Psychologists want ability to prescribe drugs
St. Louis Post-Dispatch
- March 10, 2008 Mar. 10
- March 10, 2008 Mar. 10
--For the last five years, Donna McArthur has
seen a psychologist every week for one hour. Then once a month, she
travels 80 miles to spend 20 minutes with a psychiatrist to get
prescriptions for antidepressants. She wouldn't have to make the extra trip under
a proposed law now making its way through committees in the Missouri
Legislature. Two similar bills, sponsored by Rep. Danielle Moore.
R-Fulton, and Sen. Jack Goodman R-Mount Vernon, would give psychologists the
authority to prescribe some psychiatric drugs after receiving
additional training. A similar bill was introduced in Illinois last year but did
not make it through the approval process. Supporters in Missouri
believe their bill has enough co-sponsors to get passed. Advocates say the
law is needed to address the lack of psychiatrists in the state,
particularly in rural areas. There are an estimated 350 psychiatrists and
1,800 psychologists in the state, according to the Missouri Psychological
Association. On the other side of the debate, some doctors question the
safety of expanding prescribing privileges to psychologists who don't
undergo the same medical training. McArthur, a retired restaurant owner,
travels to Springfield, Mo., to see a psychiatrist because she could
not find one closer to her home in Branson. "If I happen to have a bad
day two days after I've seen (the psychiatrist), the chances of me
remembering that and bringing it to her attention are slim," said McArthur,
45. "The psychologist is going to be more apt to control, regulate and
monitor my dosage. She's the one who's monitoring my ups and downs
every week." Psychologists generally treat mental health disorders through
behavioral and talk therapy. Typically, psychologists hold doctorate
degrees in their field but are not required to attend medical school.
Patients must visit a psychiatrist or another medical doctor to be
prescribed medications, including those used to treat depression and anxiety.
But the wait to see a psychiatrist can take months in many areas, says
Mark Skrade, president of the Missouri Psychological Association.
That's why primary care physicians such as gynecologists and general
practitioners prescribe up to 85 percent of psychiatric medicines. Skrade
argues that psychologists generally spend more time with patients and are
better suited for mental health care. Two states, Louisiana and New
Mexico, allow psychologists to write prescriptions. Psychiatrists who
oppose the legislation say the training required would not be enough to
protect patients. "Pharmacology is very complicated, and there's so much
interaction between drugs," said Dr. David Ohlms, a psychiatrist at
CenterPointe Hospital in St. Charles. "I think they're going to make
mistakes." Others say the change could put more patients on drugs they might
not need. A new British study comparing clinical trials shows that
antidepressants are of little value to people with mild to moderate
depression. Psychologists, through behavioral therapy, already have the power
to treat the majority of their patients, said Dr. John Abramson, a
clinical instructor at Harvard Medical School and author of "Overdosed
America." "The cause of those symptoms is usually not medical," Abramson
said. "It has to do with the way a person is living his or her life and
often in relation to their past experiences." But psychologists say the
prescribing power also would also allow them to take patients off drugs
when appropriate. The main goal of the measures is to remove barriers
to mental health care by allowing one caregiver the ability to evaluate
and fully treat patients, Skrade said. "This is another tool in a
psychologist's toolbox that opens up access to patients and decreases
expense for patients," he said. Thomas Parquette of Branson, Mo., spoke last
month to state legislative committees in support of the proposed law.
Parquette, 60, has tried 28 combinations of drugs to treat bipolar
disorder and depression. Having to see a psychiatrist or other physician to
get the prescriptions has led to delays of five weeks in some cases, he
said. "It requires modifications, changes, different pairings of
prescriptions," Parquette said. "This is best handled from a patient's
perspective by the psychologist who is treating me."
seen a psychologist every week for one hour. Then once a month, she
travels 80 miles to spend 20 minutes with a psychiatrist to get
prescriptions for antidepressants. She wouldn't have to make the extra trip under
a proposed law now making its way through committees in the Missouri
Legislature. Two similar bills, sponsored by Rep. Danielle Moore.
R-Fulton, and Sen. Jack Goodman R-Mount Vernon, would give psychologists the
authority to prescribe some psychiatric drugs after receiving
additional training. A similar bill was introduced in Illinois last year but did
not make it through the approval process. Supporters in Missouri
believe their bill has enough co-sponsors to get passed. Advocates say the
law is needed to address the lack of psychiatrists in the state,
particularly in rural areas. There are an estimated 350 psychiatrists and
1,800 psychologists in the state, according to the Missouri Psychological
Association. On the other side of the debate, some doctors question the
safety of expanding prescribing privileges to psychologists who don't
undergo the same medical training. McArthur, a retired restaurant owner,
travels to Springfield, Mo., to see a psychiatrist because she could
not find one closer to her home in Branson. "If I happen to have a bad
day two days after I've seen (the psychiatrist), the chances of me
remembering that and bringing it to her attention are slim," said McArthur,
45. "The psychologist is going to be more apt to control, regulate and
monitor my dosage. She's the one who's monitoring my ups and downs
every week." Psychologists generally treat mental health disorders through
behavioral and talk therapy. Typically, psychologists hold doctorate
degrees in their field but are not required to attend medical school.
Patients must visit a psychiatrist or another medical doctor to be
prescribed medications, including those used to treat depression and anxiety.
But the wait to see a psychiatrist can take months in many areas, says
Mark Skrade, president of the Missouri Psychological Association.
That's why primary care physicians such as gynecologists and general
practitioners prescribe up to 85 percent of psychiatric medicines. Skrade
argues that psychologists generally spend more time with patients and are
better suited for mental health care. Two states, Louisiana and New
Mexico, allow psychologists to write prescriptions. Psychiatrists who
oppose the legislation say the training required would not be enough to
protect patients. "Pharmacology is very complicated, and there's so much
interaction between drugs," said Dr. David Ohlms, a psychiatrist at
CenterPointe Hospital in St. Charles. "I think they're going to make
mistakes." Others say the change could put more patients on drugs they might
not need. A new British study comparing clinical trials shows that
antidepressants are of little value to people with mild to moderate
depression. Psychologists, through behavioral therapy, already have the power
to treat the majority of their patients, said Dr. John Abramson, a
clinical instructor at Harvard Medical School and author of "Overdosed
America." "The cause of those symptoms is usually not medical," Abramson
said. "It has to do with the way a person is living his or her life and
often in relation to their past experiences." But psychologists say the
prescribing power also would also allow them to take patients off drugs
when appropriate. The main goal of the measures is to remove barriers
to mental health care by allowing one caregiver the ability to evaluate
and fully treat patients, Skrade said. "This is another tool in a
psychologist's toolbox that opens up access to patients and decreases
expense for patients," he said. Thomas Parquette of Branson, Mo., spoke last
month to state legislative committees in support of the proposed law.
Parquette, 60, has tried 28 combinations of drugs to treat bipolar
disorder and depression. Having to see a psychiatrist or other physician to
get the prescriptions has led to delays of five weeks in some cases, he
said. "It requires modifications, changes, different pairings of
prescriptions," Parquette said. "This is best handled from a patient's
perspective by the psychologist who is treating me."
bbernhard@post-dispatch.com -- 314-340-8129 ----- To see more of the
St. Louis Post-Dispatch, or to subscribe to the newspaper, go to
http://www.stltoday.com.
Copyright (c) 2008, St. Louis Post-Dispatch
Distributed by McClatchy-Tribune Information Services. For reprints,
email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550,
send a fax to 847-635-6968, or write to The Permissions Group Inc.,
1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA. This news story
is not produced by the American Psychological Association and does not
necessarily represent the opinions of the association. PsycPORT® is a
product of the American Psychological Association created to provide
quick access to mass-media information related to psychology. ®2008
American Psychological Association Last updated: 03/11/2008 - 01:06 PM
Distributed by McClatchy-Tribune Information Services. For reprints,
email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550,
send a fax to 847-635-6968, or write to The Permissions Group Inc.,
1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA. This news story
is not produced by the American Psychological Association and does not
necessarily represent the opinions of the association. PsycPORT® is a
product of the American Psychological Association created to provide
quick access to mass-media information related to psychology. ®2008
American Psychological Association Last updated: 03/11/2008 - 01:06 PM
