August 2020 - “I never saw myself opening a pharmacy in my career but I realized that it was something that was needed, something that would help me—as the lone psychiatric pharmacist in Regina—and would help my patients, ” says Melanie McLeod, founder of Vital Care Pharmacy in Saskatchewan.
McLeod began her career as a hospital pharmacist and went on to become a consultant pharmacist for Mental Health & Addiction Services, where she still works with patients under the care of a psychiatrist in both the community and hospital settings. Her experiences in both hospital and clinic settings revealed some of the shortcomings of the current medical and pharmacy systems. This led her to advocate for better mental health for patients and ultimately to open Vital Care Pharmacy.
“There was an unmet need for a dedicated service for patients with mental illness, especially during transitions of care,” says McLeod. She also saw the opportunity of enabling pharmacists to enhance their scope of practice by administering injections used in the treatment of severe and persistent mental illnesses, such as schizophrenia and bipolar disorder.
As luck would have it, there happened to be a space available in a building with a psychiatrist clinic run by some of Mcleod’s colleagues, and in 2017 Vital Care Pharmacy was opened. McLeod felt compelled to open a pharmacy, and saw it as a chance to train and work with other pharmacists in helping them feel more comfortable working in a more specialized area.
Now McLeod works with a team of two pharmacists and two assistants at Vital Care. One of the major aspects that McLeod has trained her pharmacists on is reducing stigma and improving listening skills. Psychiatrists and other mental health professionals have helped provide direct training to staff, with mini-mental health status exams and clinical assessments that help pharmacists more easily recognize and communicate potential mental health concerns.
“There are lots of opportunities for staff to liaise with case managers, crisis team members, psychiatrists and primary care clinicians. We’ve established a close connection with the mental health team,” she says. “Everyone knows each other on a first-name basis, and if one of my pharmacists calls a psychiatrist with concerns they will promptly take the call recognizing that it likely relates to something important concerning one of their patients.”
It’s more costly, and currently, McLeod and her co-workers haven’t been compensated adequately for the extra work associated with administration and monitoring of patients receiving injections. (They are only able to charge a $60 fee for administering blister packs) That being said, she and her team continue to offer the service to more than 200 patients because they believe that it leads to better overall patient care and enhanced scope of practice for pharmacists.
“We provide considerable value to the healthcare system by administering injections and monitoring patients,” she says. “I am hopeful that the Ministry [of Health] will ultimately recognize this contribution that pharmacists are providing and compensate accordingly.”
Currently, McLeod continues to work as a consultant with Mental Health & Addiction Services and has reduced her time spent working at Vital Care Pharmacy to one weekend a month and relief work when required. She says she is grateful that her pharmacists have embraced the clinically expanded role and are doing an amazing job.
“It's nice to see patients that I've been involved with for a long time that used to be unwell and are now doing better,” says McLeod. “Seeing how well they're doing is extremely heartwarming and gratifying.”