A bill in the Colorado legislature would allow psychologists who complete additional training to prescribe mental health medications, such as antidepressants.
While everyone agrees that the best way for patients in need of mental health care is seamless cooperation between all those who care for them, having psychologists prescribe it is the state’s ideal. There is disagreement as to whether it is closer to or farther from.
As with all debates about who can provide certain medical services, money is part of it. Psychologists can charge for additional services, while psychiatrists and primary care physicians can lose business.
Jin Li, a Denver psychologist who is leading the movement to allow prescriptions, said the proposal would require a two-year master’s degree in psychopharmacology, passing an exam, and at least one year under direct supervision. Research, a conditional license where psychologists are required to work with consulting physicians.
“This is not a YouTube weekend course,” she said.
Bill HB23-1071 was introduced Thursday, with Senators Cleve Simpson (R-Alamosa), Steve Fenberg (D-Boulder), and Congressmen Judy Amabil (D-Boulder), and Mary Bradfield (Colorado Springs) Sponsored.
Based on other states that allow prescriptions, about 10% of Colorado’s roughly 3,000 psychologists could start the process, Lee said. New Mexico, Louisiana, Idaho, Iowa, and Illinois allow psychologists to prescribe psychoactive drugs, as does the US Department of Defense.
Dr. Jennifer Hagman, a psychiatrist at Colorado Children’s Hospital, said she was concerned that psychologists didn’t have the necessary body systems or pharmacological background to prescribe properly. Physicians must complete medical school, while psychologists must have a Ph.D.
“The bases they’re adding are very similar,” she said.
A poll commissioned by the nonprofit Healthier Colorado found that 62% of those surveyed were in favor of allowing psychologists to prescribe after additional training, 26% were against, and 12% were unsure. I was. However, it’s not specified what that training will include, so there may be more or less support for detailed suggestions. The poll was conducted among her 1,060 people deemed likely to vote in the 2022 general election.
Kyle Piccola, vice president of communications and advocacy at Healthyear Colorado, said the organization supports the bill because access to medical care is a problem. He said it could take six to 12 months, during which time the patient’s condition could deteriorate.
“The current system clearly does not meet everyone’s needs,” he said. “This is an additional way to provide people with the care they need.”
Most people taking psychotropic medications get them from their primary care provider, so it would be better to integrate a psychologist or other therapist into their practice. It may be particularly useful in working with patients to assess how their environment contributes to depression and anxiety.
“Sometimes getting to a prescription is easier than getting to a psychotherapist,” she said.
Studies show that mindfulness and medications are equally effective for anxiety, and that cognitive-behavioral therapy (a treatment that involves teaching patients to challenge negative thoughts) and medications are effective for depression. have been found to be nearly equally effective against Of course, that doesn’t mean that all patients will receive the same benefit from either type of treatment, and some studies have found a combined approach to be the best.
Kim Lavois, director of behavioral medicine at the University of Quebec, Montreal, wrote a review in 2002 on the lack of evidence supporting or against psychologists’ prescribing, and since then has Malpractice allegations against prescribing psychologists are rare, but their patients are at least as likely to be under the care of psychiatrists and primary care physicians as they are. I have never directly compared whether it works or not.
Lavoie said he is skeptical of allowing psychologists to prescribe drugs because they cannot treat the side effects of the drug. I am already seeing a doctor because I have
“How much does this actually streamline the process? I’m not convinced,” she said.
Primary care physicians may be inadequately trained in mental health conditions and unfamiliar with prescribing psychotropic medications, especially for children. You may also be more likely to misinterpret mental health symptoms. For example, misdiagnosing anxiety as attention deficit hyperactivity disorder or prescribing stimulants to make anxiety worse.
Denver pediatrician Dr. Cassie Littler says there are resources for primary care physicians who need additional guidance. One is the Colorado Child Psychiatric Consultation and Access Program, a publicly funded tool that allows providers to call a child psychiatrist or psychologist if they have questions about managing a child’s mental health. She said there is.
Littler said the funds to enable psychologists to prescribe would be used to encourage primary care physicians and mental health providers to be in the same office or integrated through record-sharing arrangements. Giving the ability to prescribe to another type of provider can further fragment care and lead to potential misunderstandings.
“It’s crazy to focus money on resources like that,” she said.
While it may be ideal for a psychologist to drop by and support a primary care physician when a patient needs it, Lee says that’s not realistic. If the patient is unfamiliar with handling psychotropic drugs, it is to refer the patient to a psychiatrist, which can mean a long wait.
“If you can find that utopia, no problem,” she said.
The prescribing psychologist should still be in contact with the patient’s doctor to monitor how well the drug is working and whether it is causing side effects during treatment appointments, which are more frequent than doctor’s visits. They could also wean patients off drugs that are ineffective or worsening their problems.
“We are all in this together. We are not taking anything away from anyone,” she said.
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