“Have an open mind, be open to nuance, and keep learning”

From left: Roshina Babaei-Rad, Nuzat Karim, and Yulya Amal.

Nuzat Karim’s recent experiential rotation at The Centre for Addiction and Mental Health (CAMH) in Toronto reinforced the importance of mental health care and demonstrated the importance of pharmacists in caring for patients with complex mental health conditions.

“There are so many different medications for mental health conditions, and because there's so much nuance, pharmacists play an important role in helping prescribers and patients navigate through them to achieve favourable outcomes,” says Karim, a fourth-year Doctor of Pharmacy (PharmD) student at the Leslie Dan Faculty of Pharmacy.

“There are a lot of dynamic conversations happening between pharmacists and prescribers, and the medication knowledge we bring to this field is really important.”

Having seen family members and friends experience mental illness, Karim has long been interested in mental health and wellness. In her second year at the Leslie Dan Faculty of Pharmacy, she joined the Initiative for Mental Health Awareness and Pharmacy student group and became co-president the following year. With other students in the group, she helped to coordinate speakers and events to raise awareness of mental health among pharmacy students.

As her final year of the PharmD program approached, she wanted to gain practical experience in mental health care. Her first advanced pharmacy practice experience (APPE) rotation was in the community setting at an outpatient pain and addiction clinic. Her most recent rotation was at CAMH, where she gained firsthand experience caring for patients with mental illness and addiction in a hospital setting.

CAMH is one of Canada’s leading mental health and addictions hospitals and research centres. Health care professionals at CAMH care for tens of thousands of inpatients and outpatients each year, providing services for a range of mental conditions such as addictions and substance use, anxiety and depression, mood and personality disorders and many others.

In the first half of the 10-week rotation, completed in the fall of 2024, she worked at CAMH’s interprofessional pain and addiction clinic with preceptor Roshina Babaei-Rad. The health care team—which included pharmacists, physicians, nurses, social workers, and occupational therapists—cared for patients experiencing chronic pain and addiction. Karim was given opportunities to follow up with patients regarding their medications and conduct patient consultations to help them manage their pain medications.

In the second half, she worked with preceptor Yulya Amal in the Psychosis Recovery and Treatment Unit, helping to care for patients often experiencing active psychosis. She helped to make medication recommendations for patients, changing ineffective medications and helping patients switch to long-acting drugs to improve medication compliance.

Each unit offered Karim insight into different aspects of mental health care.

“The interprofessional pain team all contributed their different perspectives to treat addiction, and it was fulfilling to see that many patients were able to achieve successful outcomes. My time working in the psychosis unit really demonstrated that mental health care is critical and there are patients who need significant support,” says Karim.

“Overall, this rotation was a phenomenal experience, and I learned so much about mental health care. Roshina gave me opportunities and challenged me to meet my potential, and Yulya was so supportive in helping me integrate into a challenging hospital environment.”

At times, the rotation was challenging, not just academically but also emotionally. Karim recalls meeting patients with severe, debilitating chronic pain and witnessing a patient in active psychosis experiencing an aggressive episode. But these experiences ultimately reinforced the importance of mental health care and community support for these patients.

Karim says her experience showed her how nuanced mental health care can be and that pharmacists need to be open-minded in finding medication regimens that work for each patient.

“From this experience working in mental health, I learned that you have to have an open mind, be open to nuance, and keep learning,” she says. “It's very important to be open to feedback from other health care team members and patients and understand that there are many different potential solutions that could be used to help a patient achieve the best possible outcomes. No matter where we are in our career journey, we'll always be learning something new.”