texas rank past A recent study by Mental Health America found that mental health services are available in 50 states and the District of Columbia.
With such a poor record, the recently convened Texas legislature inevitably discussion Whether to increase funding for mental health. But simply putting more money into the system isn’t always the best way to boost results.
In fact, one way to increase access to mental health services without spending any taxpayer money was implemented 20 years ago in New Mexico, just west of Texas. Louisiana, Texas’ eastern neighbor, enacted a similar program 17 years ago. Both have removed barriers to allowing clinical psychologists to prescribe medication.
Texas, like most states need It takes an average of five years of graduate school for a clinical psychologist to obtain a PhD in psychology. This includes at least 1,750 hours of her supervised clinical training, plus she must complete a minimum of 1,750 hours of a graduate internship and pass a standardized proficiency exam. Get a license. Unlike many other states, Texas requires clinical psychologists to pass a bar exam.
Clinical psychologists diagnose mental health problems and provide talk therapy. Under current Texas law, if a patient requires medication to facilitate psychotherapy, a psychologist must refer the patient to a licensed prescriber, most commonly a psychiatrist. Hmm.
Today it’s not so easy.about half psychiatrist does not approve insurance. First visit with a psychiatrist cost It costs as much as $500 and follow-up visits range from $100 to $300 per hour. and today, less than 11% of psychiatrists practice talking therapy, but instead most primarily practice medication.
What if the psychiatrist was too far away, too expensive, or too busy with appointments to confirm a clinical psychologist referral? In that case, the psychologist can always refer the patient to a primary care practitioner or other licensed physician (even a general surgeon like myself) to prescribe mental health medications. In some cases, psychologists know more about drugs, dosages, and side effects than the medical practitioner who writes the prescription.
However, in Texas, only licensed doctors can prescribe psychiatric medications.
as i explain in my briefing paper The Department of Defense began a pilot program in the 1990s from the Kate Institute to expand its workforce of prescribing military mental health providers. They developed psychiatrist-supervised programs, taught clinical psychologists psychopharmacology, and trained them to medically manage mental health problems. It was so successful that today Prescription Psychologists (RxPs) are treating patients at the US Public Health Service Commission and the Indian Department of Health.
Impressed by how RxPs can increase access to medically-assisted mental health care, the territory of Guam received a prescribing psychologist license in 1999. 2002, New Mexico The state became the first state to allow competent clinical psychologists to prescribe psychiatry.
Three years later, Louisiana followed suit. That state’s licensing board calls RxPs “medical psychologists.” In the years that followed, various states such as Idaho, Iowa, and Illinois removed regulatory barriers to prescribing psychologists.
Each of the five states a psychologist may prescribe has different licensing requirements. However, all RxPs must obtain accredited graduate-level training (usually a master’s degree) in clinical psychopharmacology, an internship, or other form of hands-on clinical experience to treat drug-induced mental health problems. and must pass a nationally standardized psychopharmacological examination.
New Mexico has the fewest barriers of the five states where competent clinical psychologists currently prescribe. The state requires RxPs to have at least 450 hours of postdoctoral instruction and 400 hours of clinical psychopharmacology clinical experience. Unlike Illinois, New Mexico avoids irrelevant didactic and clinical experience requirements. The state allows an RxP to practice independently, but only after a primary care provider has supervised her for two years.
Prescription clinical psychologists have a nearly 30-year track record of providing skilled and comprehensive mental health care to people with mental illness. With mental health needs on the rise and mental health resources in short supply, Texas legislators say removing barriers to psychologists prescribing medications will help improve access to free mental health care. You will find that it is a method.
Jeffrey A. Singer, MD, is a General Surgeon at Phoenix and a Senior Fellow at the Cato Institute. He wrote this column for his Dallas Morning News.
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