A proposal that backers claim will improve access to mental health treatments will, in fact, put Arizonans in danger.
If it becomes law, Senate Bill 1249 would give Arizona psychologists the authority to prescribe powerful medication to treat mental health conditions.
But those medications can be harmful if not prescribed correctly. And, unlike the physicians, nurse practitioners (NP) and physician assistants (PA) — who are educated in science and have significant medical experience with pharmaceuticals — already authorized to prescribe those medications, psychologists lack science and medical experience and will endanger patient safety in Arizona.
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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 health care 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.
But SB1249 would allow psychologists to take over that role from psychiatrists. 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.
The legislation doesn’t even require a prescribing psychologist to have graduated 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. Instead, the Arizona Board of Psychologist Examiners would approve the courses, 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 that: SB1249 would put a prescription pad in the hands of psychologists who have no formal science background, have never taken a science-based medical entrance exam like the MCAT, have never sat for the medical boards and have 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 SB1249 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 13 other medical organizations thus believe that prescription pads must stay out of the hands of psychologists.
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