SARATOGA SPRINGS, NY – In 2002, New Mexico made it legal to allow certain psychologists who completed specific training to prescribe psychiatric medicines.
Thus began a national debate over the appropriateness of having non-medically trained psychologists prescribing potent medications that have strong effects on the body and brain – one that continues today. Six states are currently considering bills on the matter.
The debate hasn't focused much on whether there is any financial value to allowing prescribing privileges to psychologists, but as the country grapples with a healthcare system that is financially out of control and states and the government try to hold their budgets together, that aspect is likely to add another dimension.
Not surprisingly, those who support prescribing rights are more likely to find financial advantages than those who oppose it.
Supporters of prescribing rights point out that access to psychiatrists is often difficult, with wait times to get an appointment as long as three months. In some rural parts of the country, patients have to take the time and absorb the costs of traveling to see a psychiatrist.
"Prescribing psychologists will be able to provide for their patients, no matter where they live, with a cost-effective, efficient and holistic program of psychological and pharmacological care," said Luana Bossolo, assistant executive director for practice directorate public relations at the American Psychological Association.
Jerry Grondin, immediate past president of the New York State Psychological Association, who has a private practice in Saratoga Springs, N.Y., didn't always support the idea of prescribing rights for psychologists, but has come to believe it makes sense, financially and otherwise.
If psychologists have prescribing rights, he said, mental health patients don't have to see two practitioners – a psychologist for talk therapy and a psychiatrist for medications.
Psychologists don't have the bio-medical training needed to manage mental health patients who also are likely to have other medical issues, counters James Scully, medical director and CEO of the American Psychiatric Association.
Scully said the supplemental training suggested by states to certify psychologists to prescribe just doesn't cut it. "None of the (state) proposals we've seen come close enough to provide adequate care for what patients deserve to have," he said.
If mistakes are made because of lack of training – besides the serious health consequences to patients – the cost of care increases. "It's not a minor issue to prescribe medications," he said.
Prescribing is a serious matter, agreed Grondin, but he thinks opponents use it as a scare tactic. As things stand right now, he said, "even a dermatologist" – with no training in mental illnesses and their complications – could prescribe medications for mental health patients.
Instead, he says, with proper training, psychologists would become the best-trained prescribers for mental health issues.
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