Proposal would lower quality of mental-health care

physician, I am very concerned with current state legislation that would disrupt our collaborative model. Ohio House Bill 326 would allow psychologists to prescribe prescription medications, with minimal required medical training and questionable oversight.

My perspective on this proposal is unique. During my 30 years as a mentalhealth-care professional, I have been a social worker and a psychologist and now work as a psychiatric physician. I have experienced and appreciate the critical role that each member of a collaborative health-care team plays.

When I decided to go to medical school to become a psychiatric physician, I gained even more appreciation for a patient-centered medical team. I also discovered that, when it came to practicing medicine, I didn’t know what I didn’t know. To safely and effectively prescribe prescription drugs to adults and children is an awesome responsibility that requires extensive medical training.

There’s no question that psychologists play a critical role in the care of a patient. They provide behavioralhealth services and are experts in psychotherapies and the various psychological testing assessments. However, they lack the training to effectively and safely prescribe medications.

Physicians, including psychiatric physicians, have been required to study prerequisite courses such as anatomy, microbiology, physiology, biochemistry, organic chemistry and a host of other topics.

They complete four years of residency which includes internal medicine, emergency medicine and neurology and do rotations in the psychiatric emergency service. An in-depth medical background is essential because the first rule of thumb is to rule out any medical issues. It would not be infrequent that these could masquerade as mental-health issues.

Since 1985, more than 200 bills proposing psychologists be given prescriptive authority have been introduced nationally and only five have become law. That is because legislators wisely recognize that competent medical care is in the best interest of their constituents and that there would be significant risks if psychologists, who don’t have appropriate medical education and training, were able to prescribe medications.

Ohio House Bill 326 is based on a national model of only 425 hours of online course work. I believe most psychologists, when they consider the amount of training required for a doctorate degree in clinical psychology, would be concerned about patient outcomes and safety with such minimal training for prescribing.

Beyond just the coursework, I am concerned about the lack of clinical experience and supervision that is overlooked when these proposals to expand prescriptive authority are introduced. Considering that nearly 70 percent of patients with mental illness have co-morbid medical conditions, we must have the training to know what to do for a patient’s total health history.

Access to behavioralhealth services is a concern, but there are safe and effective ways to increase the number of prescribers in Ohio. My way was to go to medical school. In Ohio, advanced-practice registered nurses and physician assistants have a solid breadth of knowledge in medicine that is needed to safely prescribe. Psychologists who want to prescribe can do so through extra training as an APRN or PA. We should also continue to advance collaboration with our primary-care physicians and expand telehealth opportunities.

A physician’s first priority is patient safety. This is compromised when the provider is not properly or adequately trained.