The first thing I noticed when I began receiving treatment for my bipolar disorder was that I needed to see two specialists for the same problem: a psychologist for psychotherapy and a psychiatrist for psychopharmacological administration. I was very confused about the necessity to duplicate services until I discovered that my psychologist could not, under the state laws of New Jersey, prescribe medications necessary to treat my disorder. I found that my psychiatrist was the only one who could accurately formulate the correct medications and dosage schedules necessary to control my manic and depressive cycles. However, I soon discovered that my psychotherapy sessions and time spent with my psychologist outnumbered my time spent with my psychiatrist by about 100 to 1. There was a great disconnect between the psychiatrist and myself which often led to misunderstanding and over/under-medication. I found myself saying, “If only my psychologist could prescribe my medications.”
Robert Resnick argues for psychologist prescribing privilege in, “To Prescribe or Not to Prescribe – Is that the Question?” Resnick indicates that “[i]n March 2002 New Mexico became the first state in the United States to permit psychologists, with additional training, to prescribe medication for nervous, emotional and mental problems.” Furthermore, the US Department of Defense tested the theory successfully by allowing several psychologists to have prescribing authority and those clinicians had zero medication errors during the program which ran several years (Halgin, 2009). The fact that these governing bodies have realized the value in granting psychologists prescribing privilege gives credence to the fact that it is a viable enhancement to the mental health community. Psychologists get to know their patients on a much more intimate level and see them far more often than their psychiatry counterparts. It only makes sense that the psychologist would be an appropriate individual to monitor medications and dosage schedules being in much greater contact with the patient.
This issue is not without controversy, however. Glenn D. Walters, a Clinical Psychologist with the Federal Bureau of Prisons, wrote, “A Meta-Analysis of Opinion Data on the Prescription Privilege Debate.” Walters cautions that “prescribing psychologists may come to rely more on medication and less on psychological interventions.” Walters is concerned that psychotherapy would fall by the wayside, so to speak, and that psychologists would spend the bulk of their time monitoring patients’ medication schedules and reactions. He writes, “two-thirds of psychologists sampled from the National Register of Health Service Providers believed psychological interventions would be systematically de-emphasized should psychologists receive prescriptive authority” (Walters, 2001).
While Walters’ argument does have merit, it is based largely on fear mongering and speculation of what might possibly happen in the future. It is equally possible that opening prescription privilege to psychologists would, according to Resnick, give exponential access to psychopharmacology and psychotropic medication to vast numbers of the mentally ill in rural and underserved areas in the United States (Halgin, 2009). All I know is that I keep wishing that my psychologist could prescribe my medications if for no other reason than to avoid paying another insurance co-pay.
Halgin, R. P. (2009). Taking Sides: Clashing Views in Abnormal Psychology. Boston: McGraw-Hill.
Walters, G. D. (2001). A Meta-Analysis of Opinion Data on the Prescription Privilege Debate. Canadian Psychology/Psychologie Canadienne , 42 (2), 119-125.