By Robert Ericson New Mexico Psychological Association
Some psychiatrists don't want psychologists to prescribe medications. What are the facts?
Those psychiatrists would remind you that psychologists are not physicians. Neither are optometrists, nurse practitioners, physician's assistants and some pharmacists — all of whom have obtained prescription privileges.
Those psychiatrists claim that the proposed training will not qualify psychologists to prescribe safely.
The prescription privilege bill now before our Legislature is based on a proven model used to train psychologists in the military. More than eight years ago the U.S. Department of Defense trained 10 psychologists to prescribe psychotropic medication in a demonstration project. Those psychologists have been practicing without a single legal complaint throughout the history of the project.
Those psychiatrists state that studies have already shown that psychologists are no more likely to practice in remote, rural areas than psychiatrists. The facts are that there are only 18 psychiatrists residing outside of Albuquerque and Santa Fe (Albuquerque Direct Marketing, 2001), whereas there are 176 psychologists who reside and work in other communities. The National Alliance of Mental Health has cited that 75 percent of the mentally ill in New Mexico are not receiving appropriate psychotropic medications.
Those psychiatrists would point out that New Mexico State University lacks both a medical school and school of pharmacy. New Mexico State University currently trains nurse practitioners to prescribe, as they have legal prescribing authority. Psychiatric and other medical experts from around the nation have been brought to NMSU to train psychologists in the most current and safe prescribing methods.
Those psychiatrists speculate that most of the physicians from whom psychologists would seek supervision are family physicians. The fact is that most of the prescriptions of concern here are currently written by primary care physicians such as family physicians and internists. They went to medical school and are competent to prescribe and supervise prescribing psychologists.
Those psychiatrists warn that the training program has never been independently evaluated and not been proven safe. The present program at NMSU is based upon the Department of Defense demonstration project mentioned above. A federal audit of that program gave it a strong approval.
Psychologists are not proposing to use the citizens of New Mexico as guinea pigs, as those psychiatrists would suggest. Prescribing psychologists would be filling a glaring gap in access to mental health services in the state.
Psychologists have a minimum of 12 years of training after high school, which includes an understanding of chemistry, biochemistry, anatomy and physiology. They work side by side with their physician colleagues treating patients throughout the state. After a debate before Gov. Gary Johnson and his staff between the proponents and opponents, the governor called up the prescribing psychologists' bill for consideration.
Although a group of psychiatrists opposes this legislation, many psychiatrists and physicians around the state are in support. After negotiations between the New Mexico Medical Society and the New Mexico Psychological Association an agreement was reached. Pursuant to the agreement, the prescribing psychologists' bill was amended so that the Board of Medicine would play an instrumental role in determining how the training and supervision of psychologists would be monitored. The medical society's representatives stated in that meeting and in public hearings that amended House Bill 170 is now supported by the New Mexico Medical Society.
We welcome the input of our medical colleagues because we are committed to being very safe prescribers, we want to provide the highest quality care and we want to continue working closely and collaboratively with our medical colleagues.
Over the years, our state senators and representatives have worked diligently to find ways to improve access to affordable, quality medical and mental health care in New Mexico.
On Jan. 31, after careful consideration, the House of Representatives voted overwhelmingly, 56-11, to support the prescribing psychologists' bill. We are confident that the Senate and Gov. Johnson will continue to look carefully at the facts and make their decisions wisely. Passing HB 170 and signing it into law would be a major step in creating an exemplary, interdisciplinary model of mental health care, which sets a new standard for the country to reach underserved rural, ethnic minority, urban, poor and elderly communities.
Robert Ericson is president of the New Mexico Psychological Association.
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