HEALING THE MIND
Melanie McLeod, who runs Vital Care Pharmacy, is one of two psychiatric pharmacists in the province who specialize in supporting patients with mental health disorders. She helps patients navigate the system to make sure the cost of their medication is covered, monitors them to ensure they take their drugs and watches for side effects.
As one of two psychiatric pharmacists in Saskatchewan, Melanie McLeod is a passionate advocate for patients with mental health disorders and “a dream come true” for Regina psychiatrists.
“I work with a lot of patients that have severe and persistent mental illness,” McLeod said. “That includes patients with schizophrenia, bipolar disorder and many patients with anxiety or major depressive disorders.”
After receiving her pharmacy degree from the University of Saskatchewan, McLeod underwent an additional four years of education to get her doctorate of pharmacy through the University of Toronto and then wrote an American board certification exam in psychiatry.
She noted it’s well documented in the literature that mentalhealth patients don’t have the same access to primary care as patients not suffering from psychological illness.
Dr. Mohamed Eisa, section head of in-patient psychiatry in Regina, said a community pharmacy that provides services specifically for patients with psychological disorders has been needed for a long time. “It is honestly a dream come true,” he said. “I practised in England before coming here, and even there we didn’t have that service.”
Psychiatric medications are an integral part of treatment for people with serious mental illness.
Eisa noted McLeod helps patients navigate the health system to make sure the cost of their medication is covered, monitors them to ensure they take their drugs regularly and watches for side effects.
“They consistently communicate with the team — specifically if they have concerns — and we see the patient as soon as possible,” he said.
The Vital Care Pharmacy’s extended hours during the week and on weekends make it more convenient for patients to get injectable drugs, which previously were only available at the mental-health clinic and hospital.
McLeod works closely with psychiatrists who send her patients not responding to medications or having side effects. “Quite honestly, psychiatric medications can be quite complicated,” McLeod said.
Part of her job entails helping patients who can’t afford their prescribed medications. Many psychiatric drugs are expensive and not all physicians are aware of resources patients can access to reduce the cost.
Employed by the Saskatchewan Health Authority, McLeod cares for patients at the mental-health clinic and the General Hospital’s psychiatric ward.
She worked as a hospital pharmacist for years before furthering her education. On her return to Regina, McLeod couldn’t find employment in the pharmacy department while maintaining her interest in mental health.
She credits Lorri Carlson, executive director of Mental Health and Addictions Services with the Regina Qu’Appelle Health Region, for hiring her in 2009.
“This is not a typical model where a department hires a pharmacist, but they had a lot of support from the physicians and psychiatrists,” McLeod said.
Working with patients and teaching psychiatry residents, her plate was full. Twice she put in proposals to the RQHR to add another psychiatric pharmacist. Both requests were denied because of budgetary constraints.
That’s when McLeod decided to create a team of community mental-health pharmacists. In March, she and her husband opened Vital Care Pharmacy, located near the General Hospital.
Owning the pharmacy lessened her workload as store pharmacists handle the drug coverage paperwork for many patients.
“Part of the reason I opened the pharmacy was to increase capacity so there would be other pharmacists with an interest and skill set in this area to help with some of the workload and are located in the community,” McLeod said.
The pharmacy fills all types of prescriptions, but it specializes in mental illness. Pharmacists provide injections for patients with mental illness and other conditions. “It could be for schizophrenia or bipolar disorder or it could be for a transgender patient that’s going through a process of change that requires hormone injections,” McLeod said. “It could also be for somebody who is going through the challenges of infertility.”
Many transgender patients have difficulty getting injections because of stigma, she said.
“Their family physicians might not feel comfortable or pharmacies typically only give injections in the arm and many have to be given in the hip,” McLeod said.
The pharmacy employs two full-time pharmacists in addition to McLeod, who works part-time.
“We really focus on having no stigma here,” she said. “That’s a deal breaker when hiring staff .... A lot of our patients are not treated well, and a lot of times it’s just their illness. They may act different and not communicate very well, and they don’t know how to ask for what they need or know exactly what they need. When they encounter barriers, they just decide, ‘I’m not going to take my medications.’ ”
That starts a vicious cycle. “Patients are admitted to hospital and utilize resources — unfortunately, I’ve seen this cycle too many times,” she said.
Her pharmacy is the first of its kind in Saskatchewan. “A lot of pharmacies administer injections, but we specifically do it for mentalhealth patients that may require it in the arm or the gluteal muscle,” McLeod said. “We have two private rooms and we take on the responsibility of reporting back any concerns we have .... Sometimes we can detect something early and nip it in the bud and they don’t have to be hospitalized.”
She hopes to train and mentor pharmacists and pharmacy students interested in working with mentally-ill patients.
“I want to pass the torch eventually,” McLeod said. “It’s just amazing to see patients when they’re well.”