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Removing stigma from the patient-pharmacist relationship

Benita Bamgbade, assistant professor in the Bouvé College of Health Sciences, joined Northeastern's faculty this fall. Photo by Adam Glanzman/Northeastern University

Benita Bamgbade knew what the medical literature said. Pharmacists don’t counsel patients with mental illness as often as they counsel others with, say, asthma or diabetes. She also knew the likely causes of this discrepancy: a lack of confidence and comfort in talking to patients with stigmatized mental health disorders.

But Bamgbade, a newly appointed faculty member in the Bouvé College of Health Sciences, was determined to change pharmacists’ perceptions and empower them to provide better care. For her master’s thesis, she designed an intervention to help pharmacy students better understand mental health patients and how to counsel them. And the project was a great success.

“We were able to decrease stigma in those students and increase their willingness to counsel patients with a mental illness prescription,” Bamgbade said. The key, it turns out, was getting students to see that they could engage with mental health patients the same way they would with anyone else.

“They’re people, and they have an illness,” Bamgbade said. “But they are not their illness.”

Bamgbade comes to Northeastern from the University of Texas at Austin, where she earned her doctorate in pharmaceutical sciences. For her dissertation, Bamgbade developed an intervention focused specifically on young adults in the African American population, which is the least likely demographic to seek help for a mental illness. The reasons for this run deep.

“A lot of African American men and women use the archetype of the strong black woman or strong black man to define manhood and womanhood,” Bamgbade said. “It’s about being able to do things by yourself and relying on your own strength. And they might think, ‘My ancestors were able to overcome slavery and discrimination, so I should be able to deal with the problems that I have.’”

The intervention examined these considerations, as well as African Americans’ general wariness of the medical community. “Medical mistrust is rooted in culture mistrust and in the history of slavery and oppression that African Americans live with in the United States,” Bamgbade said.

As part of the intervention, she brought in a consumer educator and a psychologist to speak with students and conduct learning exercises, exploring the unique challenges associated with mental health patients who are African American.

Bamgbade explained that without proper counseling, patients can receive suboptimal care. This is especially critical with mental illness medications, which often don’t start working for several days or weeks. If a patient doesn’t know to expect the delay, he or she might assume the drug doesn’t work and stop taking it altogether.

“Pharmacists are the medication experts,” Bamgbade said. “It’s their responsibility to make sure patients have all the information they need.”

It’s not that pharmacy students don’t receive cultural sensitivity training, Bamgbade said. They do. But implicit bias and stigma toward mental illness often precludes them from providing adequate counseling. Pharmacy students need help understanding a patient’s lived experience, and then they need practice communicating what they know.

“You can teach somebody something for so long, but at the end of the day, it comes down to experience,” Bamgbade said. “We give you the tools and then you have to go out and use them.”

At Northeastern, this is where co-op comes in. Bamgbade views experiential learning as a critical component of the curriculum that makes a significant difference for pharmacists in training. Co-ops allow students to practice what they’re learning in the classroom and build confidence—an essential part of pharmacy counseling.

“I get the feeling that these students are a different breed,” Bamgbade said.

For her own professional development, Bamgbade is looking forward to collaborating with her health policy colleagues to explore how interventions similar to those she’s designed in the past could help inform public health policy. As a new faculty member, she said she also appreciates the willingness of other professors in her department to offer mentorship and guidance.

“I’m proud that I’m here,” Bamgbade said. “This is the perfect place for me to launch my career and build and continue to grow.”

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