These articles may help you, kind regards.

http://www.sciencedirect.com/science/article/pii/S1551741106001045

http://onlinelibrary.wiley.com/doi/10.1592/phco.23.15.1634.31952/abstract

http://www.sciencedirect.com/science/article/pii/S1544319115305914

http://search.proquest.com/openview/9a98e51db43584d505eb6b375f31a16b/1?pq-origsite=gscholar

http://link.springer.com/article/10.1007/s11524-011-9573-6

http://www.ajpe.org/doi/abs/10.5688/aj7409163

Hi,

I am also mental health clinical pharmacist. This is very important question. I paste my discussion on this topic on ResearchGate below. Please feel free to contact me back. Also see my publications (especially case reports), where interventions done by clinical pharmacist have been described.

Regards, Matej

https://www.researchgate.net/post/Is_a_collaborative_care_between_general_practitioner_and_psychiatric_clinical_pharmacist_beneficial_for_patients_with_major_depressive_disorder?_tpcectx=profile_questions

https://www.researchgate.net/post/Is_a_collaborative_care_between_general_practitioner_and_psychiatric_clinical_pharmacist_beneficial_for_patients_with_major_depressive_disorder?_tpcectx=profile_questions

https://www.researchgate.net/post/Is_inappropriate_prescribing_and_medical_errors_in_psychiatry_and_neurology_underreported_Who_will_deal_with_them?_tpcectx=profile_questions

https://www.researchgate.net/post/What_is_your_opinion_about_the_inclusion_of_clinical_pharmacy_service_in_to_the_psychiatric_settings_and_psychiatric_patients_pharmacotherapy?_tpcectx=profile_questions

Great, thank you both very much!

I can recommend you a paper of Antoni Serrano-Blanco about the effectiveness and cost-effectiveness of a community pharmacist intervention in depressed patients 

https://www.researchgate.net/publication/255959590 

Article Cost-Effectiveness of a Community Pharmacist Intervention in...

Dear Tiffany,

Each year in the U.S., serious preventable ME occur in 3.8 million inpatient admissions and 3.3 million outpatient visits, whereas inpatient preventable ME cost $16.4 billion annually and outpatient $4.2 billion, which represents 7,000 deaths in the U.S. each year are due to preventable ME. Although this serious important topic has been discussed recently, a burden and costs of this problem in many countries remains unknown. Numerous strategies to prevent from ME exist, including an inclusion of clinical pharmacists next to the patients' beds. In this point of view to involve clinical pharmacist next to the patients' beds is one of the most powerful strategy established in the health system supported also by Network for Excellence in Health Innovation. If you include clinical pharmacist you get at least more than half less of medical errors (ME), which system is also cost-effectiveness.

In this point of view, we have well designed RCTs and many important support to do it. Many countries in Europe does not have this type of collaborative care, where clinical pharmacist is including in selecting, monitoring the patients' outcomes next to the patients' beds within multidisciplinary team.

This paper above is about community pharmacist not clinical pharmacists specialist for mental health within the hospital or ambulatory work. In this point of view this is very bad general example about this problem. Often we think that patients with MDD are treated appropriate, although the real situation is completely different as was shown in study writen by Kessler only about 25 % of patients with MDD were treated as they should be treated. Antipsychotic polypharmacy (irrational) is another story. Admission and discharge from the hospitals is also another story. There are many things where mental health clinical pharmacist can ensure better clinical outcomes.

If I sum up, to establish multidisciplinary team within the wards next to the patients' beds with clinical pharmacists is one of the most powerful strategy to ensure better clinical outcomes (as was shown in study published by Finley et al. in 2003) and minimize medical errors (at least for 50 %). In many countries the governments don't want to see that problem, which is very huge problem and they do not see that this type of care (collaborative care) is necessary in their hospitals.

Regards,

Matej

http://www.nehi.net/bendthecurve/sup/documents/Medication_Errors_%20Brief.pdf

http://jamanetwork.com/journals/jama/fullarticle/196765

http://www.japha.org/article/S1544-3191(15)30608-7/abstract

http://onlinelibrary.wiley.com/doi/10.1592/phco.23.10.1175.32760/abstract

https://www.ncbi.nlm.nih.gov/pubmed/14504113

 Thank you for all the information, Matej. I appreciate your concern for this. Network for Excellence in Health Innovation seems very important.  Research companies also share that MH facilities mostly do not survey for consumer satisfaction and effectiveness. This is all a terrible shame, and we should continue advocating for these causes.

reasons to question both the costs and effectiveness of chemical agents for treating mental illness. Rationale for chemical agents is that they will correct biological brain malfunctions.  So far as I know, the FDA requires evidence that the medication shows some reductions in symptoms as spelled out in the DSMs, but no evidence for correcting biological malfunctions.  On the flip side we have evidence in masses of adverse biological "side effects" in both neurological and endocrine systems.  

 I am glad Tiffany! Yes we should be very direct when we talk about clinical pharmacists specialist from mood disorders in hospitals or ambulatory care. Another story is a community pharmacy, which usually does not have a direct possibilityy for drug chosing together with psychiatris on the ward. This is the main difference. We should do a risk assesment about this problem, if we do it there is clear that MDD treatment should be better for example as was shown in trial done by Kessler. Finley et al. showed that ambulatory clinical pharmacist can improve treatment of MDD.

To add a clinical pharmacist next to the patients' beds is the most powerful approach to minimize medical errors and selecting the best drug for each patient. Many European hospitals do not know this problem, because they do not want research about this problem. If we think we are the best then do not recognize this problem.

As a surveyor in many European hospitals i saw many problems with medical errors in mental health facilities, especially inappropriate antipsychotic polypharmacy, drug-drug interactions and non-evidence based pharmacotherapy. First of all, do a risk assesment for this problem in your institution and after do it with evidence-based approach, which is the best approach, although an eminence-based approach is widely seen.

Regards, Matej

pharmacists should be in the front lines of health care team in psychiatric disorders. this is because of the seriousness and dangerousity of drugs used in these mental problems. antipsychotic drugs and antidepressants, anxiolytics and etc. all are with side effects profile and addiction liability. so assessment and regulating the use of these medications if one responsibility of pharmacists.