January 9, 2008
Prescription Privileges Law for Missouri Psychologists Improves Patient Access to Quality Mental Health Care
JEFFERSON CITY-- A grassroots coalition of patients, concerned citizens and health care professionals urged state lawmakers Wednesday to pass legislation allowing highly trained psychologists to prescribe certain medications for the treatment of mental health disorders to improve access to the badly needed care that Missourians deserve.
Supporters of the coalition Missouri Families for Access to Comprehensive Treatment said giving prescriptive authority to psychologists will put Missouri at the forefront of providing safe quality mental health care to patients, who can sometimes wait up to eight months to see a psychiatrist for medication in underserved rural and inner-city communities.
"Most psychologists' training exceeds that of dentists, podiatrists, optometrists and nurse practitioners. They can all prescribe medications, but a psychologist cannot. Something is wrong with this picture," said Thomas Parquette, a coalition member from Taney County who has suffered from a bi-polar disorder and depression since he was a child. "This bill is a prescription for progress by ensuring Missouri patients will have access to timely care."
Rep. Danielle Moore, a longtime champion of health care issues in the Missouri Legislature, plans to file a bill to give prescription privileges to psychologists to fix a critical problem with access to health care that exists in the state for patients who live in rural and urban communities.
"There is nothing more important to the welfare of our citizens than having access to health care, whether it is for treatment of an injury or for treatment of an emotional or mental disorder," Moore said during a news conference in the House Lounge. "When people run into obstacles finding affordable care, they become frustrated and too often will go untreated."
Only licensed, doctoral psychologists who successfully complete two additional years of academic psychopharmacology training and pass a national qualifying psychopharmacology exam would be eligible for prescriptive privileges. They would be required to maintain an ongoing relationship with a physician. Prescriptive authority also would be limited to mental health medications such as antidepressants and medicines for anxiety.
"Many psychologists are already experts on psychotropic medicines and provide consultation to general practice physicians on medication issues," said Dr. Mark Skrade, president of Missouri Psychological Association. "Passage of this bill will result in affordable comprehensive care for patients, with one provider combining appropriate psychotherapy and, if necessary, medication."
Access to mental health services is a serious issue in Missouri, which has fewer than 400 licensed psychiatrists, Skrade said. To make matters worse, many psychiatrists have opted out of the state's Medicare and Medicaid systems. General practitioners fill in the gap by prescribing approximately 80 percent of the psychotropic medications, but they have only about eight weeks of training in mental health, according to research by Missouri Psychological Association.
Dr. Roy Holand, a physician and former state Representative, said allowing highly trained psychologists to prescribe certain medications for the treatment of mental health disorders will provide patients with a greater variety of safe quality treatment options. Those with emotional or mental disorders often see a psychologist for diagnosis and treatment, but they currently must also see a psychiatrist or their primary care doctor for medications.
"This costs the patient extra time, extra money and many times discomfort in repeating their story to other individuals," Holand said. "This may lead to months of suffering and relapses in condition."
Parquette is among Missouri's patients whose treatment has been delayed and the cost of care increased because his highly trained psychologist cannot prescribe medications. In addition to the extra expense, it typically takes a month to get an appointment with his general practitioner.
"Talking with other patients has confirmed that my experience is not unusual. Missouri Families for Access to Comprehensive Treatment was formed to ensure that patients have access to the care they need and deserve," Parquette said. "We have fast grown to more than 500 members and will continue working to build support across Missouri for this vitally important bill."
Members of Missouri Psychological Association spent Wednesday at the state Capitol, meeting with their legislators and asking them to support Moore's bill, along with the companion bill sponsored by Sen. Jack Goodman.
More specifically, the proposed legislation mandates that prescriptive authority shall only be given to psychologists who:
Complete a post doctorate masters in psychopharmacology
Pass a national qualifying exam in psychopharmacology
Fulfill a one-year fellowship and a one-year collaborative practice agreement with a physician
Maintain a ongoing referral agreement with a physician
Missouri is among a number of states where broader privileges for psychologists to prescribe medications are being sought. Louisiana and New Mexico, along with the U.S. territory of Guam, have passed laws to allow psychologists to prescribe medications to patients.
The United States military also recognizes the benefit of having psychologists fully involved in the treatment of mental disorders. The Defense Department has authorized specially trained psychologists to provide prescription medications.
To learn more about the need to grant prescription privileges to psychologists in Missouri and to join Missouri Families for Access to Comprehensive Treatment, visit Missouri; email; or call 1-877-MOFact6.
SOURCE: Missouri Families for Access to Comprehensive Treatment
CONTACT: Connie Farrow of Missouri Families for Access to Comprehensive