Suicide prevention training for community pharmacy teams

Dr Hayley Gorton

The importance of pharmacies as frontline healthcare providers has been evident during the pandemic – including stepping up to provide COVID-19 vaccinations.

Policymakers increasingly value the skills of the modern pharmacist and their accessibility for local communities. Dr Hayley Gorton, Senior Lecturer in Pharmacy Practice at the University of Huddersfield, has identified another potential key role for community pharmacists and their teams – suicide prevention. She says: “When I attended the annual conference of the International Association for Suicide Prevention (IASP) in 2015 I realised that I was the only pharmacist amongst the 700 or more people there. I asked myself what I would do if someone came into my pharmacy who was possibly in crisis and who I thought might be contemplating suicide.” Dr Gorton began to explore the issue with colleagues in pharmacy circles and realised there were gaps in knowledge. She recalls: “It was clear that this was an area where community pharmacists and their teams had a role to play, and I felt it was important to take this further.”

Building the evidence

This insight spurred Dr Gorton into a research project in which she led interviews with pharmacists, pharmacy technicians and pharmacy counter staff. She says:

“It was really important to talk to those other staff because they are often the first people that a customer would see. And, indeed, many of them reported interactions with people who were thinking about suicide. Reflecting on those experiences, they felt that training could equip them with the skills to be a useful gatekeeper and to have valuable conversations with those people.”

Seven years on from that conference epiphany and following research into practice in the UK and North America, many of Dr Gorton’s insights and research findings are now reflected in official thinking and in the work of community pharmacies.

Influencing policy

In January 2022, the National Institute for Health and Care Excellence, recognised the potential role of community pharmacists in this area for the first time when it cited Dr Gorton’s research in its draft guidance on self-harm. Her paper was the only pharmacy-related research cited in the draft guidance, suggesting it has had a significant impact. Meanwhile, the latest NHS England contract for community pharmacies includes a requirement that all patient-facing pharmacy staff undertake suicide awareness training – a key recommendation in Dr Gorton’s paper. “I can’t say whether or not our research directly influenced this decision, but it was one of our key recommendations.”

Maintaining the international dimension

Having been a driving force behind formation of the IASP’s special interest group about suicide prevention in primary care, Dr Gorton is working with colleagues to connect the different types of expertise within the sector and identify new research opportunities. She says: “It’s very surprising how little research has been done in this area, even with GPs, but there is obviously more than there is in pharmacy. One of my goals is to understand which of the other professions working in primary care – such as allied health professionals or practice nurses – is involved in suicide prevention.” In her international role as co-chair of the IASP group, Dr Gorton draws on contacts made while studying policies and practices around pharmacy and suicide prevention in North America in 2018, when she was awarded a Winston Churchill Memorial Trust Fellowship. She travelled to meet academics and clinicians researching the impact of small pharmacy teams in suicide prevention. “Although we were probably ahead in the UK some aspects of community pharmacy practice, it was something they were considering in other countries. In Washington State, for example, they had just made it a legal requirement for pharmacists to have suicide prevention training.”

Research into practice

On her return from her Fellowship, Dr Gorton immediately began to put her new knowledge to practical effect. She explains: “I worked with the training body for registered pharmacy professionals in England, the Centre for Pharmacy Post-Graduate Education. We did an ‘on the sofa’ type interview video to raise suicide awareness, with an accompanying research study.” Huddersfield pharmacy students are also benefitting from Dr Gorton’s leading role in the field as she has included suicide prevention in her module to final year undergraduates. Dr Gorton is now talking to academic and clinical counterparts across the UK about incorporating mental health first aid training into the pharmacy curriculum. It looks certain that pharmacists will have a future role in efforts to reduce suicide numbers, thanks in part to Dr Gorton’s work.