Prescriptive Authority in Arizona

Prescriptive Authority

Although psychologists have more training in the assessment, diagnosis and treatment of mental disorders than any other health care professional, the majority of all psychotropic medications are prescribed by health care providers with little to no mental health training. The American Psychological Association (APA) Services Inc. supports the efforts of our state, provincial, and territorial psychological association partners to obtain prescriptive authority for qualified, licensed psychologists in to help fill the need for access to comprehensive, quality mental health care in Arizona.

History: Prescriptive Authority

  • 1981 – APA Board of Professional Affairs takes public position that the right to prescribe (RxP) is within the scope of practice of psychology
  • 1985 – First bill seeking RxP for psychologists is introduced in Hawaii
  • 1989 – Board of Professional Affairs endorses psychopharmacology training program for psychologists
  • 1991 – Licensed psychologists begin prescribing in the US military
  • 1995 – APA Council of Representatives makes RxP for psychologists APA policy
  • 1999 – Guam grants RxP to appropriately trained psychologists.
  • 2002 – New Mexico grants RxP to appropriately trained psychologists
  • 2004 – Louisiana grants RxP to appropriately trained psychologists
  • 2005 – First prescription written by civilian psychologists
  • 2014 – Illinois grants RxP to appropriately trained psychologists
  • 2016 – Iowa grants RxP to appropriately trained psychologists
  • 2017 – Idaho grants RxP to appropriately trained psychologists

         (McGrath, 2010)

Why AZ…Why Now?

According to the CDC, patients often receive psychotropic medications without being evaluated by a mental health professional and less than half of those taking psychotropic medications have seen a mental health professional in the past year (APA) (CDC). “The shortage of psychiatrists is an escalating crisis,” notes the physician search firm Merritt Hawkins in a 2017 report. “[The gap is] of more severity than shortages faced in virtually any other specialty.” Only 55 – 60% of psychiatrists accept insurance (Satiani et al., 2018). Nearly 60% of individuals with depression in the US receive mental health treatment from their Primary Care Provider (PCP) (Barkil-Oteo, 2013). PCPs were responsible for prescribing a higher percentage of psychotropic medications to children than psychiatrists (Anderson et al., 2015)

Arizona

  • Suicide is the second leading cause of death in Arizona (ages 15 – 44) (ADHS, 2019)
  • In 2015 - 2016, “more than 20% of Arizonans ages 18 to 25 reported having a mental illness in the past year” … “However, only about half of those individuals received mental health services during that period” (ADHS, 2019, p. 58)
  • In 2018, Arizona ranked 30th among all states in its overall health status (ADHS, 2019)

Prescribing Psychologists

  • Improved access to mental health care providers for all those in need
  • The right to prescribe is also the right to unprescribe
  • Comparable training to current non-physicians with RxP such as: physician assistants and nurse practitioners (Linda & McGrath, 2017)

Research has shown the most effective form of treatment for mental illness is a combination of psychotherapy and medicine. For psychologists, prescriptive authority is another tool for potential approaches or interventions used to treat mental illness and promote mental wellness (Pimental et al, 1997).
With appropriate education and training, psychologists are equipped to prescribe and unprescribe psychotropic medications both safely and effectively. In other states, prescribing psychologists offer access to more individuals, reducing the wait time for individuals requiring medication. The non-prescribing psychologists continue to treat their similar caseloads while consulting with prescribing psychologists, while psychiatrists are less burdened. 

Prescribing Psychologists

  • Required to have a PsyD or PhD.
  • Required to have a 2 year Masters in Psychopharmacology
  • Required to have supervised clinical hours under a currently licensed prescribing physician
  • Required to pass licensing exam

            Resource: https://www.apa.org/about/policy/rxp-model-curriculum.pdf

What Now...

Prescriptive authority legislation.

Legislation must be drafted, sponsored, submitted, and voted on. These legislative efforts are costly but the need is undeniable.

For further information please contact Kristen Northup at [email protected] or Ryan House at [email protected]

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