Addressing the Myths Behind Psychologists' Claims

 

Myth: Proponents claim that with training developed by the American Psychological Association, psychologists practicing in Ohio should be able to prescribe psychotropic medications to Ohioans.


FACT: Prescription drugs that treat mental illnesses in children and adults change chemical levels
in both the brain and body. This affects mood, behavior, other organs, and other medications. Current behavioral health prescribers (MDs, DOs, APRNs and PAs) in Ohio are trained in the medical model of care. As a result, current prescribers integrate a patient’s entire medical history with their mental health symptoms to evaluate and treat patients safely. Prescribing medications without that knowledge is unsafe.


Myth: Proponents claim that allowing psychologists to prescribe medications is the only plan that can address shortages in mental health workers and addiction treatment services.
 

FACT: Potential solutions must promote patient safety and maintain the collaborative approach to care. Expanding prescriptive authority to psychologists does neither. Two innovations are boosting access to behavioral health care in Ohio:


1. Telemedicine (including telepsychiatry) is a powerful tool that can connect people with
mental health and addiction treatment services. It is a key innovation in support of health
care delivery reform.

2. Integrated/collaborative care models between primary care physicians and psychiatrists,
as well as increasing collaboration between physicians and psychiatric advanced practice registered nurses (APRNs) and physician assistants (PAs), expand care and treatment. Such collaborative models already provide a path for psychologists to prescribe in Ohio, once they are educated to become a psychiatric APRN or PA.

Myth: Proponents claim if allowed to prescribe, psychologists could significantly address access issues for both mental health and addiction treatment – particularly in rural areas.
 

FACT: According to the American Medical Association, in the only two states where psychologists
have had the legislative authority to prescribe for 10 years or more (New Mexico and Louisiana),
there is no scientific evidence that prescribing psychologists have moved to rural areas to practice,
or improved access to care.


Myth: Proponents claim that psychologists have been prescribing medications safely for decades.
 

FACT: There are no scientific data to show that psychologists can prescribe safely and competently.
No evidence-based research has been done to assess the safe and competent prescribing or
outcomes of care by psychologists.


Myth: Proponents claim that the training proposed by psychologists has proven to be more than adequate in
both the military and other states with years of experience with prescribing psychologists.

 

FACT: In 1991 the Department of Defense (DoD) instituted a demonstration project to educate psychologists in the military to prescribe medications. Thirteen persons participated in the program; three dropped out; 10 graduated (two of which moved on to medical school). The remaining eight went on to prescribe in the Army, Navy or Air Force. Based on exit interviews, many of the psychologists believed they were still ill-prepared to prescribe competently and the program was abandoned. It’s important to note that the DoD project required a significantly more rigorous course
load than what is proposed in HB 326 and the model enacted in states where psychologists have prescriptive authority.

 

Myth: Proponents claim the proposed training exceeds the training of APRNs and PAs and is focused on the work that prescribing psychologists will be doing.


FACT: The training proposed in Rep. Manning's bill requires only 425 contact hours (that is designed to be taken completely online in a psychologists spare time). The web-based program is promoted as a two-year psychopharmacology degree program, however, it can be completed in as little as 10 weeks - and psychologists are given three chances to pass the exam(s). While psychologists do complete a significant amount of academic coursework in social and behavioral sciences, there is very little, if any, biomedical education/training and no skills labs.

The proponents have finally agreed that psychologists who want to prescribe need biomedical training and the sponsors added an amendment to the bill that would require psychologists to complete basic science courses within 5 years
after obtaining a certificate to prescribe medication. These courses are the equivalent of prerequsite required coursework before being accepted into an APRN or PA program.


Myth: Proponents claim the Ohio Board of Psychology is capable of, and should be, the authoritative body
to regulate the practice of prescribing psychologists.


FACT: The regulation and practice of psychologists who want to prescribe must be under the jurisdiction of the State Medical Board just as it is for all physicians including psychiatric physicians and PAs. Since APRNs are regulated by the Ohio Board of Nursing, they are already regulated by a board with medical knowledge.

There is no evidence that members of the Psychology Board have the knowledge and experience to determine whether there has been a departure from, or failure to conform to, minimal standards of care of similar prescribers that function under the medical model of care. Prescribing psychologists licensed in another state would similarly not have the required knowledge to determine patient harm. While the substitute bill now includes language to appoint one physician to serve on the Psychology Board, it does not address the concerns of safety because of the imbalance of board member’s clinical expertise.

 

Allowing the Psychology Board to regulate the practice of prescribing psychologists would create inconsistent standards for patient care and thereby potentially increase the risk of harm to Ohioans.