Mona Qassim - Mental Health Pharmacist
00:00:01:19 [Speaker 1]: Okay, just checking. You're happy with the lighting and everything. Uh, the thing is with being a pharmacist, we're not always
00:00:48:22 available, obviously, other than what people see us in a pharmacy. So when people go into hospital or GP practice, now they're starting to see pharmacists more often. So I think that has been starting to dispel the
00:01:02:00 myth about pharmacists, just working in a community pharmacy, but I guess the traditional roles have been community-based where people do kind of, um, stereotype pharmacists as working in one profession or one, one sector. So I guess maybe the same, I own four pharmacists and I'm in a pharmacy.
00:01:32:23 And, but when I would find different roles, I went into hospitals and all were fun to work with. Well, in hospital and other things have changed over the years, dramatically in how, where, where work. So, yeah, I guess I could think I probably had the phone and then other people had about. Okay.
00:02:07:07 Can I put it on the other side?
00:02:11:16 [Speaker 2]: Yeah,
00:02:14:11 [Speaker 1]: I'm looking towards you.
00:02:16:24 [Speaker 2]: Okay.
00:02:20:13 [Speaker 1]: Do you want me to start again? So pharmacists work in lots of different sectors and most visually most publicly available
00:02:51:12 pharmacist you will see is in the pharmacy. So usually they're busy behind the counter, um, and they're not always very visible because of them being busy behind the scenes kind of thing. So I think pharmacists have always been kind of publicly, you know, busy behind the counters or, um, but things are changing now with introduction of pharmacists more in GP practices of people are more aware of pharmacists working in different
00:03:19:11 sectors. And yeah, I'm saying hello.
00:03:31:08 [Speaker 2]: Yes.
00:03:32:06 [Speaker 1]: So pharmacists has dramatically changed over the years and I think pharmacists have worked hard to create new roles and challenge, you know, the stereotype and the status quo, where we are available in a lot more places and a lot more visual, a lot more seen in the public than we have been. So I think there's always been a need for, for more better kind of, um, kind of rationalization and optimization of
00:04:06:24 medication. So I think just being mindful that medication is such a big part of the NHS prescribing it's it, we've kind of realized the niche of a pharmacist where we can help people more with medication and we can support that big area, which, you know, for many years, it's not been introduced to GP practices because it's, it's not seeing the value, but now that they see the value, it's making a big difference to how people are cared for in
00:04:37:22 primary care. And I'm shifting a bit of that responsibility. Yeah. So it's quite hard when you're young, you're not sure about what to do. And I, I was always interested in how medicines were made and, um, you know, the impact of medication has on the body and how it helps with
00:05:03:06 health. And I was also interested in psychology and how people think and, and how, um, those two things interact. That's why I ended up going into mental health, um, sector because I was interested in both. But then I was lucky to find a role where I was able to do that. The more I got into it, I
00:05:41:00 realized there's a lot more opportunities. And w w w what you see on the surface. So, um, even, you know, when you go into university, you think I'm usually going to go to community hospital, but once you do the degree, you realize there's a lot more options. And with that degree, you can do a lot more than just a few options. So I think that's what surprised me once I
00:06:04:21 kind of got into it. I was able to work in mental health. I was able to teach, I was able to do, um, expanding on research and other things which never came across when I first went into the role and more and more things interested me as, as I got into, um, got into it.
00:06:29:07 [Speaker 2]: Yeah.
00:06:48:04 [Speaker 1]: Yeah. So I have a few roles that, um, kind of interlink in different ways, but my main role is a specialist mental health pharmacist. So I work, um, across the community, mental health teams, allowing more access to medication, information, and support around reducing side effects and reducing, um, kind of complex physical health complications that can happen with severe mental illness. By also part of that, do a lot of teaching for carers and patients in different capacities,
00:07:23:16 whether it's one-to-one or groups. And I also do medication reviews and prescribing of medication. And then the other part of my role is teaching. I teach undergraduate and postgraduate pharmacists and nurses and other healthcare professionals about mental health medication and assessment. And then another part of my role, which is really ad hoc. I do work for
00:07:50:04 one-on-one and GP out of hours where I, I guess mainly focus on mental health, but I do minor illness. I prescribe and support in that service as well. Yes, that's a 24 seven service, but I, yeah, I am quite busy and also trying to complete my CBT training at the moment. So continuously studying
00:08:17:02 and trying to develop other skills. So it's important to kind of have a timetable and kind of structure your time and make sure it's all clear in the, in the timetable. And yeah. So to give everything its proportion of time and allocation really, that's how I keep going. So there is overlap. So with my teaching them, the more
00:08:56:12 clinical I am, the more advanced I am with my clinical services, I guess it informs my teaching and it helps my teaching and research and things like that. I do at the university. And sometimes I do have to compartmentalize it because it can get quite overwhelming if you've got too many emails and too many things to juggle. So, but I do see them as overlapping. So that
00:09:20:13 helps me to see that one helps the other and the skills are overlapping.
00:09:43:12 [Speaker 1]: Yeah. So I liked variety. I'm the type of testing that like one here and where I'm learning. But I think in that sense, if I was just doing one, one path or one job, I probably would find it boring. Paul. So I liked that Brian for learning and developing, and that's what I get from my role, the world developing. Yeah. So yeah, no worries. So when
00:10:42:24 I was at university, I worked, um, in the hospital, which was next to my
00:10:48:04 house. So I was really lucky because I had a hospital and a prison next to my house I could walk to. So I worked as a care assistant because I was interested in kind of really being hands-on in the hospital and seeing what was going on. And that was my way of kind of exploring the hospital environment as well and seeing what was going on and at the same time as well, I also had a Saturday job in a pharmacy. I worked in, uh, a local pharmacy, again, walking distance. I used to work,
00:11:17:23 um, at some points, you know, more in the summer as well to kind of, and that really helped me to understand, you know, visualize medication and see, you know, what people come into a pharmacy with over the counter products and, you know, mine elements skills, which I learned from working in the pharmacy on a Saturday and on the summer. And then another summer I worked in a hospital prison, which again, I was really lucky to kind of get
00:11:46:19 that opportunity. So I, so throughout my studies, I always was interested in to kind of develop my CV and have those on my, um, my training to kind of get me better opportunities when I come to apply for jobs when I am a pharmacist. So when I did qualify and finished my degree, I worked in hospital.
00:12:08:13 [Speaker 1]: I worked in, um, Portsmouth hospital as a pre-read, but I always had this in the back of my mind. I wanted to do mental health. And, um, so I, I guess partly kept an eye on for jobs and try to, again, someone advise me and wisely advise me is that don't go into mental health too quickly, just get a broad, general background, which I really valued that advice because it really helped me to kind of again, gain insight to
00:12:39:09 other settings. So after working for about a year and a half in general pharmacy in a hospital, I found a job where I could go into mental health. And so I've been there ever since. And, and then from then I realized there was a lot more things I could do in mental health. You know, it started off working on the wards, going and visiting lots of outpatient settings where patients were more on rehab or dementia wards. And then I saw a niche area where pharmacists weren't involved in was
00:13:12:07 crisis teams and community mental health teams where 80% of patients were, you know, staying in those services, not in hospital, which we put a lot of effort in as pharmacists, we've put a lot of effort into seeing the patients on the wards, but not in the community settings. So again, I explored the area and then I found a role where they were looking at community mental health. And from that, I started to develop other services
00:13:42:12 like cooking up the crisis teams, looking at the psych liaison, which is the mental health team within and then expanding it even more to look at, you know, what other things we could do, like develop training for patients and carers. So it kind of, I guess it was, uh, you know, over the years, you start to see where those areas, you know, where there's a niche for, for the, uh, pharmacy involvement. And then I was lucky as well to get a
00:14:13:20 role in the university because they had a, a lack of mental health input into the university. So that's where I ended up trying to put in a lot of my knowledge from over the years of learning from, you know, general to mental health and to this, to developing the students and helping them understand what it's like to be a pharmacist and balancing theory and practice.
00:14:36:21 [Speaker 1]: And then over the last flu is practice for more advanced fiber in assessment and a part of that, I want to learn more about psychotic. So it was always that thing. I felt like even being a pharmacist, I need to know more about psychology. I need to know how to help people beyond like, so that's why I pursued the CBT triangle kind of feel better at helping people without many things. So I'm trying to improve
00:15:07:18 my toolbox. And when you look at mental health, it's sometimes it's about relationship with your patients about giving people skills that they will you fly. And that's the thing is I'm now finding, you know, one thing around in developing, but I am getting there. So I think I'm that. But if the game thing, my mindset, because I was like cooking and learning on my
00:15:41:23 own. So I guess I grew up in, um, obviously I grew up in, uh, a middle Eastern
00:16:23:01 country where there was a lot of stigma against mental health. And I had an uncle who had schizophrenia. He has schizophrenia now, and I saw how he struggled with his mental health and the support he was given was very much
00:16:38:07 medication focused. So I was always interested in how he was treated, but also how people perceived him and how people treated him. And I realized that that wasn't much different. Again, obviously even in a more developed country, there's still stigma and there's still a lot of, um, push to give people medication and things are changing now where we are balancing with both medication and therapy, but I was just interested of how they compliment each other, how both really can be important as each other,
00:17:12:06 like, and people actually do better when they have a combination.
00:17:28:17 [Speaker 1]: Yeah. Yes, exactly. Yeah. So I had a lot of, um, kind of, I guess, you know, my own people, you know, people stigmatizing my role thinking you're a pharmacist and, uh, what do you know about therapy and these things. But I had to do a lot of different courses to develop skills, like making, doing motivational interviewing, um, developing my questioning skills, just doing courses about children's development and
00:17:59:02 things like that to kind of get some baseline and foundation to go onto the course. I think, I guess we pointed out the varieties that I'm very lucky. I've got so much variety in my week that I have, you know, there's never a
00:18:29:23 boring week, never a boring day. I've always got, um, I'm constantly learning. I feel like I'm actually helping people. I'm making a difference. Um, whether it's me helping people know their medication better and reduce the side effects or me helping people with skills that they can use when they're anxious or they're, they feel more able to manage their life better. So these are all really, I guess I feel like I'm in a, people's
00:18:58:21 most vulnerable and you're helping them to feel more powerful in their own lives. And it's very, yeah, it's very humbling. Yes. There's so many stories you could write. You know, everybody has a
00:19:29:15 story in a book they could write about their life. And it's really interesting to hear people's life stories and help them explore their strengths and human that we all go through. Um, very well. It's a very unusual place to being some time. Um, you know, my background is a pharmacist and I'm, I'm moving people in and helping them move away from
00:20:00:04 this medical thinking about when we're not reflecting on it. I feel like I've come a long way, will follow that. Well, I'd like to think that it's made me more resilient in the sense that you start to learn about your own mental health and what keeps you going and, you know, the things that are
00:20:33:18 stressful and about how to cope with stress. But also I think, I think it's made me appreciate the small things. And especially now with COVID, you start to realize what's important and yeah. How, how complex people are, how many, many things, um, that, you know, one thing doesn't work for one
00:20:56:21 person, you have to try sometimes lots of different approaches.
00:21:07:10 [Speaker 1]: Yeah. That's a very good question. So I guess, I guess personally, I've, I, um, I grew up, I have dyslexia, so it's challenged me to think, you know, the, uh, you know, partly you start to treat yourself because I felt like I wasn't able to do these things and I was challenged. And, but this has challenged me in thinking that I can do lots of things. And I, I I've got evidence that I haven't been able to do lots of things despite my dyslexia. So it has challenged me in the sense
00:21:39:06 that, you know, if I can do it and that gives people, sometimes my patients even help us. So, you know, you know, I'm dyslexic and I can do these things. Sometimes you, you don't disclose these things to patients directly, but it, it helps them to see there is hope sometimes. And that's what we instill in people's hope. Um, I mean, I think now that I'm doing one-to-one CBT, I feel like I am
00:22:29:06 making small changes with people, but I would say just doing the group therapy sessions where we're doing sessions on the recovery college and I'm
00:22:38:16 doing teaching sessions. And when you get verbal feedback written feedback, that's really powerful. So it's sometimes really nice to get that written feedback, to really see whether there is an impact. And, um, those are projects that took a while to establish. And I remember starting off with one patient and building up to having 10 people in a room. So sometimes these things start small and then they develop into something a bit bigger. So I would say I'm most proud of that as a, as an achievement to kind of
00:23:09:23 get it up and running and then getting it established and having a bigger audience and now having it online to help people make it more accessible to them. And so I would say that was one of them and at the university I've, as I said, I suppose, established mental health didn't have before. So that was also, um, to help with student well, ball work we're involved in and
00:23:41:23 passionate about helping to and helpful to them value and want to be part of it. I had that as one of my proud moments, we'll have students who will do something to help the other.
00:24:08:03 [Speaker 1]: Um, we'll also kind of also quite challenging because it took so much time and stuff like that, that, but we got there in the end. You're right. There is that curiosity. And then the sense of, you
00:24:43:05 know, the unknown and there's a lot of questions, but there, there are a lot more aware than, I mean, what we perceive they are because the mental health is so kind of current and students know there's a need for it. So I think it's almost breaking the stigma and getting them talking, which was really nice to make them feel like, actually this is very human and very
00:25:09:00 normal. So I think it's more their, their perception of the wards and, and what goes behind the scenes is what scares them. But, but for them, they realize mental health is very current for them because they're all experiencing struggles and stresses and changes in their life circumstances. So they can relate to it, which I think is really interesting. Cause they, they, they do value, um, like the things I'm doing
00:25:40:20 with CBT, they value it a lot more than probably I thought they would because it's, it's, it's very relevant to them. Yeah. So, yeah. As I said, when I went into this course or the degree and finished, I thought I was going to work in hospital and I thought, you know, that's where I want to be, but now I realize there's so much more
00:26:10:05 that I can do. And there's this constant change and developments and yes, it's completely different to what I expected 10 years ago. I never thought I'd be here now. It's completely different.
00:26:44:10 [Speaker 2]: Um,
00:26:45:02 [Speaker 1]: I think they're just breaking down barriers. Like it's, it's not really like, just because you did one degree doesn't mean that you're pigeonholed in one area you can expand and learn across. And that I think that's, what's happening with advanced practice. We are kind of overlapping and doing more in different areas. And, and for me, like I was saying to, to do CBT now, originally I was, I had a lot of difficulties getting on the course, but now it's become more normal. And I think that's
00:27:18:08 that's, that is probably what other people will find in doing other areas of, um, any other sector or we are expanding our skills in different areas. They do. Yeah. They, they, they kind of, um, like again, asked me same question around how do you do it with your time? And, and I guess when
00:27:45:10 you're interested in and passionate about something and you, you see that it's, it's doing something different, you, it pushes you to keep going. I think obviously we'll be good time to have a break at some point, but it's something that it's driven me and I keep, I feel like it helps me wake up in the morning and plan to keep going. Um, because it is, it is going in the right direction and it is working. Yeah. That's a good question. So I think it's following your passion and
00:28:42:10 I've always been like that. I think that's really important to see what,
00:28:46:24 what do you like about pharmacy and what is it that drives you? Just because it is a long course, it's, you know, there's four years and then another year, um, you know, registration. So for somebody that goes to do the course, they, they have to have interest in the subject to some degree, but you have to also realize that that course will give you other options. It will give you opportunities to explore other things in healthcare or
00:29:16:03 going down. Um, you know, if you want to go do the research or teaching, so that one degree will open options for other things, if you're thinking about a well-rounded degree, but being a pharmacist is about, you know, being interested in medication, being interested in people, being interested in lots of different things to help, um, the NHS. So it has to be somebody that is interested in health care to start with and passionate
00:29:47:17 about helping.
00:29:58:13 [Speaker 2]: Yeah. Yeah.
00:30:03:05 [Speaker 1]: So yeah. Again, don't lose a good question. Um, what does it mean?
00:30:10:01 [Speaker 2]: So I think,
00:30:11:08 [Speaker 1]: Like I was saying about like being with people at their most vulnerable, we don't appreciate how it can be, how difficult we can be to open up about these difficult things. And I get that a lot when I'm working one on one, um, to some degree because people can't see me and all they can hear is my voice. So, you know, me being warm and welcoming and inviting for them to open up about some dark and difficult things is really important. And I feel, you know, sometimes that's really a big deal
00:30:41:13 because you've actually made someone feel better by just opening up. And, and that goes beyond me, obviously the can after the fact of medication, but actually helping someone, you know, when we're not, when no one else is listening to them or no one else's, um, being able to be, um, in that environment where they can open up, which is really kind of special where people feel that they can do that with me. Um, and I think that's when I think about, yeah, I'm helping someone with their health, whether it's
00:31:12:17 letting them off letting off some steam or letting them feel heard, um, helping them through their problems, whether it's medication or not. It's it's, it's, that's what makes it helpful.
00:31:44:23 [Speaker 2]: yeah. Yeah.
00:31:51:19 [Speaker 1]: Um, hello, my name is Mona Kassam. I'm a specialist mental health pharmacist, and I also work as a teacher practitioner lecturer at the university of Redding. And I also do, uh, work with one-on-one. So I, I helped with triage and assessment and treatment with the out of hours services.
00:32:49:10 [Speaker 2]: Um, I guess, um, I guess what would I tell my younger self would be, you know, just believe in yourself and think about, you know, all the different opportunities that are available to you in, in whether it's, um, you know, in healthcare or just in the world in general, there's a lot of opportunities and a lot of things that will help develop you. So just kind 00:33:20:19 of, um, make the most of all those relationships and all those opportunities that come your way.