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Plan giving psychologists power to prescribe mental-health meds passes Senate

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ILLINOIS_ETHICS_30957461.JPGState Sen. Don Harmon (D-Oak Park), pictured in this February photo, pushed legislation through the Senate Thursday that would grant psychologists authority to prescribe mental-illness medications to patients, who now can only get those drugs through their physicians or psychiatrists. (AP Photo/Seth Perlman)

SPRINGFIELD-A plan to enable psychologists to prescribe anti-depressants and other psychotropic drugs moved out of the Illinois Senate Thursday over objections from groups representing physicians and psychiatrists.

The proposal sponsored by Sen. Don Harmon (D-Oak Park) passed the Senate 37-10, with four members voting present. The legislation, Senate Bill 2187, now moves to the House.

"I used to oppose this bill. I am now the sponsor and am a firm believer this is a sensible way to provide access to mental health care to countless constituents who don't have it today," Harmon said.

Harmon said his legislation would address the "critical shortage of mental health professionals" that now exists in Illinois, giving patients in need of mental-health medication more avenues to safely acquire their drugs.

Under Harmon's plan, psychologists seeking to dispense mental-health prescriptions would have to be licensed to practice psychology by the state and hold a doctorate in psychology.

They also would need a master's degree in psychopharmacology, have five years experience treating patients and consult with patients' primary-care physicians.

If the plan were to pass the House and be signed by Gov. Pat Quinn, Illinois would join Louisiana and New Mexico as the only states that now permit psychologists to prescribe mental-illness medications. The military also permits its psychologists to dispense psychotropic drugs, Harmon said.

"For all of this time, there has not been one single complaint or incident of which we've been aware where there's been a failure in the system, where a psychologist has prescribed a medicine that has compromised a patient's safety," Harmon said, referring to the track record in states that now allow the practice.

Among those opposing the legislation was Senate Minority Leader Christine Radogno (R-Lemont), who worried psychologists wouldn't necessarily have the medical training to understand the side effects of mental-illness medication or how the drugs interact with other medications that a patient might be taking.

"My main concern...is that the core nature of the training of psychologists is not in the physical sciences," Radogno said.

The Illinois State Medical Society urged lawmakers to reject the legislation, warning earlier this month that empowering psychologists with prescription-writing authority would "put patients at risk." The group remains opposed to the legislation.

"Simply requiring minimal instruction in pharmacology, neuroscience and physiology independent of a professional's overall education and training is far from adequate and does not prepare a person to treat a patient as a medical doctor would," the group said in a statement

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6 Comments

Here is what the data shows: Psychologists have written over 50,000 prescriptions for our soldiers, for Native Americans on Indian reservations, and in New Mexico and Louisiana. There has not been one reported adverse incident or any complaints filed against a prescribing psychologist. Zero out of 50,000 is a very good track record. Wait times to see a prescriber are upwards of 2-3 months even in urban areas. Thus, although some psychologists will be prescribing in urban areas, these areas are still underserved. However, if one looks at the distribution of prescribing psychologists in New Mexico (available on the New Mexico Psychological Asoscation’s website under the “RxP News” link), quite a few psychologists are in very rural areas with no mental health prescribers. Ask these people receiving the medications they need in these areas if they are happy that psychologists are prescribing; do not rely on a psychologist who is far removed from these underserved areas and has no idea of their suffering.

Psychiatrists have been promising to expand access for 20+ years but the problem is only growing. There are fewer and fewer psychiatrists and the wait times are growing to see them. If psychologists do not step in, then who will?

Complaints filed against mental health providers are notoriously low, because having a good relationship with your patient protects someone from filing complaints. No one is looking for the errors, so none will be found. For the millions spent on the bureaucracy in New Mexico, only 16 providers are registered, many of whom don't live in state, and only 2-3 of them actually practicing in rural underserved areas. The money is better spent to increase incentives for those with actual MEDICAL training, rather than this scary sham.

Psychologists are flooding their own market with for-profit schools pumping them out on a too frequent basis. This is nothing more than an attempt to keep their field relevant, in an industry where psychologists have little identity, with masters level providers offering therapy for much cheaper. This, like so many legal grabs, is about $$$$$.

Safety? DDT and smoking were safe for years before studies came out after people were already maltreated. We're creating a number of patients who will be UNDER or MIS TREATED for years. These don't show up in studies.

So many inflammatory, incorrect, and uninformed assumptions in your post.

1. Psychologists have been prescribing for years in 2 states with over 90,000 prescriptions written and no complaints issues. This isn't just due to "good relationships". If someone had experienced a serious issue or had a valid claim, it would be known by now. Psychotherapists may not have many complaints due to relationships, but to compare that to prescribing clinicians is a HUGE false equivalence.

2. Psychologists prescribing is not in any way a sham. The first prescribing psychologists were created by the military. Their final report concluded that with proper training and supervision, everything was fine. What people don’t realize is that prescribing psychologists have a very limited range of what they are allowed to prescribe. Also, nurse practitioners who have about 3 years of training are allowed to prescribe a MUCH wider range of medications. Prescribing psychologist requires 3 years POST-DOCTORAL training, a supervised internship, and extensive licensing exam. Yet, similar concerns are not raised, at least not with the same intensity.

3. In terms of for-profit psychology schools, psychologists are actually very concerned about this issue. Professional school graduates are often shunned in the field of psychology and have many limitations in their careers.

4. The field is still quite relevant and research easily proves psychotherapy’s effectiveness. What this is about is consolidated mental health care that allows patients to see one clinician. Also, psychiatry has failed in terms of its effectiveness. For years psychiatrists have over prescribed medications, not performed adequate assessments, and sold out to drug companies for profit at patient expense. The hypocrisy of an MD accusing psychologists of a “money grab” is HILARIOUS and shows your grand lack of perspective.

Paul Purl and Dan Smith, your arguments are exactly WHY psychologists need prescription privileges. To equate a years-long history of successful prescribing with DDT is simply malfeasant and craven. And to point to an erosion of relevance, when psychiatrists are relegated to the role of psychotropic pez dispensers, trained poorly in psychodiagnostics, etiological/behavioral bases, or even non-pharmacological intervention makes it clear these histrionics are less about patient care and more about protecting turf. You're keeping the ocean back with a broom: time to look to your own house.

Dear John Holmes

Could you please be so kind as to make available your sources RE "...Psychologists have written over 50,000 prescriptions for our soldiers, for Native Americans on Indian reservations, and in New Mexico and Louisiana. There has not been one reported adverse incident or any complaints filed against a prescribing psychologist..."

Much appreciated. In favour of RxP.

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