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New Mexico Allows Psychologists to Prescribe
New law should improve rural mental health services 
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The state of New Mexico has become the first in the United States to grant prescription privileges to psychologists. New Mexico governor Gary Johnson signed the bill into law on March 6, 2002. The measure had earlier passed the state legislature with a 56-11 margin in the House and a 29-9 vote in the Senate. The new law goes into effect July 1, 2002, but it may take longer to get all of the required regulatory structure in place.

New Mexico is a largely rural state and much of the population does not have access to quality mental health care. The New Mexico Psychological Association commissioned a market study which found that a total of 18 psychiatrists and 176 psychologists live and work outside the cities of Albuquerque and Santa Fe. The issue of access to care was central in the debate over this issue.

The new law allows psychologists with proper training to obtain a "conditional prescription certificate" to allow them to prescribe psychotropic medications for two years under the supervision of a licensed physician. Following that two year stint a psychologist can apply for an additional two years, or can apply for a "prescription certificate" to prescribe without supervision.

The New Mexico law specifies that prescribing psychologists take courses above and beyond what most psychology graduate schools currently offer. The requirements are based on a model already used by the Department of Defense to train psychologists in the military to prescribe psychotropic medications.  Psychologists must complete at least 450 classroom hours in "neuroscience, pharmacology, psychopharmacology, physiology, pathophysiology, appropriate and relevant physical and laboratory assessment, [and] clinical pharmacotherapeutics."  After this coursework an 80 hour practicum in clinical assessment and pathophysiology and an additional 400 hour physicial-supervised practicum treating at least 100 patients with mental disorders.

This law opens new doors for psychologists, but it also requires that they get additional training. Psychologists in Guam, a U.S. territory, gained prescription privileges in 1999.  Four other states, Georgia, Illinois, Hawaii and Tennessee, have psychologist prescription privilege legislation pending.  Some psychologists are opposed to the move to seek prescribing privileges, and others are neutral.  Psychiatrists have generally been opposed to these initiatives.  With the help of the American Psychiatric Association they took out an emotional full page ad in a Santa Fe newspaper with the message "You wouldn't do it to your dog, so why would you do it to your child?"  This emotional appeal failed to sway the legislature.

Leonard Holmes, Ph.D.      http://mentalhealth.about.com

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