Within required pharmacy school curricula, focus is placed on educating students on the most common disorders and medications that may be encountered within patient care settings. A published review describing pharmacy curricula focused on psychiatry and neurology reported that programs dedicate the most didactic time (between 3 to 5+ hours) toward learning about epilepsy, depression, schizophrenia, substance use disorders, and pain. Disorders such as autism, personality, and eating disorders were either not taught or given less than one hour. Required integrated pharmacotherapy courses are often very fast-paced with emphasis placed on pharmacology and clinical use of psychiatric and neurologic medications. There is limited time left to focus on the patients’ lived experiences, non-pharmacological treatment options, and barriers to care such as stigma. A mental health elective is an opportunity for faculty to capture this content with more flexibility, creativity, and autonomy.
There have been several articles published describing the positive impact of mental health-focused electives on students' perceptions, social distance, and stigmatizing views of mental illnesses. Improvements have also been noted in confidence and willingness to initiate conversations on mental health. In this article, I will briefly describe an elective that we have taught at SIUE School of Pharmacy for the past 15 years, including personal student feedback on their experiences taking the course.
The elective was designed to be discussion-based, with a smaller cohort of students. Since its inception in 2007, it has remained a 2-credit hour course, with a maximum capacity of 30 students. Limiting the number of students allows for the creation of a safer, more manageable environment, promoting more thoughtful and empathic conversations. Over the years, documentaries surrounding the impact of serious mental illness on family and loved ones, understanding suicidality, and overdose prevention have been incorporated into the class. Students are routinely given opportunities to engage in discussion and practice skills, such as administering the AIMS, suicide risk assessment, and how to provide harm reduction education. Topics that are consistently covered every year include:
The second week of class involves a more in-depth discussion on Motivational Interviewing, with opportunities to practice conducting a psychiatric patient interview. This is meant to prepare the students for a required patient interview experience that occurs in waves throughout the semester. Students are tasked with performing a psychiatric patient interview (formerly in person, and now via telehealth due to pandemic restrictions). Following the interview, the student must prepare a thorough psychiatry SOAP note, including subjective information taken from the interview, objective information obtained from the patient chart, as well as a complete mental status examination. This exercise continues to be the most influential and impactful student learning experience in the class.
Student feedback surrounding this course has remained positive through the years, and the following comments represent personal reflections on its impact:
The classroom experience:
The patient interview experience:
Since the creation of this elective course, it continues to be one of my most joyful experiences in academia. I have learned that giving students the space and opportunity to further explore their own biases and beliefs surrounding mental health disorders and empowering them to be a part of the positive change we hope to see within behavioral health care, can have a profound impact on both the student and the instructor. While most students may not aspire to specialize in psychiatric pharmacy, all students will likely have some influence on the provision of patient care. An elective course such as this can inspire future pharmacists to approach patient care with more empathy and understanding, and equip them with the tools and confidence to routinely incorporate mental health care into holistic conversations about overall health and wellness.