A qualitative exploration of the interaction between mental illness stigma and preparedness for practice in pharmacy students

Introduction: Mental illness stigma can result in discriminative practice in pharmacy, such as providing less pharmaceutical care to people living with mental illness (PMI) than those with physical illness. Pharmacy education should aim to reduce the impact of mental illness stigma on the pharmaceutical care of PMI. Whilst previous research has shown that some interventions can reduce stereotyping and prejudice in pharmacy students, the impact on subsequent discrimination is questionable and the reasons for successful and unsuccessful outcomes are unclear. This study aimed to explore pharmacy students' views on working with PMI and how these views might interact with mental illness stigma. Methods: Focus groups and semi-structured interviews with final year pharmacy students and recent graduates were conducted at one UK university. Question guides were developed based on the aim of the study and investigated participants' attitudes and beliefs about mental illness. Following transcription, data were analysed in line with the guiding principles of constructivist Grounded Theory. Results: Three major categories were developed which accounted for the data: Knowing, Doing and Valuing. Participants reported that in common with the general public, pharmacy students possess insufficient knowledge about mental illness, which limits what can be done to help and support people living with it. Finally, participants reported that mental illness is ascribed insufficient value in the pharmacy curriculum, healthcare, and in wider society. Interactions between stigma and each of these categories were identified. Conclusion: The findings offer a novel, qualitative description and explanation of mental illness stigma among pharmacy students from one UK university. Further, the factors identified by pharmacy students as modifiers of preparedness for professional practice provide an evidence base for curriculum development with possible international relevance. This may help pharmacy educators to develop evidence-based strategies aimed at reducing the impact of mental illness stigma in future professional practice.