Mental ill health is increasingly prevalent in Scotland. For example, there has been a significant increase in the proportion of adults reporting symptoms of depression (1), with one-in-five adults now prescribed an antidepressant each year (2). In 2023/34 alone, there were >11.5 million prescriptions for antidepressants, antipsychotics, and anxiolytics (3). The Scottish Mental Health Stigma survey identified that people with mental health conditions are commonly stigmatised within health care, including within pharmacies and community care services (4). This stigma manifests through discrimination and stereotyping by health care professionals (4), whether conscious or unconscious. This may relate to various beliefs, such as the belief that people with mental health conditions are dangerous and cannot be helped in the same way that people with physical health conditions can be (5). The experience of this stigma exerts a negative impact on people with mental health conditions’ engagement with healthcare and their future health seeking behaviour (4). Unsurprisingly, addressing mental health stigma is a core priority of the Scottish Governments Mental Health and Wellbeing Strategy Plan (6).

UK research indicates that pharmacy staff are willing to offer further support to people with mental health conditions, yet felt they themselves were unsupported to do so (7). Furthermore, a review by the International Pharmaceutical Federation identified that pharmacists have a role in mental health triage, early detection, optimising medicines, adherence support, education, and collaborative care (8). The Royal Pharmaceutical Society (RPS), the professional body for pharmacy in Great Britain, postulates that community pharmacy staff can have a role in mental health by identifying vulnerable individuals, accelerating access to support, collaborating with the wider healthcare team, offering support to patients initiating anti-depressants, and signposting / onward referral (9). There is therefore broad scope for pharmacy personnel to further support this patient population. This is further corroborated by a recent systematic review by Weir et al (2025), which identified five different types of community pharmacy services to help people with depression (10). This research also identified that lack of mental health educational resources for pharmacy staff was a key barrier to supporting people with mental health conditions, such as depression (10). With stigmatising attitudes associated with lack of education, understanding and awareness (11), education and communication campaigns are central to addressing and tackling stigma to enable the workforce to better support this patient population (11).

Within undergraduate pharmacy curricula in Scotland, Dr Weir co-delivers undergraduate pharmacy education with Scotland’s leading mental health charities ‘Voices of Experience’ (VOX Scotland) and ‘See Me’, which involves people with lived experience of various mental health conditions offering their perspective both in-person and via recorded video. An evaluation of this showed positive impact of this education on changing students attitudes and reducing stigmatising beliefs (12). Additionally,  students reported a better understanding of how to support people with mental health conditions and felt more confident discussing mental health with patients (12). This indicates that attitudinal change of pharmacy staff can be achieve through education interventions.

International reviews of education interventions designed to address pharmacy-related mental health stigma, supervised by Dr Weir, identified a plethora of education interventions (13,14). This provides a repository of underpinning evidence of interventions which could be trialled and tested with Scottish pharmacy staff. However, there was a lack of data on behaviour change (13,14), so it was unclear the impact of the educational interventions. While mental health challenges and education interventions are understood and documented, it is unclear which approaches are most effective. Broader impact and systemic change requires educational interventions for practicing pharmacy staff within Scotland, which will require in-depth exploratory research to ascertain the most effective method tailored to the local context. Recent efforts in this direction have already been initiated by NHS England with suicide prevention education targeted towards community pharmacy staff, yet no such education exists for Scotland. To achieve the Scottish Governments/ mental health and wellbeing strategy goals, educational interventions needed introduced for Scottish pharmacy staff. This should involve pharmacists as well as dispensers, technicians and medication counter assistants, and would address a key public health issue and promote more equitable care across Scotland. 

Aims

You will co-create, with people with lived experience of mental ill health, online training designed to equip pharmacy staff with essential skills to support people with mental health conditions and address existing stigmatising beliefs/attitudes. The online training will be designed to be scalable, showcasing feasibility and engagement potential, and the evaluation with explore the learning. 

Project partners 

Three project partners have agreed to support this work and future national dissemination of the online education intervention:

•  Voices of Experience (VOX Scotland) is run for-and-by people with lived experience of mental ill health, with >600 members nationally. They influence policy/practice through real-world insight. They are Scotland’s national voice on mental health; they will support recruitment of volunteers to ensure meaningful co-production.
• Community Pharmacy Scotland (CPS) represents pharmacy owners and supports community pharmacy teams nationally. Their newsletter is a key channel for disseminating training/service updates. CPS will promote the module and facilitate pharmacy staff involvement in co-production, ensuring sector-wide relevance/engagement.
• NHS Education for Scotland (NES) is the training body for NHS in Scotland, supporting the pharmacy workforce and will support co-production and engagement of pharmacy teams during testing and dissemination.
  Research Activities 

Phase 1: Updated literature search

An updated literature review, using established systematic review methodology, will be conducted to synthesis the international literature on online education interventions designed to upskill clinicians in mental health care. This will be used to aid in the develop of the educational intervention (phase 2 and 3) and will inform the exact methods and approached to be adopted in the subsequent phases. 

Phase 2: Idea generation

Online and in person co-production workshops will be conducted with ~60 participants [including community pharmacy staff; mental health pharmacists; people with lived experience of mental health conditions; and policymakers (e.g. NHS NES, Community Pharmacy Scotland representatives)]. The aim of this will be to agree on the focus of the educational intervention such as: reducing stigma through language and actions, initiating mental health conversations, supporting patients in distress (e.g. suicidal ideation), suicide prevention skills, and/or upskilling pharmacy staff on basic mental health knowledge. Underpinning evidence identified from Phase 1 will be presented to participants and a proforma, guided by the Template for Intervention Description and Replication (TIDieR) checklist (15), with consideration of how best to incorporate the voices of people with lived experience in the education. The workshop will be delivered online and in person to maximise accessibility across Scotland. Consensus methodology may be adopted in this phase; qualitative analysis will likely be conducted (the exact methodology will be informed by the PhD student and their prior literature search).

Phase 3: Development of the educational interventions 

The PhD student will adopt agile design principles to develop the online educational interventions, which will include videos/testimonials from people with lived experience of mental health conditions (facilitated by collaboration with VOX Scotland). This will utilise StrathLab Living Lab facilities to ensure high quality. The educational intervention could constitute information/videos on a webpage, or an interactive module (depending on the output of Phase 2). This will be the first national, co produced mental health training for the entire pharmacy workforce in Scotland, which integrates lived experience in a scalable digital format.

Phase 4: Evaluation & Impact

The educational intervention will be hosted on VOX Scotland’s website and disseminated via Community Pharmacy Scotland. The PhD student will lead on an evaluation and impact assessment phase, which will likely involve pharmacy staff participants completing validated tools, such as the Opening Minds Stigma Scale (5) before-and-after to explore belief/attitude changes. Up to 30 pharmacy staff participants will participate in semi-structured interviews to explore changes in behaviours and impact on confidence, capability and practice (which will overcome limitations of prior research in this area). Quantitative data will also be collated on numbers accessing and completing the module as an indicator of reach. Findings will inform future directions and wider dissemination.

Anticipated outcomes

The project will deliver an accessible, evidence-informed online educational intervention that enhances pharmacy staff’s confidence and competence in engaging with patients experiencing mental health challenges. Likely outcomes include improved practitioner attitudes, reduced stigma, and more effective communication, leading to better patient experiences and possible increased health seeking behaviour. The module will also generate evaluative data on learning outcomes, attitudinal shifts, and feasibility of this training approach, which could be adopted for a variety of other clinical areas where stigma exists.

References

1. Mental Health and Wellbeing [Internet]. [cited 2026 Jan 8]
2. Quality prescribing for antidepressants: guide for improvement 2024 to 2027 [Internet]. [cited 2026 Jan 8]
3. Dispenser payments and prescription cost analysis - Financial year 2023 to 2024 - Dispenser payments and prescription cost analysis - Publications - Public Health Scotland [Internet]. [cited 2026 Jan 8]
4. MHF-Scotland-See-Me-SMISS-Final-Report-2022.pdf [Internet]. [cited 2026 Jan 8]https://www.mentalhealth.org.uk/sites/default/files/2022-11/MHF-Scotland-See-Me-SMISS-Final-Report-2022.pdf
5. Őri D, Mirkovic A, Rus Prelog P. Psychometric properties and validation of the Opening Minds Stigma Scale for Health Care Providers in Slovenia. Front Psychiatry [Internet]. 2025 Nov 12 [cited 2026 Jan 9];16
6. Mental health and wellbeing strategy: delivery plan 2023-2025 [Internet]. [cited 2026 Jan 8]
7. Gorton HC, Littlewood D, Lotfallah C, Spreadbury M, Wong KL, Gooding P, et al. Current and potential contributions of community pharmacy teams to self-harm and suicide prevention: A qualitative interview study. Vaingankar JA, editor. PLOS ONE. 2019 Sept 9;14(9):e0222132. 
8. FIP Practice. Mental Health Care: A handbook for pharmacists [Internet] 2022
9. Royal Pharmaceutical Society. The role of pharmacy in mental health and wellbeing: COVID-19 and beyond [Internet]
10. Weir NM, Kernaghan D, Alshammari H, Akram G, Pratt J, Maxwell M, et al. Identifying and developing a Community Pharmacy Depression Service in the UK: a systematic review and multi-stakeholder eDelphi study. Res Soc Adm Pharm. 2025 Nov 1;21(11):e69. 
11. Smith RA, Applegate A. Mental health stigma and communication and their intersections with education. Commun Educ. 2018 July 3;67(3):382–93. 
12. Al-Dahiree Z, Weir NM. Stigma & Recovery in Mental Health and Substance Misuse Seminar. Glasgow: University of Strathclyde; 2025. 
13. Kusay H. An international scoping review of interventions that address mental health stigma among pharmacists. [Glasgow]: University of Strathclyde; 2025. 
14. Hanif S. An International Scoping Review on Mental Health Stigma Education Within the Pharmacy Degree. [Glasgow]: University of Strathclyde; 2025. 
15. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014 Mar 7;348:g1687. 

Further information

You will complete a 60 credit Postgraduate Certificate in Researcher Professional Development. Within SIPBS, the student will have access to tailored modules on essential skills, employability and research skills. To support viva preparation, the student will also complete 9 month, 22 month and 33 month repots alongside a meeting with an internal assessor. Within the Pharmacoepidemiology and Health Care group, you will also have access to our group seminars (with opportunity for you to present your findings to fellow group members including other MPhil/PhD students, academics and researchers) and attend monthly Methods Forums meetings hosted by the group which focuses on methodological discussion amongst postgraduate students. In addition, you will attend specific training related to your PhD studies, which will depend on the students existing skill set. For example, this could be on: qualitative methods, co-production, design principles. You will also have the opportunity to join the Doctoral Researchers Group.