For Mental Illness Awareness Week, Bloom Program coordinator Laura Miller believes ‘connections between people are mutually beneficial’ for pharmacists and patients alike
For Bloom Program coordinator Dr. Laura Miller, the most important medication many patients take away from their local pharmacies is often positive “connection with other human beings.”
Miller started in June as Nova Scotia Health Authority’s provincial lead for the Bloom Program, which aims to improve the health and well-being of people living with mental illness and addictions by connecting them directly with pharmacists who can offer patient-centered medication therapy management, help patients more easily navigate the health care system including community supports, offer educational resources with in-house pharmacy libraries, and provide friendly faces and helpful advice as soon as you walk through the door – both free of charge and without any sort of wait list.
When she’s not in her E.C. Purdy Building office at the Nova Scotia Hospital site in Dartmouth, or travelling across the province on behalf of NSHA to recruit more pharmacists to join the Bloom Program, Miller can still be found working on the front lines, spending half of her work hours behind the counters of various community pharmacies across Halifax Regional Municipality, filling prescriptions, and more importantly, making personal connections with patients.
While taking a break from being a community pharmacist in Halifax after almost a decade, Miller decided to pursue her doctorate in pharmacy from the University of Toronto. It was during that time that, “the biggest thing that I learned when I was travelling across the country for my rotations, is that the opposite of addiction, or indeed mental illness in general, is connection with other human beings.”
“So by creating connections with people, you’re going to promote wellness. And it doesn’t need to be a major intervention that creates that connection; it can be as simple as someone coming in every day for their methadone, and you ask them what book they’re reading, and you get a daily update on their reading status.”
“That connection is the thing that the patient takes home with them and promotes their wellness almost better than any other intervention.”
Miller, who is originally from Halifax and has a bachelor of science in pharmacy from Dalhousie University, believes the Bloom Program – which was also born and bred in Nova Scotia – is exactly the type of program needed to help “foster those connections between people.”
In fact, the Bloom Program itself is the product of local connections. It is a partnership between NSHA, community pharmacies across the province, and the hard work of Drs. David Gardner and Andrea Murphy, from Dalhousie University, who initially started the Bloom Program as a pilot project.
“When I was a community pharmacist, I found that my favourite work to do was with patients who have mental health and substance use disorders,” Miller said. “That was also the most meaningful work I did.”
So to pursue a career of meaningful work, Miller decided to reach out to Dr. Gardner, who recommended she go for a doctorate degree in pharmacy.
“It was the best decision I’ve ever made because now I get to advocate for people who really don’t have a voice and I get to do it while still working in community pharmacy, which I have a deep love for,” Miller said. “But now I’m also working in a way that is a little bit different and more change-inducing.”
The Bloom Program’s goal is to work with community pharmacies to become “hubs for mental health and addictions services in the community,” Miller said.
“Patients are enrolled for a six-month period of time (during which) they receive extra care from their pharmacist, including resources and navigation help through the mental health system,” she explained. “So it ends up being an extra source of mental health and addictions services in the community for patients.”
When the pilot project started in 2014, there were 23 pharmacies across the province offering the Bloom Program, with up to 20 patients enrolled in the program per pharmacy.
“They really monitored the progress of all the patients and the pharmacists’ experiences, and published a study of that pilot project in 2017 that found it to be quite successful,” Miller said.
“We were then able to solidify the program and move it forward into the NSHA framework for mental health and addictions.”
For patients interested in signing up for the Bloom Program at their local pharmacy, Miller said that means “more tailored care … and access to more resources” from pharmacists who have received specialized training in mental health and addictions.
“That translates into more specific care for patients who otherwise tend to fall through the cracks, or may not be getting the same holistic care in the community as other patients may be.”
Miller is committed to increasing the number of pharmacies offering the Bloom Program across the province.
Currently, there are 37 pharmacies in Nova Scotia offering the program, thanks to the dedication of community pharmacists taking on roles of Bloom Program site leads. But there is still the capacity for many more pharmacies, pharmacists and patients to get on board with Bloom.
“Community pharmacists are profoundly under-used in our health care system,” Miller said.
“We are drug experts. We go to school for a long time to become experts in drug therapy, and mental health and addictions services rely heavily on medication to help treat our patients,” she said. “As such, we become the experts in treating those patients.”
Miller said many pharmacists already have positive relationships with regular patients, giving them the chance to recommend people who might benefit from the Bloom Program and making patients feel comfortable enough to ask questions about what the program offers.
“At the end of the day, people with mental illness or a substance use disorder are people,” Miller said, “in the same way that pharmacists are people.”
It’s those little wins with patients that Miller finds most rewarding about her job in the pharmacy, adding that she too feels rewarded knowing that she gets to go home having made a difference in someone’s life.
“Connections between people are mutually beneficial,” Miller said, adding working in health care, you do have to adjust your daily definition of a “win.”
“It’s not necessarily going to be that patients never touch a substance again or that they are completely in remission from depression or are never going to have another psychotic episode; those aren’t really realistic goals.”
“But if a patient comes in every day of every week for their medication, then that is a win, because now they have stability in life that they didn’t used to have before.”
“Community pharmacies can offer that stability,” and the Bloom Program is focused on welcoming more patients to take advantage of that and all other resources and supports that pharmacies have to offer in their communities.
For more information on the Bloom Program, please visit https://bloomprogram.ca.
For more information on NSHA’s mental health and addictions programs, resources and services, please visit http://www.nshealth.ca/mental-health-addictions.
For more information on Mental Illness Awareness Week, which this year runs from Oct. 6-12, please visit https://www.camimh.ca/mental-illness-awareness-week/about-miaw.