public awareness of the importance of looking after mental health,” says Cal. “An increased media focus on mental health has pushed it up the public agenda. We hope this increased awareness translates into more help seeking behaviours,” he adds.

However, there is still a long way to go, says Nia: “Unfortunately, the impact of stigma can mean that people are unsure about seeking help, and years of cuts to funding to vital services mean that when people do seek help, it can be difficult to access appropriate support, meaning people only come into contact with mental health services when they’ve reached crisis point. Early intervention, in both seeking help and accessing treatment, can make all the difference to recovery.”

Pharmacy staff are well placed to encourage customers to seek help. “Anyone can engage in open, non-judgemental conversations. For example, just asking how someone is, openly listening to their answer, and providing reassurance that help is available can be hugely helpful. Staff can also offer reassurance and information on the advice and support available,” says Nia. To assist pharmacy in teams in knowing how to help people, Rethink has an SOS guide, which gives advice on recognising distress signals and how and when to act in different situations.

“The Improving Access to Psychological Therapies (IAPT) scheme, launched in 2011, has made strides into better access to talking therapies. Raising awareness of the range of talking therapies available through IAPT is a great way in which pharmacists can encourage more people to ask about and access the range of therapies available to them,” explains Cal.

Stephen Buckley, head of information at Mind, says asking for help can be difficult: “Speaking to a GP might seem daunting, but it’s the first step to getting the help and support that’s right.” 

Tackling stigma

The issue of stigma around mental health is the biggest obstacle in terms of recognising problems, asking for help and recovering from a mental health problem. However, things are starting to change, thanks to help from several large campaigns. As well as Rethink and Mind’s Time to Change, these include the new ‘Heads Together’ campaign, set up this year by the Duke and Duchess of Cambridge and Prince Harry, as well as World Mental Health Day.

“Addressing stigma could play a big part in improving quality of life for your customers with mental health problems,” says Nia. “Some 60 per cent of people with mental health problems say stigma and discrimination is as bad or worse than the illness itself. Staff could take part in mental health training so that they feel more comfortable and confident talking about mental health and know how to respond in helpful ways,” she adds.

Jo Loughran, interim director of Time to Change at Mind agrees: “We’d encourage pharmacy staff to be open to discussions, to be there and to listen. They don’t need to give expert advice, just lending an ear can help.”

Public Health England recently published a survey that found that 91 per cent of people were confident they knew what it meant to have good mental wellbeing. However, levels of stigma still need to be tackled – only half of those surveyed said they would be willing to socialise with someone with schizophrenia. The MHF produces a Fundamental Facts report on mental health each year, which aims to increase awareness of mental health disorders, lessen stigma and encourage people to seek help, and looks at the impact of treatment and early intervention.

Rethink is also encouraging employers to sign the ‘Time to Change employer pledge’. Nia explains: “This is an aspirational statement with meaning, indicating to employers and the wider community that an organisation wants to take action to tackle the stigma and discrimination around mental health. Behind this pledge, the organisation creates an action plan of activities that staff can engage in to bring an end to the stigma and discrimination around mental health.”

Protecting mental health

“So many areas of our lives can impact on our mental health – from work to relationships – but there are a lot of simple things we can all do to support our mental wellbeing,” says Nia. “These could include eating a balanced diet, doing regular exercise, or trying techniques such as mindfulness.” 

Mindfulness is an integrated mind-body based approach that can help with many mental health problems and has been recommended by NICE for people with recurrent depression.

Regular exercise has been proven to be beneficial and protective to mental health by many studies. A Dutch study of 7,000 people, for instance, found that exercise reduced the risk of a mood or anxiety disorder over the following three years.

The MHF recommends the following prevention tips to pass on to your customers:

• Talk about your feelings: talking can be a way to cope with a problem you’ve been carrying in your head. Being listened to can help you feel supported
• Keep active: regular exercise can boost self-esteem and help you concentrate, sleep and feel better. Ideally, aim for 30 minutes of physical activity a day
• Drink sensibly: drinking is not an effective way to manage difficult feelings – when the effects wear off, you feel worse because of the way alcohol affects the brain and body 
• Keep in touch with family and friends: they can make you feel included and cared for. They can offer different views from what’s going on in your head
• Ask for help if you’re finding it difficult to cope: talk to family and friends or get in touch with local support services to talk to a counsellor or GP
• Take a break: a change of scene or pace protects mental health. Try to give yourself some ‘me time’ every day. You can do something active, or something relaxing such as yoga, meditation or simply putting your feet up and reading a book
• Do something you’re good at: concentrating on a hobby or something you enjoy doing can help change your mood and enable you to forget your worries for a while
• Care for others: volunteering and helping others can make you feel needed and valued, which boosts self-esteem. Caring for a pet helps too.

Only 25 per cent of those experiencing mental health problems in any given year have accessed any support