Can Psychologists Prescribe Medications?

In the vast majority of cases, psychologists cannot prescribe medications to their patients. However, there has been a recent push in several states to grant psychologists prescribing privileges, and there are actually already a few places where psychologists do have prescribing privileges.

Where Can Psychologists Prescribe Medications?

Psychologists are able to prescribe medications anywhere in the military and the Indian Health Service if they are credentialed in Louisiana or New Mexico. Psychologists can prescribe in five states: Louisiana, New Mexico, Illinois, Iowa, and Idaho.

Professional psychologists gained prescribing privileges in New Mexico in 2002 and in Louisiana in 2004. In 2014, Illinois became the third state to grant prescribing powers to psychologists who hold appropriate training. Iowa granted prescriptive authority to psychologists in 2016, and Idaho followed suit in 2017.

In such cases, psychologists are required to receive proper training and are permitted to prescribe certain medicines used in the treatment of mental disorders.

What Training Do Prescribing Psychologists Have?

What kind of training is needed? In Louisiana, for example, psychologists who want to gain prescribing powers must complete a postdoctoral master's degree in clinical psychopharmacology, pass a board-recognized national exam, and hold a certificate of responsibility from the Louisiana State Board of Examiners of Psychologists.

• In Louisiana: Psychologists must first complete a postdoctoral master's degree in clinical psychopharmacology before they can prescribe medications.
• In New Mexico: Psychologists must complete 450 hours of didactic training and 400 hours of supervised practice in psychopharmacology.
• In Illinois: Psychologists must receive specialized training in psychopharmacology. In addition to this training, they must complete a supervised clinical rotation that lasts 14 months and covers a variety of settings including hospitals, prisons, and mental health clinics.
• In Iowa: Psychologists must complete a postdoctoral master's degree in clinical psychopharmacology. They also need relevant clinical experience in assessment and pathophysiology.
• In Idaho: Psychologists need a postdoctoral master's degree in clinical psychopharmacology. There are no specific hourly requirements for training.

Psychologists are not the only non-physicians who have been granted prescribing rights. Advanced psychiatric nurses generally have prescriptive authority, although their powers may be limited depending on which state they are in.

Arguments for Prescribing Privileges

Supporters of prescribing rights for psychologists include the National Alliance of Professional Psychology Providers and Division 55 of the American Psychological Association. Advocates suggest that psychologists should be allowed to write prescriptions for a number of different reasons.

On average, 30% of a primary care physician's caseload consists of people with psychiatric conditions. Primary care physicians prescribe psychiatric medication for an average of 70% of their mental health patients, even though they often have limited training and experience with mental illness. Proponents suggest that many people would be better served by a psychologist who can also utilize other treatment strategies outside of pharmacological interventions.

Some other reasons cited by supporters include:

• Increase accessibility to mental health care
• Allow patients faster access to treatments
• Help rural patients access treatments more readily
• Decrease wait time for treatments; many states face a shortage of psychiatrists, making it difficult for clients to access mental health care in a timely manner.

Arguments Against Prescribing Privileges

Organizations against offering prescribing rights to psychologists include the American Medical Association, the American Psychiatric Association, and the National Alliance on Mental Illness. Opponents cite a number of reasons why psychologists should not be able to write prescriptions, including:

• Insufficient training in medicine and pharmacology.
• Risks of side effects of medications.
• Danger of overlooking medical disorders that might be mistaken for mental disorders.
• Many patients prescribed psychotropic medications also have one or more coexisting medical conditions.
• Physicians and psychiatrists are better trained to determine when and if medications are needed.