Arizona opinion: Giving prescription pads to Arizona psychologists would endanger us all without expanding mental health coverage

SB 1249, Psychologist Prescribing; Authority, if passed, would give Arizona psychologists the authority to prescribe powerful medication to treat mental health conditions that can be harmful if not prescribed correctly. Unlike physicians, nurse practitioners (NP) and physician assistants (PA), who are educated in science and have significant medical experience with pharmaceuticals, psychologists lack science and medical experience and will endanger patient safety in Arizona. The FDA and pharmacies do not have the authority or ability to restrict any provider from prescribing any drug once they have a license to do so. This includes the prescribing of the most dangerous drugs, sedatives like Xanax, opioids like OxyContin and Fentanyl and stimulants like Adderall.

In our healthcare system, psychologists serve vital functions performing psychological testing and evidence-based therapy to assess and treat patients using their psychological training. If a patient’s condition becomes a medical issue requiring further intervention, a psychiatrist, who is a physician, is consulted. Psychology prescribing would come at the cost of our loved ones being treated for serious mental health illnesses by those who are medically unqualified. It’s just too risky. For example, a physician knows it is easy to misdiagnose symptoms as low-grade depression when it is actually diabetes, hyperthyroidism or a reaction to other complex medications the patient is taking. If those medical conditions are not properly treated, the patient may have serious complications and could die.

SB 1249 does NOT require a prescribing psychologist to graduate from an accredited program. Forget having a physician, who has medical training and experience, determining if the courses and clinical training the student experienced is the same level of rigor as the accredited programs. The Psychologist Board would approve the courses, and the exams and set the licensing test. Without a psychiatrist or other physician on the board analyzing these exams or the licensing tests there would be no real medical quality control over the rigor of the tests and licensing process.

Think about it. SB 1249 would put a prescription pad in the hands of a psychologist who has no formal science background, has never taken a science-based medical entrance exam like the MCAT, has never sat for the medical boards, and has never done a residency or robust clinical training program treating patients that is equal to a physician, NP or PA. Full stop.

In New Mexico, one of a handful of states that allow psychologists to prescribe, there were 17 recent deaths related to an underqualified psychologist overprescribing Xanax. This is in the context of only 250 currently licensed psychologists in the country who are prescribing medication in six states.

Perhaps even more frightening is that SB 1249 would allow psychologists to prescribe to children of any age and those over 65 years of age. These are the most vulnerable populations because of their complex organ and brain functions that change frequently unlike other populations.

This bill is touted as a way to increase mental health access to Arizonans but it will have the opposite effect. We and thirteen other medical organizations thus believe that prescription pads must stay out of the hands of psychologists.