Recent polls suggest a startling 1 in 5 U.S. adults are currently experiencing a mental illness. Unfortunately, the current mental health workforce is unable to meet the increased demands, resulting in long wait times or practices being closed to new patients. Those seeking psychiatric medication management have particular challenges finding care.
The shortage of psychiatric providers locally in Pennsylvania mirrors the national trends: A recent analysis conducted by the Pennsylvania Psychological Association found that only 40.28 percent of the present psychiatric needs of patients are being met across the state with 1.7 million Pennsylvanians living in mental health professional shortage areas.
Allowing specially trained psychologists to prescribe medications to treat mental illnesses (commonly referred to as RxP) in Pennsylvania would be an important piece of the solution to improve access to quality and comprehensive mental health services.
Prescribing psychologists are well prepared to tackle the mental health crises endemic to the U.S., particularly the unsettling growth of “deaths of despair,” which refer to substance overdose-related deaths and deaths by suicide.
Few people realize that psychologists have been prescribing since the 1990s. Prescribing psychologists now practice in five states (New Mexico, Louisiana, Illinois, Iowa, and Idaho), the Department of Defense, the Public Health Service, and the Indian Health Service. But the need for more prescribing clinicians is still significant.
In Pennsylvania, in both rural and urban areas, wait times for psychiatrists are often 4 to 6 months, or more, if the group is accepting new patients at all. Although most psychotropic medications are prescribed by primary care providers, many feel unprepared and overwhelmed by the demand to treat serious mental illnesses like bipolar disorder and schizophrenia.
In Pennsylvania, it is estimated that more than 1,000 additional psychiatric prescribers are needed to meet population demand. Of the current 6,000 licensed clinical psychologists in Pennsylvania, 14 percent of respondents suggested they would be interested in pursuing the additional training in psychopharmacology for prescriptive authority, which would result in approximately 840 prescribing psychologists in Pennsylvania.
Prescribing psychologists are well prepared to tackle the mental health crises endemic to the U.S., particularly the unsettling growth of “deaths of despair,” which refer to substance overdose-related deaths and deaths by suicide. A recent analysis from the Center for Growth and Opportunity at Utah State University suggests that RxP is associated with a 5 to 7-point percentage point decrease in deaths by suicide. This could translate to many saved lives in Pennsylvania. Prescribing psychologists also have unique skills to bring to collaborative mental health care practices in Pennsylvania, including more advanced training in non-pharmacologic interventions for mental health disorders.
The greatest need for psychiatric services in Pennsylvania is among historically marginalized populations that more likely receive mental health care through Medicaid. Due to current reimbursement rates for mental health services and administrative burden, many psychiatrists currently practice in private clinics or as out-of-network providers, which leads to enormous wait lists for Medicaid patients to reach the more limited number of in-network prescribers.
Prescribing psychologists are prepared through rigorous training programs to collaborate in the medication management of patients’ mental health needs while leveraging their existing expertise in psychological assessment and psychotherapy to promote more enduring changes for patients. The current mental health crisis in Pennsylvania, and across the United States, deserves innovative solutions that address mental health equity directly. Prescribing psychologists are ready to help.
Jennifer Collins, PsyD, MSCP, is a licensed clinical psychologist in Lancaster, PA. Joseph Harrison, MBDS, is a clinical psychology doctoral student in Philadelphia.
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