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Pharmacy Times
This movement has aimed to address the mental health care epidemic in the United States.
As of 2024, 7 states (Colorado, Idaho, Illinois, Iowa, Louisiana, New Mexico, and Utah) have granted prescribing authority to licensed psychologists. This movement emerged to address the mental health care gap, particularly in underserved areas with limited access to psychiatrists. By allowing trained psychologists to prescribe psychotropic medications, such as antidepressants, anxiolytics, and mood stabilizers, these states aim to reduce wait times and enhance patient care through integrated treatment models.1 Prescribing psychologists combine talk therapy with pharmacological interventions, reducing the discontinuity often caused by multiple providers.2
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To qualify for prescriptive authority, psychologists must hold a doctoral degree (PhD or PsyD) and complete a 2-year master’s degree program in clinical psychopharmacology (MSCP), which includes both coursework and supervised clinical training. After passing the Psychopharmacology Examination for Psychologists, candidates receive a provisional license, requiring 2 years of supervised practice before they can prescribe independently. These requirements are designed to ensure prescribing psychologists have the necessary knowledge to manage medications safely and effectively.2
Mallory P. Schwartz, BS, is a PharmD candidate at the University of Kentucky College of Pharmacy in Lexington.
Joseph L. Fink III, JD, DSc (Hon), BSPharm, FAPhA, is professor emeritus of pharmacy law and policy as well as former Kentucky Pharmacists Association Professor of Leadership at the University of Kentucky College of Pharmacy in Lexington.
The American Psychological Association supports prescriptive authority for psychologists, citing their extensive training in diagnosis, therapy, and psychopharmacology. Findings from studies from New Mexico and Louisiana have shown that prescribing psychologists can improve patient outcomes, such as reducing suicide rates.3 Supporters argue that this initiative addresses critical gaps in care, especially in rural communities where psychiatrists are limited. With many psychiatrists not accepting insurance, prescribing psychologists offer a more accessible and cost-effective option for patients needing medication-assisted therapy.4
Despite these advantages, the initiative faces opposition from the American Medical Association and the American Psychiatric Association. Critics argue that psychologists lack the medical expertise required to safely prescribe medications, particularly in complex cases involving multiple conditions or drug interactions. These organizations believe that prescribing authority should remain with medically trained professionals such as psychiatrists and primary care physicians, who have broader medical training that covers these complexities.1
Most states limit psychologists’ prescribing to psychotropic drugs, aligning their scope with their mental health expertise. This limitation is important for maintaining patient safety because it ensures psychologists prescribe within their specialized training, reducing the risk of inappropriate medication use or harmful interactions.5
The shift in prescribing authority also affects pharmacists, who may need to collaborate more closely with prescribing psychologists to verify prescriptions, manage potential drug interactions, and provide patient counseling. This increased collaboration helps mitigate risks and ensures that patient safety remains a top priority. Pharmacists are positioned to support prescribing psychologists, especially in complex cases involving multiple medications. This partnership can lead to better overall patient care, as both psychologists and pharmacists bring their specialized expertise to the table.5
The debate over prescriptive authority for psychologists will continue as more states consider similar legislation. Supporters argue that the benefits, including increased access to care, reduced wait times, and integrated therapy and medication management, outweigh the risks. Opponents remain concerned about patient safety and professional boundaries. Achieving a balance between expanding access to mental health care and ensuring patient safety will be crucial as this movement evolves.
