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News extra Psychologists allowed to prescribe drugs for mental illness New Mexico has become the first US state to allow psychologists to prescribe drugs. The controversial move pits psychologists against psychiatrists and may be followed by similar legislation in other states. Clinical psychologists hold doctoral degrees and have extensive training in psychotherapy but are not medically qualified. The American Psychological Association has been lobbying since 1984 to gain legislative support for bills that authorise psychologists to prescribe psychiatric drugs. The association argues that it is more cost effective for patients to receive their psychotherapy and drug treatment from one practitioner. Before New Mexico’s act, only the US territory of Guam allowed psychologists to prescribe drugs. Guam lumped psychologists with physician assistants as allied healthcare specialists with prescribing privileges in 1998, but to date no psychologists there have taken advantage of the law. The new law requires psychologists to undergo additional training, including 450 hours of course work in neuroanatomy, physiology, pharmacology, and psychopharmacology. They will also have to pass a 400 hour practical and tend to 100 patients under a doctor’s supervision before passing a national exam. After successfully passing the exam they will be issued a limited licence allowing them to prescribe drugs for two years under a doctor’s supervision. Only then can they apply for an independent licence. The impetus for the bill was an effort to expand mental health services in the medically underserved state. New Mexico has only 95 psychiatrists for a population of 1.8 million. The shortage leads to long waits for psychiatric services, said the association. The association also pointed out that the suicide rate among New Mexicans aged 15-24 is 75% higher than the national average and argued that if such patients had access to drugs from their psychologists this rate would dramatically decrease. But psychiatrists argue that giving psychologists prescribing privileges is bad medicine. Dr Paul Appelbaum, president elect of the American Psychiatric Association, said: "New Mexico’s decision to allow psychologists to prescribe medications and order and interpret laboratory tests derives from a deeply mistaken view of the nature of psychiatric disorders and their treatment. "Medications used to treat these disorders can affect the functioning of other organ systems, especially when those organs are already compromised by illness, and interact with medications prescribed for other medical conditions. "To pretend that a few months of training regarding the brain and psychoactive medications can render a psychologist fit to prescribe drugs that can affect the entire body — and to monitor their impact — is to belie the intricacies of human physiology. "The effect will be to confer second class status on people with psychiatric disorders, rendering them the only group of patients who can be treated by practitioners with no training in the physiology, pathophysiology, and pharmacology of the body as a whole." Deborah Josefson Nebraska BMJ 2002;324:698 ( 23 March ) http://bmj.com/cgi/content/full/324/7339/698/d janet paterson: an akinetic rigid subtype, albeit perky, parky pd: 55/41/37 cd: 55/44/43 tel: 613 256 8340 email: [log in to unmask] smail: 375 Country Street, Almonte, Ontario, Canada, K0A 1A0 a new voice: http://www.geocities.com/janet313/ ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn