Pharmacists can help prevent suicides: here is how

Pharmacists are the most trusted group in the health care industry, according to a recent survey. The survey found that patients have more trust in people who directly provide their health care. It should be no surprise then, that pharmacists receive continued high ratings by Americans for their honesty and ethical standards. Further, studies have shown that pharmacists, with 6-7 years of college education, are the most underutilized member of the primary healthcare team.

A majority of Americans come into regular contact with pharmacists, and their high ratings speak to putting the patient’s needs first and foremost. In that context, we should look to pharmacists to take on a new and lifesaving role in the changing landscape of value-based healthcare delivery: suicide prevention.

Suicide rates are increasing, rising rapidly especially among African American and veteran groups. But most suicides can be prevented with timely interventions – and this is where pharmacists can play a crucial role.

Research has shown that most persons who commit suicide are users of anti-depressant medications – legally prescribed by a physician and dispensed by a pharmacist. This is not to say that all who uses anti-depressant medications are potential suicide victims; however, studies have shown that there is a direct correlation in risk assessment. Accordingly, then, pharmacists are in a unique position to be first responders to persons at risk – if they had training in suicide prevention techniques and could take the time to ask, probe and refer. 

There five things that pharmacists can do as first responders:

• identify at-risk patients. Because pharmacists regularly dispense antidepressants, they are in a unique position to identify patients who may be struggling with suicidal thoughts. 
• monitor medication uses and mental health. If pharmacists observe any changes in how a medication is taken or prescribed, then they should learn the reasons behind them.
• collaborate with the health care team. Patients who have divulged thoughts or a plan of self-harm/suicide should be strongly encouraged to immediately discuss these thoughts with their primary care or mental health provider.
• refer to suicide prevention resources. There are a number of tools and resources available for both patients experiencing suicidal thoughts and those concerned that a patient, friend, or loved one may be suicidal.
• engage by being encouraging and empathetic. Pharmacists should listen carefully and attentively if and when patients open up about any suicidal thoughts.

There is one death by suicide in the U.S. every 12 minutes, which is not only tragic for the victims but also devastating for the family. The impact of the suicide is, to some extent, informed by the family’s function (or dysfunction) prior to the suicide. Moreover, the suicide may affect family communication and the developmental processes of children. Marital breakup is also more common in parents of children who died by suicide.

But there is hope. Suicides can be prevented.

Pharmacists Preventing Suicides (PPS), a not-for-profit Missouri corporation, has been established to train health professionals – pharmacists, in particular – in proven intervention techniques designed for persons at risk of taking their own lives.

Founded by the late Dr. Patrick Tharp seven years ago, PPS has conducted numerous community education seminars and has worked closely with St. Louis College of Pharmacy, in establishing suicide prevention training as part of its 7-year PharmD curriculum. Also, PPS has established an annual $2,500 scholarship at the college for a last year pharmacy student who has either volunteered at a suicide prevention organization or has had a personal experience with suicide in their own family.

However, more help is needed from the community for PPS to fund these activities and to lobby the state Legislature to reimburse pharmacists for time spent in counseling persons at risk. PPS has determined that reimbursement for pharmacist counselling time is equally important as the pharmacist training in suicidality.

Clearly, creating a new role for pharmacists is a massive undertaking but PPS believes, it can be done. One life lost to suicide is one too many.

Robert Lawrence Salter, EdD, MHA, RPh, is president of Pharmacists Preventing Suicides, Inc. and adjunct faculty at Washington University at St. Louis.