Pharmacists Welcome Mental Health Interventions for Long-Term Condition Patients

Community pharmacists expressed positive feelings toward offering mental health interventions to improve depression and anxiety among long-term condition (LTC) patients, according to a study published in Exploratory Research in Clinical and Social Pharmacy.¹

“Subthreshold depression (sDep) and anxiety (sAnx) represent conditions in which people experience signs and symptoms that are significant enough to affect their lives but do not meet the threshold for a clinical diagnosis and are common conditions in the general population,” wrote authors of the study. “The prevalence of sDep is estimated to be between 10% to 24%, and sAnx is estimated to be up to 13.7%.”

While not serious enough to warrant targeted interventions at first, 35% of sDep and sAnx cases develop into clinical depression and anxiety. Cases of sDep and sAnx are especially detrimental to patients living with LTCs, such as diabetes or cardiovascular disease (CVD), since poor mental health has been known to exacerbate chronic conditions.

Chronic diseases have been found to significantly impact mental health outcomes, while poor mental health has also been known to impact long-term conditions. | image credit: VadimGuzhva / stock.adobe.com

READ MORE: Inflammation Linked With Depressive Moods for Older Adults With Insomnia

Researchers have uncovered significant evidence that links depression, anxiety, and mental health conditions with many chronic diseases. According to the National Institute of Mental Health, chronic diseases can lead to depression and vice versa. Indeed, aside from diabetes and CVD, depression has been known to lead to stroke, chronic pain, osteoporosis, Alzheimer disease, and more.²

“It has been suggested that intervention may be warranted for up to 80% of those affected by subthreshold conditions. However, the mental health system is under pressure,” the authors continued.¹ “There is a key opportunity for primary care services to potentially meet the general mental health needs of the population with subthreshold needs.”

However, with primary care physicians reporting some of the highest burnout rates among any medical specialty,³ experts are looking to pharmacists to carry the load for potential mental health interventions. Over 90% of patients with mental health conditions seek care in a community setting. With the high levels of access and trust community pharmacists have garnered over the years, researchers believe they may be perfectly positioned to administer mental health interventions, especially among patients with LTCs.

“No study has explored the views of community pharmacists on delivering interventions for LTC patients with sDep and sAnx,” they wrote.¹ “The aim of this study is to explore the views and attitudes of community pharmacists on providing a brief intervention for LTC patients with sDep and sAnx and the barriers and facilitators for providing such an intervention.”

Researchers conducted 1-on-1 interviews with community pharmacists in New Zealand from diverse backgrounds and experiences. Led by the study’s primary author, interviews were conducted either in person or through video conference. They lasted approximately 45 minutes long and occurred between May and August of 2023.

The final analysis consisted of 11 total participants (45.5% between 25 and 34 years old; 63.3% in urban practices) that conducted interviews during the study period.

Regarding participants’ willingness to adapt a mental health intervention in community pharmacy practices, they welcomed the idea. Pharmacists participating in the study saw significant value in benefits like early interventions, meeting a gap in services, and reducing the burden of the health care system. Furthermore, commonly noting themselves as accessible and approachable providers, participants also mentioned the sheer availability of community pharmacies multiple times in their responses.

Aside from their willingness and opinions on providing mental health interventions, they also discussed approaches to implementing such services in a community pharmacy setting. The participants identified 4 key themes in introducing a mental health intervention: existing support mechanisms, perceptions and attitudes, barriers and facilitators, and design and implementation.

Serving as an overarching framework for implementation, participants provided researchers with a detailed approach to identifying existing support, filling in gaps in providers’ perceptions on these services, overcoming barriers and utilizing facilitators, and finally, implementing the new service.

“If a pharmacist-led service were to be successfully implemented in practice, it would have the potential to reduce the number of individuals progressing from subthreshold to clinical depression and anxiety, therefore reducing the overall prevalence of LTC patients with depression and anxiety,” the authors said.¹ “Furthermore, this research will also inform future primary care mental health services/interventions by highlighting key elements that need to be considered in the service design process.”

Like many other necessary patient services, pharmacists have shown both their capabilities and passion for improving health outcomes for patients in their communities. As mental health becomes yet another area of exploration for patient-facing pharmacists, further research will be conducted to test these services and adopt them in more communities.

“Many participants saw the value of such an intervention and described a range of factors that need to be considered when designing an intervention,” they concluded.¹ “These findings can be used to inform the future design of an intervention, with the potential to address sDep and sAnx in a community pharmacy setting.”

READ MORE: Mental and Behavioral Health Resource Center

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REFERENCES

1. Cabasag P, Beyene K, Sundram F, et al. A qualitative exploration of community pharmacist views on providing a mental health and well-being intervention for long-term condition patients. Explor Res Clin Soc Pharm. 2025;19:100629. https://doi.org/10.1016/j.rcsop.2025.100629

2. Understanding the link between chronic disease and depression. National Institute of Mental Health. 2024. Accessed July 29, 2025. https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health

3. White N. Reducing primary care provider burnout with pharmacist-delivered comprehensive medication management. Am J Lifestyle Med. 2020 Dec 10;15(2):133-135. doi: 10.1177/1559827620976539.