After four years of legal wrangling, the Spanish Supreme Court has ruled on four separate appeals to the government's decision to give clinical psychology the same status as psychiatry in the public health system.
In October, the court threw out appeals from Spanish medical and psychiatric associations to a 1998 law that created a separate specialty of clinical psychology, granting psychologists the ability to conduct psychological diagnosis, assessment and treatment. Of the Spanish Psychological Association's 35,000 registered members, 7,500 have so far applied for official recognition as clinical psychologists.
Spanish medical and psychiatric associations immediately objected to the 1998 law, says José M. Prieto, PhD, a professor of personnel psychology at Complutense University in Madrid, arguing that psychologists were "useful under the supervision of a psychiatrist or a physician, but they could not diagnose, assess and treat patients in an autonomous manner." The physicians were concerned because they cannot apply to join the specialty of clinical psychology, and they claimed that most mental illnesses have a biological basis, so only a medical doctor can diagnose them and prescribe medications.
The psychologists submitted counter-arguments, which led the Supreme Court to request testimony from a variety of specialists within psychology and psychiatry on the professional expertise and competence of psychologists, says Prieto, who provided testimony on personnel assessment issues. Several international groups--including the World Psychiatric Association, the European Federation of Psychological Associations and the International Association of Applied Psychology--also weighed in on both sides of the debate.
The Supreme Court said it was not qualified to rule on internal discussions between mental health specialists concerning the boundaries of mental illness or proper diagnoses. However, it said that, legally, the psychiatrists and other medical professionals could not claim mental health, psychotherapy or diagnosing as their exclusive province.