New York needs more psychologists who can prescribe. Here's why

Throughout the pandemic, the shortage of health care providers and workers was well documented. But even before the pandemic, the provider shortage was making it extraordinarily difficult for those of us working in healthcare to find appropriate, qualified professionals to prescribe psychotropic medications to our patients.

Despite living in a state with many psychiatrists, we continue to face roadblocks in trying to get our patients connected with one. This is true both in rural and urban areas of New York. Many psychiatrists do not participate in insurance panels and many charge rates that are out of reach for patients, even for those with good out-of-network reimbursement programs. While psychiatric nurse practitioners have filled some of the gap, and some of my patients have chosen to go that route for medication management, the demand still outweighs the supply of qualified prescribers.

In New York, there is legislation — S.66A / A. 1262 — sponsored by state Sen. Pete Harckham and Assemblymember John McDonald, that, if passed, would allow appropriately trained, licensed psychologists to begin prescribing, and better meet the need — and ensure access — for an ever-increasing population seeking mental health treatment.

Six states and the military already allow psychologists to prescribe medications, without incident. New Mexico and Louisiana have had prescribing psychologists for two decades and the response has only been positive. So why the holdout in New York? Along with nurse practitioners, there are other professionals who prescribe medication, even if in limited scope, including dentists, podiatrists, and midwives. Why not psychologists?

Let me be clear, while there is much support for these bills in New York, including from the New York State Psychological Association, we do not expect a flood of psychologists suddenly obtaining the proverbial prescription pad. At this time there are about 1,000 psychologists in training in the U.S. who are eager to fill some of this need if allowed, but most practicing psychologists plan to continue providing therapy and will not pursue the rigorous training needed to prescribe. And the training is rigorous: it entails a two-year post-doctoral master’s degree with a large focus on medicine and biochemistry, with a national exam at the end of the training.

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Additionally, it is important to note that besides improved access to appropriate medications, psychologists are also in an excellent position to help decrease medication use. Most psychiatrists today do medication management and leave the therapy to psychologists, clinical social workers and other mental health professionals. If the same provider is doing both the therapy and the medication management, it is easier to help wean a patient off medication by replacing it with teaching coping strategies, insight-oriented therapy and other modalities to address the psychiatric symptoms.

If granted the privilege to prescribe, we would only be allowed to prescribe certain medications. Psychologists would not expect to prescribe antibiotics or pain medication, only those used as psychotropic medications and approved by New York to be part of our medication arsenal. Moreover, our patients often express their concerns or ask us questions about their medications, even though we are not allowed to prescribe or discontinue these medications for them. We see our patients more frequently and for longer sessions than their medicating providers and are privy to much more of what is going on in their lives, addressing the biopsychosocial whole.

In the past, psychiatrists did double duty as both prescriber and therapist, but today that is quite rare, and the reality is that many people are obtaining prescriptions from primary care doctors, who have no substantial psychiatric training. By allowing those who choose to pursue it to prescribe, we can better address the needs of the general public and ensure access to care for a growing population seeking mental health services that is currently struggling to obtain appropriate, balanced treatment.

Barbara Kapetanakes was the 2022 president of the New York State Psychological Association, past (2006-2011) and current president of the Westchester County Psychological Association, and is in private practice in Sleepy Hollow, New York.

This article originally appeared on NorthJersey.com: New York psychologists should be able to prescribe medication