Three years ago I wrote in The CT Mirror that we in Connecticut had a growing mental health crisis on our hands: that too many people who needed psychiatric medications for behavioral health or substance abuse issues could not get them.
I recounted that during those pre-pandemic days, my office manager tried to find services for her daughter. She called 19 psychiatrists without one return call. As I said at the time, the reasons could have been many: they were too busy, too full, or maybe they didn’t accept that person’s health insurance.
Here we are three years later, with requests for mental health help reportedly increasing by 20%. The frustrations and despair around finding mental health and addictions prescribers is only growing. As all health care needs rise, there is an overall shortage of all health care providers in Connecticut putting a strain on the health care system. Thankfully, our legislative leaders have made mental health a top priority this session.
The simple truth is that three years ago there weren’t enough psychiatrists and APRNs to meet the behavioral health and addiction prescribing needs of Connecticut’s residents—and that imbalance is getting worse
Currently, Connecticut’s psychologists cannot prescribe medications. As many Connecticut residents of all ages have experienced, we have a system in which many patients need two providers: one for medication and one for therapy.
While there is no one simple answer to Connecticut’s behavioral health issues, here is something that would go a long way towards fixing the prescriber shortage problem: psychologists with additional training that prepares them to prescribe medication. Six states in the U.S. have addressed this situation with psychologists safely prescribing (and a dozen more are considering the change); as well as the military and numerous branches of the federal government.
This training in clinical psychopharmacology involves a rigorous medical program designed for practicing doctoral psychologists. It’s similar to how many APRN programs are structured—a two-year, comprehensive Master of Science program in pathophysiology, clinical medicine, laboratory studies, neuroscience, neuroanatomy, pharmacology and psychopharmacology. It includes comprehensive exams and supervised clinical experience, followed by a national board exam.
The movement to grant prescriptive authority to appropriately trained psychologists has always run into opposition from our psychiatric colleagues and some advance practice nurses. Data clearly shows that our patients and the public are largely in favor of it and that we have been doing it safely for over two decades. Given that the pandemic has stretched mental health resources to an unprecedented degree, shouldn’t they welcome the help of well-trained, doctoral-level colleagues who can provide desperately needed assistance?
Connecticut is a leader in so many areas relative to mental health and addiction services. Given the enormity of the problem surrounding access to behavioral health medications, shouldn’t Connecticut expand that ability to appropriately trained psychologists? We are not reinventing the wheel here—we are adding another skill to our scope of practice after additional clinical and academic training. The pandemic has saddled us with numerous burdens, but this is one we can take steps to address. Legislators should pass mental health bills to start to address the mental health crisis facing the state, but there are other solutions they should consider down the line, including prescriptive authority for appropriately trained psychologists.
David Greenfield of West Hartford is a psychologist and specialist in addictive medicine.