title: Community pharmacists' experiences in mental illness and addictions care: a qualitative study.
abstract: BACKGROUND
  Community pharmacists are accessible health care professionals who encounter people with lived experience of mental illness and addictions in daily practice. Although some existing research supports that community pharmacists' interventions result in improved patient mental health outcomes, gaps in knowledge regarding the pharmacists' experiences with service provision to this population remain. Improving knowledge regarding the pharmacists' experiences with mental illness and addictions service provision can facilitate a better understanding of their perspectives and be used to inform the development and implementation of interventions delivered by community pharmacists for people with lived experience of mental illness and addictions in communities.
  
  
  METHODS
  We conducted a qualitative study using a directed content analysis and the Theoretical Domains Framework as part of our underlying theory of behaviour change and our analytic framework for theme development. The Theoretical Domains Framework facilitates understanding of behaviours of health care professionals and implementation challenges and opportunities for interventions in health care. Thematic analysis co-occurred throughout the process of the directed content analysis. We recruited community pharmacists, with experience dispensing psychotropics, at a minimum, through multiple mechanisms (e.g., professional associations) in a convenience sampling approach. Potential participants were offered the option of focus groups or interviews.
  
  
  RESULTS
  Data were collected from one focus group and two interviews involving six pharmacists. Theoretical Domains Framework coding was primarily weighted in two domains: social/professional role and identity and environmental context and resources. We identified five main themes in the experiences of pharmacists in mental illness and addictions care: competing interests, demands, and time; relationships, rapport, and trust; stigma; collaboration and triage; and role expectations and clarity.
  
  
  CONCLUSIONS
  Pharmacists are not practicing to their full scope of practice in mental illness and addictions care for several reasons including limitations within the work environment and lack of structures and processes in place to be fully engaged as health care professionals. More research and policy work are needed to examine better integration of pharmacists as members of the mental health care team in communities.
authors.affiliation: College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada. andrea.murphy@dal.ca.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Murphy
authors.affiliation: College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada. heather.phelan@dal.ca.
authors.forename: Heather
authors.initials: H
authors.lastname: Phelan
authors.affiliation: College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada. scott.haslam@dal.ca.
authors.forename: Scott
authors.initials: S
authors.lastname: Haslam
authors.affiliation: School of Nursing, Dalhousie University, 5869 University Ave., PO Box 15000, Halifax, NS, B3H 4R2, Canada. ruth.martin-misener@dal.ca.
authors.forename: Ruth
authors.initials: R
authors.lastname: Martin-Misener
authors.affiliation: Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University/IWK Health Centre, 5850 University Ave., PO Box 9700, Halifax, NS, B3K 6R8, Canada. Stanley.kutcher@iwk.nshealth.ca.
authors.forename: Stan P
authors.initials: SP
authors.lastname: Kutcher
authors.affiliation: Department of Psychiatry, Dalhousie University, QEII HSC, AJLB 7517, 5909 Veterans' Memorial Lane, Halifax, NS, B3H 2E2, Canada. david.gardner@dal.ca.
authors.forename: David M
authors.initials: DM
authors.lastname: Gardner
mesh_terms: D003157:Community Pharmacy Services / Q000458:organization & administration; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration; D010595:Pharmacists; D024382:Professional Role; D036301:Qualitative Research; D000078329:Workforce
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