Prescribing Psychologists

The RxP Difference: Answering the Crisis in Mental Health Care

Bottle with Pills in Lid

The Issue: Funding struggles and cuts, doctor shortages and inadequate care options have created a very real, very dangerous mental health care crisis in Illinois.

• With resources stretched to the limit, psychiatrists and other mental health professionals are in short supply and the demand far exceeds the capabilities of the existing network. Mental health hospitals and community centers are in dire straits as state funding has dropped dramatically.

• More than 50 Illinois counties have no inpatient psychiatric services in their hospitals. Another 24 counties have no hospitals at all. Yet, 614,000 Illinoisans need treatment right now for serious mental illness. The unmet need is greatest with people who need help the most: low-income, rural, and minority populations whose needs are often underserved.

• As more people are placed on Medicaid, as a result of federal health care reform, and states continue to struggle to cover the cost of Medicaid, the problem will only worsen.

• The pain is widespread and growing. When people do not receive the mental health care they need, they end up in hospitals or jails – driving up those costs dramatically and further crunching our tax dollars.

• Cook County Sheriff Tom Dart says his jail has become the state’s largest mental health care provider. Yet, for people with serious mental illness, who need appropriate psychotherapeutic and pharmacotherapeutic care, the County jail cannot meet their needs.

There is a better way. The RxP Difference campaign provides a meaningful answer to this problem by demonstrating that comprehensive care can be provided by psychologists. Giving prescriptive authority to specialty trained and experienced psychologists will help the mentally ill live better lives; will save money for the public municipalities; and will make our communities safer, since the mentally ill, who are treated, will be less likely to engage in criminal behaviors.

How It Works: The RxP Difference puts in place a much-needed safety net by:

• Improving access to care and allowing freedom of choice for Illinoisans who are stymied by mental health challenges

• Promoting effective, comprehensive, timely patient treatment

• Easing the enormous pressure on the system with licensed, superbly trained psychologists who do collaborative work with their patients

Why It Works: The RxP Difference does not replace the good work done by psychiatrists and hospitals and community centers. It builds on that foundation and takes Illinois’ mental health care to the next level.

• Prescribing psychologists will work collaboratively with their patients as well as with all of the other healthcare providers in the community. Prescribing psychologists will understand the importance of conducting a thorough review of a patient’s history and symptom presentation. If they determine that a medication may be appropriate for treatment, they will prescribe that medication but often recommend a combination of psychotherapy and pharmacotherapy. More people will be able to get the care they need. With mental illness affecting 30 percent of the 700,000 new Medicaid patients expected when federal health care reform hits in 2014, physicians and hospitals desperately need the help. Prescribing psychologists are the answer.

• The RxP Difference has been an unequivocal success in New Mexico and Louisiana where psychologists are prescribing. Overwhelmingly, primary care physicians report work with prescribing psychologists to be of great benefit to them. United States military and civilian psychologists have written hundreds of thousands of prescriptions without a single complaint or malpractice case in 20 years of work.

Prescribing psychologists are dedicated to the highest professional standards. They spend four times as many didactic hours on the study of Clinical Psychopharmacology than primary care physicians. In many states, psychologists, who have specialized in Clinical Psychopharmacology, train family practice medical residents. The prescriptive authority of psychologists is limited to the medications that treat the mental illnesses and the behavioral disorders. The history of prescribing psychologists is that they prescribe 60 – 70% fewer medications than other health prescribers. Moreover, they will be more likely, than other health prescribers, to “unprescribe” medications because they are aware of behavioral therapeutic strategies that can be more effective than medications, thus reducing side effect complications.

The mental health care crisis impact is staggering: 60 million people nationwide with a diagnosable mental disorder each year and estimated annual economic costs of more than $315 billion.
The RxP Difference responds to the call for help by providing timely, effective, and comprehensive treatment that gives people greater opportunity for recovery and hope.

We encourage our policymakers to give us prescriptive authority
so we can make The RxP Difference for Illinois.

Governor Pat Quinn (D) Signed Into Law Historic Bill, Sponsored by the Illinois Psychological Association

Prescriptive Authority Given to Licensed Clinical Psychologists

PRESS RELEASE
FOR IMMEDIATE RELEASE

CONTACT:
Beth N. Rom-Rymer, Ph.D., President, Illinois Psychological Association
docbnrr@gmail.com
cell: 312-961-1735

Terrence Koller, Ph.D., Executive Director, Illinois Psychological Association
ipaexec@aol.com
office: 312-372-7610 x202

Chicago, Illinois (June 25, 2014) Today, at 3:30 pm, Governor Pat Quinn (D) has signed into law the historic bill, sponsored by the Illinois Psychological Association, that gives prescriptive authority to licensed clinical psychologists, with advanced, specialized training, to prescribe certain medications for the treatment of mental health disorders. Illinois has now become the third state in the country, after New Mexico and Louisiana, to give prescriptive authority to licensed clinical psychologists with this specialized training. Introduced by Senator Don Harmon (D), President Pro Tem of the Illinois Senate, Senator Dave Syverson (R), Representative John E. Bradley (D), and Representative Raymond Poe (R),

American Psychological Association
Recommended Postdoctoral Education and Training Program In
Psychopharmacology for Prescriptive Authority

Education and training in psychopharmacology for prescriptive authority has evolved rapidly over the past two decades. As of the writing of this document, there were approximately 10 programs in a range of educational contexts offering this training on a postdoctoral basis. As more states pass laws authorizing properly trained psychologists to prescribe it will continue to be necessary to define what is meant by “properly trained psychologists.” Psychology’s ethical responsibility to the public requires that the profession be able to define the training needs and minimum competencies required for prescriptive authority. This document reflects the most current thinking in the field as to the nature of such education and training. It incorporates knowledge and experience derived since the 1996 version of this document, Recommended Postdoctoral Training in Psychopharmacology for Prescription Privileges, became APA policy.

In accordance with Association Rule 30-8.3 requiring that all APA standards and guidelines be reviewed at least every 10 years, and in light of the advances that have been made in prescriptive authority education and training and legislation enacted since the document APA Recommended Postdoctoral Training in Psychopharmacology for Prescription Privileges (1996 Recommended Training) was approved in 1996,1 the Council of Representatives authorized a joint BEA-CAPP Task Force in February 2006 to review the current program requirements and recommend any necessary updates and revisions.

When the original model program standards were developed over a decade ago, few programs existed and no state legislation, enabling psychologists to prescribe, had been enacted. Since then, a number of new programs have developed operating under varying education and training models, and enabling legislation has been passed in two states and one U.S. territory (with legislation pending or planned in several others). These developments clearly called for revisions of the existing policy.

Download the full document in the attached pdf.

Bill Status of HB3074 98th General Assembly

PRESCRIBING PSYCHOLOGIST CERT

Synopsis As Introduced
Amends the Clinical Psychologist Licensing Act. Provides that the Clinical Psychologists Licensing and Disciplinary Board shall grant certification as prescribing psychologists to doctoral level psychologists licensed under the Act. Provides application requirements for certification as a prescribing psychologist. Provides that the Board shall establish a method for the renewal every 2 years of prescribing psychologist certificates. Provides procedures for safety and record keeping. Provides that when a psychologist is authorized to prescribe controlled substances, a prescribing psychologist shall file, in a timely manner, any individual Drug Enforcement Agency registrations and identification numbers with the Board. Requires certain communication between the Board and the State Board of Pharmacy. Provides requirements for licensure by endorsement. Defines related terms. Amends the Illinois Controlled Substances Act. Includes prescribing psychologist in the definition of "prescriber".

Learn more and track the bill’s progress here.

Bill Status of SB2187 98th General Assembly

PRESCRIBING PSYCHOLOGIST CERT

Synopsis As Introduced
Amends the Clinical Psychologist Licensing Act. Provides that the Clinical Psychologists Licensing and Disciplinary Board shall grant certification as prescribing psychologists to doctoral level psychologists licensed under the Act. Provides application requirements for certification as a prescribing psychologist. Provides that the Board shall establish a method for the renewal every 2 years of prescribing psychologist certificates. Provides procedures for safety and record keeping. Provides that when a psychologist is authorized to prescribe controlled substances, a prescribing psychologist shall file, in a timely manner, any individual Drug Enforcement Agency registrations and identification numbers with the Board. Requires certain communication between the Board and the State Board of Pharmacy. Provides requirements for licensure by endorsement. Defines related terms. Amends the Illinois Controlled Substances Act. Includes prescribing psychologist in the definition of "prescriber".

Learn more and follow the bill’s progress here.

Let Your Legislator Know

You Support Prescribing Psychologists

Indicate your support for licensing specialty trained psychologists to prescribe medications, where appropriate, by filling out the form below. We will be using your name, on a list of our supporters, to be presented to Illinois lawmakers. We will not use your information, in any other modality, unless you indicate, in the comments section, that you would like us to contact you about other ways in which you can support this legislative initiative. By filling out the form, you will be indicating your support for the statement below:

Funding cuts, doctor shortages, and other inadequate care options have created a very real, very dangerous mental health care crisis in Illinois. Giving prescriptive authority to psychologists, who elect to complete extensive additional training and clinical work, beyond the traditional doctoral degree, internships, and fellowships, will provide a meaningful answer to this problem. Allowing comprehensive care by psychologists can help solve the current healthcare crisis.

The work of the prescribing psychologist would not supersede the good work done by psychiatrists, hospital medical and social service staff, primary care physicians, and community center staff. Instead, the prescribing psychologist becomes a vital member of the healthcare community who can buttress existing services as well as serve populations who are currently underserved.”

Practice Guidelines Regarding Psychologists’ Involvement in Pharmacological Issues

These guidelines were developed by the American Psychological Association (APA) Division 55 (American Society for the Advancement of Pharmacotherapy) Task Force on Practice Guidelines. The task force was chaired by Robert E. McGrath. Task force members included Stanley Berman, Elaine LeVine, Elaine Mantell, Beth Rom–Rymer, Morgan Sammons, and James Quillin. Additional input on the guidelines was provided by Robert Ax, representing Division 18 (Psychologists in Public Service). None of the individuals involved in the development of this document has any personal investment in pharmaceutical products of any kind, nor did the developers receive any financial support for its creation.

The task force anticipates that these guidelines may deserve reconsideration in a relatively brief time frame, given anticipated changes in psychologists’ role in pharmacotherapy as well as changes in the perceptions and use of psychotropic medications. In particular, it is the belief of the members of the task force that future efforts should include consideration of whether some elements of the enclosed guidelines merit elevation to the level of practice standards. Accordingly, this document is scheduled to expire as APA policy in August 2014, five years after the date of its approval and adoption by the APA Council of Representatives. After this date, users are encouraged to contact the APA Practice Directorate to confirm whether this document remains in effect.

Correspondence concerning this article should be addressed to the Practice Directorate, American Psychological Association, 750 First Street, NE, Washington, DC 20002–4242.