(392) Current Practices, Stigma, and Barriers to Implementing Depression Screening Services in Rural Community Pharmacies

Trainee Category: Graduate Student

Objective : To investigate current practices, stigma toward patients with mental health conditions, and barriers and facilitators associated with implementing a depression screening service among pharmacists in rural areas.

Methods: A web-based survey was developed with a stakeholder panel consisting of two rural pharmacists, two rural community members who used pharmacies, and one psychologist. The survey collected data on demographics, confidence, stigma towards mental health conditions, and barriers to implementing a depression screening service among Alabama and Mississippi pharmacists practicing in rural areas (RUCA codes 4-10). The survey was sent by postcard to all pharmacists (n=621) practicing in rural Alabama and Mississippi identified using the Hayes directory.

Results: Of 621, 13% (n=83) pharmacists responded with 50% (n=42) female, 73% (n=61) white, and 96% (n=81) non-Hispanic. Only 8% (n=5) currently offered depression screenings and 10% (n=8) had used the PHQ-9 (depression screening tool) before. The indicated average confidence in performing a depression screening was 2.5 (standard deviation [SD]=1.1) on a 1 (low) to 5 (high) scale. Stigma toward patients with mental health conditions was 2.9 (SD=0.6) on a 1 (low) to 5 (high) scale. Barriers identified were staff and pharmacists’ lack of skills, knowledge, time, and insufficient reimbursement.

Conclusions: Findings demonstrate deficiencies in the confidence and knowledge of pharmacists concerning depression screenings as well as increased stigma, which may contribute to a low implementation of depression screening services in rural pharmacies. A pharmacist training program that addresses these deficiencies is in development to increase depression screening services in pharmacies in rural areas.