In response to ‘Mental health patient safety must come first’
Psychologists must have extensive training to prescribe medications
I write this letter to the editor in attempt to dispel some of the myths tied to requirements necessary for a psychologist to prescribe medication. In Dr. Tichianaa Armah’s April 1 article, she states, “SB 966 would permit psychologists to prescribe medications after taking a 400-hour online class, and supervision by an MD, or APRN for as little as 1,000 hours.” This is particularly troubling as Dr. Armah’s fails to distinguish between credit clock hours and clock hours. Presumably, her calculations come from dividing 400 didactic hours by 40-hour weeks. In doing so, she comes to 10 weeks of training. Similarly, she suggests only 25 weeks of patient contact. However, this is unequivocally false.
To be eligible for most master’s degree programs in psychopharmacology, the trainee must be a licensed psychologist at the doctoral level. Before a psychologist can prescribe their first independent script, they have to have four years of undergraduate training, five to seven years of doctoral studies, and a one-year of post-doctoral fellowship. So, to even enroll in a post-licensure masters degree, they psychologist has roughly 10-12 years of schooling. After licensure, a candidate typically enrolls in a two-year master’s program, followed by a one-year residency. All, in all, a typical prescribing professional would have 13-15 of education and training. In Connecticut, it would be one year less because there is no postdoctoral year.
Dr. Armah starts the education and training clock for all other professions except for psychologists. If we were to use her 40 hour weeks, 10 months (or 40 weeks) a year for 13-15 years (or 12-14 years in Connecticut), psychologists hours education and training hours would likely range between 20,800-24,000 hours (or 19,200-22,400 in Connecticut). This is markedly different than Dr. Armah assertion of “10 weeks of an online course and 25 weeks of patient contact.” She even diverges from the talking points provided to her from the Connecticut Psychiatric Society (linked to her article), acknowledge that several other states who have prescribing psychologists require, “In Louisiana: Psychologists must first complete a post-doctoral master’s degree in clinical psychopharmacology before they can prescribe medications” and “In New Mexico: Psychologists must complete 450 hours of didactic training.”
Dr. Armah also references a talking point from the Connecticut Psychiatric Society that, “[Department of Defense demonstration program] was deemed a failure by the U.S. Government Accountability Office (GAO).” In doing so, they failed to state the GAO’s (1999) finding that, “We also reviewed the PDP graduates’ credentials files, 3 performance reviews, and relevant reports. Our work was performed from June 1998 through May 1999 in accordance with generally accepted government auditing standards. The 10 PDP graduates seem to be well integrated at their assigned military treatment facilities. For example, the graduates generally serve in positions of authority, such as clinic or department chiefs. They also treat a variety of mental health patients; prescribe from comprehensive lists of drugs, or formularies; and carry patient caseloads comparable to those of psychiatrists and psychologists at the same hospitals and clinics. Also, although several graduates experienced early difficulties being accepted by physicians and others at their assigned locations, the clinical supervisors, providers, and officials we spoke with at the graduates’ current and prior locations — as well as a panel of mental health clinicians who evaluated each of the graduates — were complimentary about the quality of patient care provided by the graduates.”
Whatever “failure” referenced by Dr. Armah is in relation to cost effectiveness for the military. However, the report clearly acknowledges psychologists’ ability to safely and effectively prescribe medication. In fact, psychologists have been prescribing safely in the U.S. Military, Indian Health Services, Louisiana, and New Mexico for roughly 30 years.
It is my hope that this letter to the editor adds clarity to this matter.
Daniel Kaplin, PhD, is a NYS Licensed Clinical Psychologist and Assistant Professor, Psychology Department, St. Francis College.
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