Psychologists Prescribing Medication: A Risky Proposal Under Fire

Arizona lawmakers are once again considering a controversial proposal, SB1125, which would allow psychologists to prescribe psychiatric medications. This marks the fourth attempt at such legislation, and concerns regarding patient safety have been raised by medical professionals.

Critics argue that psychologists do not possess adequate medical education or clinical training to prescribe powerful psychiatric drugs. The bill stipulates only 1,000 in-person hours and 900 virtual hours of clinical training over two years. In contrast, medical doctors undergo over 15,000 hours of clinical training, highlighting a significant discrepancy.

Additionally, SB1125 lacks rigorous academic requirements. While the American Psychological Association outlines an extensive academic program, the bill permits psychologists to take any general science course instead of mandated courses on chemical reactions and pharmacology.

While advocates of SB1125 claim that they will limit the types of medications that psychologists can prescribe, the legislation does not specify a practical enforcement mechanism. Psychologists would have the authority to prescribe a range of medications, including stimulants and sedatives, often with minimal oversight from supervising physicians, who may not be adequately present.

The oversight mechanism outlined in SB1125 raises additional concerns. It relies on three separate boards—the Medical, Osteopath, and Psychologist Examiners—that may struggle with responsibilities due to limited staffing. Furthermore, the bill evaluates psychologists’ care based solely on their supervising agreement rather than standard medical guidelines, undermining accountability.

Another alarming aspect of the proposal is the training environment. Nearly half of the prescribed training would occur in prison settings, where medication options are severely restricted. This limited exposure may hinder psychologists’ ability to recognize serious medical conditions that could complicate mental health diagnoses, jeopardizing patient safety.

Moreover, history offers cautionary tales. In 2023, an instance in New Mexico saw 17 deaths linked to a psychologist’s over-prescription of Xanax, highlighting potential risks in similar legislative measures.

Though addressing mental health is essential for Arizonans, SB1125’s method of empowering inadequately trained professionals poses risks. The medical community advocates for approaches that maintain patient safety, such as the Collaborative Care Model, which integrates trained mental health professionals like physician assistants and nurse practitioners into care teams.

The Arizona Psychiatric Society, among other organizations, continues to oppose SB1125, deeming it a threat to patient safety akin to previous legislative attempts. As discussions progress, calls for more effective and responsible patient protections are gaining momentum across the state.