Iowa has become the fourth state to allow psychologists to prescribe psychotropic medications, furthering the effort to expand mental health treatment to the nation's underserved areas and helping to pave the way for a larger role for prescribing psychologists.
APA supports prescription privileges for appropriately trained psychologists as a way to help address the shortfall between demand for medications and the number of behavioral health professionals—particularly psychiatrists—who can prescribe them.
"Lacking mental health prescribers, we are not offering the full range of available options to our patients," says Sean Evers, PhD, president-elect of Div. 55 (American Society for the Advancement of Pharmacotherapy). "Clinically, it becomes frustrating to know that 'Gee, I could really fix this motor if I had this one wrench, but there's no wrench store in this town, and there's a six-month wait to order one.'"
The Iowa Psychological Association (IPA) says prescription privileges for psychologists were sorely needed in the state, which ranks 47th in access to psychiatrists per capita, according to the National Center for Health Workforce Analysis. Two-thirds of Iowa's counties have no psychiatrists. Even in urban areas, it can take months for patients to get an appointment with one, says Elizabeth Lonning, PsyD, who chairs the IPA psychopharmacological committee.
APA saw this growing need decades ago. The association's Council of Representatives endorsed prescription privileges in 1995. APA and the APA Practice Organization have assisted state psychological associations advocating for such laws. In 2009, APA created a designation system to help regulators identify training programs that adhered to established criteria for training psychologists in psychopharmacology for prescriptive authority.
New Mexico was first to pass a prescribing law in 2002, followed by Louisiana in 2004 and Illinois in 2014. Psychologists can also prescribe throughout the military, the U.S. Public Health Service, and the Indian Health Service, as long as they are credentialed in New Mexico or Louisiana.
Iowa's move should boost momentum in more than a dozen states where bills are making progress, including Hawaii, Idaho, New Jersey, New York and Ohio, says Deborah Baker, JD, director of legal and regulatory policy in the APA Practice Directorate.
All told, there are some 200 prescribing psychologists in the nation, Baker says, and training more will take time. Though state laws differ, psychologists must do significant work on top of their doctoral degree, including completion of a master's degree in psychopharmacology (or equivalent), supervised clinical training and passing a national exam.
