Just a quick opinion question....

[charebec65]

I had to do an assignment for my psychology class on the pros and cons of psychologists being able to prescribe psychotropic medications. I'm just curious as to the general opinion of nurses on this subject. Thanks...

Added later.....

I guess I should add that the states that I read about that are proposing/doing this do have a post-doctoral educational component including coursework in pharmacology & physiology, etc......

[traumaRUs, MSN, APRN]

No - I don't think they should be able to prescribe:

1. Psychologists' training is based on counseling theory versus medical theory.

2. They practice independently often - who would oversee this authority?

3. Follow-up is very difficult for many psych patients - what would be the measures in place to have adequate follow-up?

4. If psychologists managed psychotropic meds, their educational program would need to be expanded as would their scope of practice.

[RNsRWe, ASN, RN]

The only "pro" I see would be to increase the convenience for the prescriber and the patient. Not nearly enough of a reason to permit it, IMO.

The cons are many. The simplest one, and the one that stops the issue cold for me, is that no one without medical training (and proven competency) in drug side effects, desired effects, potential risk factors etc, those without medical clinical experience have any business prescribing such treatments to vulnerable human beings.

When standards are loosened we see worse outcomes than when they are adhered to and improved upon.

[Todd SPN]

Not unless they go to medical school. However, I am for allowing any nurse who works LTC to prescribe prn Ativan!

Todd

[Multicollinearity, BSN, RN]

New Mexico allows prescriptive authority for psychologists IF they take several psychopharmacology classes (and a few other classes).

I think it's great, if there is a collaberative relationship with a physician. I do think some aren't aware how much physiology training psychologists receive regarding the brain. Counseling is only one facet of their education. Some psychologists don't even do counseling. Some perform psychometric testing (psychiatrists cannot do this) and only diagnose. The specialties of neuropsychology and rehabilitation psychology are much more medically based.

This may sound odd, but I think psychologists could have an edge to prescribing that psychiatrists don't have. Psychologists spent a full hour with their patients. That full hour allows them to pick up on how the patient is really doing. This allows more time to monitor mental status, mood, sleeping, emotions, etc.

Psychiatrists have med school (general med education) and then what, 4 years of psychiatry residency? Psychologists have 4-6 years of phd program psychology training in the brain and psychological science. Then they have a one-year fellowship (like residency). To work in a more 'medicalized' specialty like neuropsychology or rehabilitation psychology they do another one-year fellowship. Frankly, as a patient, I'd rather have the psychologist. They have more focused training just on the brain and psychology. I also do respect the overall approach of more therapy and less drugging. But sometimes medication is necessary.

Some of my family members have mental illnesses. I can tell you that their best results came from seeing psychologists, not psychiatrists. The only problem is getting the meds.

[Multicollinearity, BSN, RN]

Here's an article on psychologists with prescriptive authority:

http://www.apa.org/monitor/julaug06/pioneers.html

This link describes the required education to have prescriptive authority. It's not exactly light. Education requirements are in the second paragraph.

http://www.nmpa.com/displaycommon.cfm?an=1&subarticlenbr=9

[romie]

I've heard of psychologists becoming psychiatric mental health nurse practitioners to obtain the same prescriptive authority of these ANPs.

My only concern is that if psychologists start prescribing meds, then wont many of them devote more of their time to medication management and less to psychotherapy and talk therapy? I believe that billing for medication management can be much more lucrative because you can see more patients in an hour. Then wont they begin to delegate their previous responsibilities to other less qualified (or differently abled/ educated) professionals? Wont they, in a sense, become more like the psychiatrists, who normally see their patients for a few minutes every three months at most?

[Multicollinearity, BSN, RN]

I suppose it's possible. I think it's unlikely though. That would be going against the grain of their training/purpose/everything they know, and clinical psychology practice guidelines. I think that could get them in hot water with the licensing board.

I don't know that insurance codes (ICD-9) would allow them to simply bill for med management, either.

[romie]

After reading both articles that you posted, I think it could really great idea if it increases access to mental healthcare for all people. The extent of additional education for these psychiatrist seems pretty thorough and I doubt any one who met these requirements would be underprepared for the responsibilities of prescriptive authority.

[charebec65]

Thanks for all the responses. We talked about this in class last night but our professor, who has a PhD in Psychology, won't give us his opinion. lol He claims not to have a strong science or anatomy background but he sure is comfortable in teaching it as it relates to Psychology.