Bill broadening prescribing rights to psychologists unsafe

Setting the stage for another legislative battle that puts mental health patients in the middle, a bill seeking to give licensed psychologists prescribing privileges for dangerous medications is scheduled to be heard on April 23, 2007 in the Senate Business, Professions and Economic Development Committee.

The bill, SB 993, is the fifth legislative attempt since 1995 to broaden psychologists' scope of practice.

At issue is whether psychologists who would be trained under SB 993 lack the medical education and clinical experience needed to diagnose and effectively treat disease, manage side effects from medications and appropriately integrate medications into patients' overall health management.

"Who would seriously entertain the notion of allowing psychologists to treat cancer with chemotherapeutic agents?" asked Barry F. Chaitin, M.D., past president of the California Psychiatric Association. "Being biologically- based, genetically-influenced diseases of the brain, mental illnesses, such as schizophrenia and depression, are medical conditions."

Under this measure, psychologists would have less education and training than nurse practitioners (NPs) and physician assistants (PAs), who have prescribing authority, and would not be subject to direct supervision by a medical doctor. NPs and PAs generally have at least six years of study in a science-based curriculum. In contrast, psychologists' undergraduate and graduate education is generally based on liberal arts coursework.

SB 993 would allow a licensed psychologist to become a fully certified "prescribing psychologist" by taking one year of coursework and undergoing "relevant supervised clinical experience." No specific requirements are set forth regarding the amount of time needed to obtain "relevant supervised clinical experience."

"Psychiatrists, mental health nurse practitioners and physician assistants with special training in psychiatry receive much greater medical education and clinical experience in diagnosing and treating mental illnesses than psychologists under this bill," said Chaitin. "Only very close supervision of a patient's entire medication regimen can ensure that potential interactions are avoided and adverse events handled quickly and appropriately. There is no reason to subject patients to the additional risks posed by having non-medical professionals prescribing medications."