Psychology

Currently New Mexico is the only state in the United States of America that allows Psychologists to prescribe Psychiatric medication. The usual argument for denying psychologists the ability to prescribe psychiatric drugs rests on the fact that psychologists generally do not receive any extensive training in pharmacology. It is possible for someone to receive a doctorate in Psychology and to advance to the highest levels in the field without ever receiving any knowledge of chemistry greater than the high school level. It is said that it is very important that anyone prescribing any psychiatrics drug be able to understand issues like its neurological and physiological effects and its interactions with other drugs, the pharmacokinetics and pharmacodynamics etc. All this has been addressed in the New Mexico legislation that authorizes psychologist to prescribe medication. According to the New Mexico law HB 170, psychologists can apply for a two-year license to prescribe medication, under a medical doctors supervision after

a) Receiving pharmacological training from a recognized institution.
b) Passing a standard certification examination that tests the applicants knowledge of pharmacology in the diagnosis, care and treatment of mental disorders
c) Received at least 450 hours of instruction in neuroscience, pharmacology, psychopharmacology, physiology, pathophysiology, physical and laboratory assessment and clinical pharmacotherapeutics.
d) Having had at least 80 hours of supervised practice in clinical assessment and pathophysiology and at least 400 hours of medically supervised treatment involving at least 100 patients with mental disorders.

Opponents of the measure to grant psychologists prescribing privileges, often express the fear that Psychologists will over prescribe medication such as anti-depressants. The fact is that General Practitioners prescribed most people that are on psychotropic medicine these medicines. According to a study over 60 of the prescriptions for psychotropic drugs were by general practitioners (Sleek, 1994). These General Practitioners often do not have any training in mental health and have a tendency to over prescribe medication. According to a study undertaken in 1991, 82 of the psychotropic medication prescribed, was written by family practitioners and medical internists who had no significant knowledge in the field of mental health (DeLeon and Wiggins, 1996). According to a 1992 report by the APA task force on Psychopharmacology, over-prescription of psychotropic drugs has risen to the extent that around 20 of all drugs now prescribed are psychotropic drugs (American Psychological Association, 1992).

Doctors often believe in the purely medical models of the mind, to them all illness including mental illnesses can be overcome by prescribing medication. Patients too, are often looking for quick fixes and are willing to take medication instead of coming to terms with their underlying mental issues. Nowadays General Practitioners are prescribing psychotropic medication even to little children (Dean, Hendy and McGuire, 1999). A childs behavioral problems that in the past would be treated by a spanking or the child being sent to bed without supper are now treated with anti-depressants and Ritalin. The common complaint about General Practitioners handing out psychotropic medicines, like anti-depressants, as if they were handing out candy, is a complaint based on fact. Out of people who go to their primary health care physician complaining of mental problems, only five percent are ever referred to psychologists. Rural areas often have under-utilized psychologists and a scarcity of Psychiatrists (DeLeon, Sammons and Sexton, 1995).

According to researchers, having psychologists involved in the care of patients with mental problems leads to better results than the prescription of psychotropic drugs by general practitioners (Pollin and DeLeon,1996). The strategy of having primary care physicians prescribe anti-depressants for the treatment of depression has generally proved to be a failure (Wiggins, 2000).

Psychologists on the other hand are more adept at talk therapy, which is their primary method of treatment. If psychologists are given the authority to prescribe drugs, it is more likely that they will only prescribe these drugs once they have tried out non-medicating methods of alleviating the patients condition. Studies have found that therapy is better than medication in a variety of mind related illnesses, including illnesses such as irritable bowel syndrome (Kraft and Kraft). Allowing Psychologists to prescribe drugs will therefore reduce the over prescription of psychotropic medication.

Another problem with the prescription of psychotropic drugs is the problem of low-adherence to the prescription. People with mental health problems often fail to take their medications, or take them at the wrong times or at wrong doses. As we have noted earlier, these people are most often prescribed their medication by overworked general practitioners. These General Practitioners do not have the time form a bond with the patients and convince them to follow through on their prescriptions. Psychologists on the other hand see their patients for long sessions of talk therapy. Thus Psychologists are better able to convince their patients to keep taking their medicine and to supervise their adherence to the prescription schedule.

Nowadays psychologists are increasingly being integrated into the healthcare system. Medical doctors are starting to realize the value of Psychologists in the treatment of mental illnesses. An increase in Psychologist referrals by medical doctors will result in a reduction in prescription of psychotropic medication. An increase in close co-operation will also make it easier for Psychologists prescriptions to be monitored by medical doctors.