To the editor: We commend Buhler and Karimi on their study of the role of peer-level patient presenters in mental health pharmacy education.1 The lack of mental health education has been described as the most important barrier to the provision of community pharmacy services for people with mental illness.2 In addition, suboptimal attitudes toward people with mental illness may be common among health professionals.3 The innovative education described by Buhler and Karimi addresses barriers to mental healthcare that are commonly reported by pharmacists and pharmacy students.
In their report Buhler and Karimi state that the effect of the pharmacy curriculum on reducing social distance has not been studied. In addition they report finding no literature describing the use of patient presenters in mental health education. We have previously reported the use of consumer educators as partners in a continuing professional development program for pharmacists,4 and the impact of consumer participation in mental health education for pharmacy students.5 In the later study we evaluated the impact of the consumer participation using a survey instrument that included a 7-item social distance scale. Our results were consistent with those of Buhler and Karimi, and also those of previous research that demonstrated an association between increased contact and improved attitudes toward people with mental disorders.6
There are conflicting reports as to whether workplace experience reduces social distance from people with mental illness.7-9 Contacts between pharmacy students and people with mental illness during clinical placements typically occur in the context of a provider-patient interaction. This kind of interaction may not contribute to students developing a greater understanding of a consumer's experience of their illness. However, recent research conducted in Estonia found that previous employment in a pharmacy was associated with lower social distance among pharmacy students.10 The determinants of social distance among pharmacy students may be culturally specific and, therefore, education programs may need to be tailored accordingly.11 Buhler and Karimi achieved “peer-level” interactions by using presenters with graduate-level education or work history as a health care professional. We attempted to achieve equal status interactions by formally recognizing consumers as university instructors.
In 2008, consumer-led education was again successfully trialed as a part of the degree program for third-year pharmacy students at The University of Sydney.12 This education was supported by the Schizophrenia Fellowship of New South Wales, a nonprofit community-based organization. We agree with Buhler and Karimi that future research is needed to determine whether improvements in students' attitudes will translate into improved provision of pharmacy services. We are presently following-up with students who received this form of education to assess the impact on self-reported behavior. Regardless of the potential improvements in service provision, we concur with Buhler and Karimi that people with mental illness have a valuable role in improving students' attitudes, addressing common misconceptions, and highlighting the importance of the patient/pharmacist relationship.
J Simon Bell, PhD
Faculty of Pharmacy, University of Helsinki, Finland; Faculty of Pharmacy, The University of Sydney, Australia
Claire L O'Reilly, BPharm(Hons)
Timothy F Chen, PhD
Faculty of Pharmacy, The University of Sydney, Australia
REFERENCES
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