Should Psychologists Be Allowed to Prescribe Medication?

A few weeks ago, Idaho became the fifth state to authorize clinical psychologists to prescribe medications. As it stands today, New Mexico, Louisiana, Illinois, and Iowa also permit certain psychologists to prescribe medications to their patients. The prescriptive authority for psychologists is popularly referred to as "RxP."

Possible improved access to a wider range of mental health services

Should psychologists be allowed to prescribe medications? On one hand, allowing psychologists to prescribe medications for mental disorders will improve access to a wide range of mental health services, particularly in poorly served or rural areas, where psychiatrists are scarce.

As American Psychological Association (APA) President Antonio Puente explains, "The need for prescribing psychologists in Idaho is clear. Wait times to see a psychiatrist in northern Idaho can be as long as a year, and are often two to three months in the Boise area, according to reports collected by the Idaho Psychological Association. What’s more, the suicide rate in Idaho is consistently among the highest in the country.”

Furthermore, RxP legislation may decrease the cost to the patient because rather than seeking treatment from multiple providers (e.g. a psychologist for therapy and a psychiatrist or primary care provider for prescriptions), the patient will be able to consolidate to a single provider for their mental health needs. In addition, the Department of Defense Psychopharmacology Demonstration Project (PDP) successfully trained psychologists to prescribe psychotropic medications in military health situations with positive outcomes.

Lack of medical training

On the other hand, psychologists may lack the medical training necessary to prescribe medications. Some argue that the medical knowledge and training attained in medical school and residency is essential to prescribing medications and effectively predicting potentially negative outcomes or complexities.

While proponents of the RxP legislation respond by pointing to other prescribing non-physicians, such as podiatrists, dentists, and nurse practitioners, all of these specialists have undergraduate and graduate degrees that concentrate in courses relevant to medicine, whereas a majority of psychologists do not. Furthermore, the training required by the RxP legislation (typically, a Master's degree) is significantly shorter than that required for a physician or a PDP.

An emerging trend

While RxP states are still undoubtedly in the minority today, there appears to be an emerging trend in favor of the legislation. In addition to the five states that have passed RxP legislation, three states (Oregon, Hawaii, and Texas) have RxP legislation currently pending.

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