State grants psychologists Rx privileges

May 1, 2002

Pharmaceutical Representative

New Mexico Governor Gary Johnson has signed legislation into law authorizing properly trained psychologists to prescribe psychotropic medications to patients.

New Mexico Governor Gary Johnson has signed legislation into law authorizing properly trained psychologists to prescribe psychotropic medications to patients. The law, which was passed on March 5, makes New Mexico the first state in the country to allow psychologists to prescribe psychotropics.

"The American Psychological Association is quite pleased that New Mexico enacted a law allowing prescription privileges for psychologists," said Russ Newman, executive director for professional practice for the Washington-based American Psychological Association. "Statistics show that there is a public health need in large rural areas with mental health service gaps, and it is our understanding that this is particularly true in New Mexico."

According to the American Psychological Association, only 18 psychiatrists serve the 72% of New Mexicans who live outside Albuquerque and Santa Fe. Waiting time to see a psychiatrist is six weeks to five months in these areas. Suicide in New Mexico for ages 15 to 24 is 75% higher than the national average, and 75% of those with mental health disorders in New Mexico are not receiving treatment.

Getting licensed

Under the new law, to receive a prescribing license in New Mexico, psychologists must complete at least 450 hours of coursework and a 400 hour/100 patient practicum under physician supervision, and pass a national certification examination. The academic component includes psychopharmacology, neuroanatomy, neurophysiology, clinical pharmacology, pharmacology, pathophysiology, pharmacotherapeutics and pharmacoepidemiology, as well as physical and lab assessments.

After completing coursework and supervised training and passing a national exam, psychologists licensed to practice in New Mexico are eligible for a two-year license allowing them to prescribe under supervision of a physician. At the end of two years, if the supervisor approves and the psychologist's prescribing records pass an independent peer review, the psychologist can apply to prescribe independently. As an independent prescriber, the psychologist will maintain a collaborative relationship with the patient's healthcare practitioner.

Patients at risk?

The law was opposed by groups like the Chicago-based American Medical Association and the Washington-based American Psychiatric Association.

"The American Psychiatric Association deplores the decision of the New Mexico legislature and governor to permit clinical psychologists to prescribe potent medication for the treatment of people with mental illness," said Richard K. Harding, president of the American Psychiatric Association. "The new law … is the result of a cynical, economically motivated effort by some elements of organized psychology to achieve legislated prescriptive authority without the benefit of medical education and training."

Harding also said that the new law does not provide psychologists with sufficient training to enable them to prescribe medications: "Psychologists have always had a clear path to prescribing privileges: medical school. No psychology-designed and -administered crash course in drug prescribing can substitute for the comprehensive knowledge and skills physicians achieve through medical education and rigorous clinical experience."

Newman, however, disagrees. "Independent evaluations of prescriptive privileges training for psychologists have clearly demonstrated that psychologists can be trained to prescribe safely and effectively," he said. "Psychologists are mental health professionals already trained in providing health and mental health services. Allowing properly trained psychologists to prescribe is a logical step in helping to improve access to quality mental healthcare for consumers." PR

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