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.

According to the Centers for Disease Control and Prevention (CDC), 16.5% of American adults take psychiatric medications. This means there is a need for professionals who know how to prescribe and manage these medications properly.

Unfortunately, there is a serious shortage of psychiatrists (medical doctors with specialized training in mental health). This means that family doctors and primary care physicians are often the ones left filling in the prescribing gap.

Because of this, there has been a growing push to grant prescribing privileges to psychologists. Psychologists are not medical doctors. Instead, they hold a PhD or PsyD in Psychology. Some states, however, have opted to grant limited prescribing privileges to psychologists who receive additional training as a way to increase access to mental health medications.

Where Can Psychologists Prescribe Medications?

Psychologists can prescribe medications anywhere in the military and the Indian Health Service if they are credentialed in Louisiana or New Mexico.

Professional psychologists gained prescribing privileges in New Mexico in 2002 and 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 who want to prescribe must pass a national psychopharmacology exam. In some cases, they may also be required to coordinate with a patient's primary care provider.

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.

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.

Research also suggests that only 34.5% of psychiatrists accept Medicaid, which limits access to mental health services for many people. Allowing psychologists to prescribe may help increase access to these services for those on Medicaid.

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.

Keep in Mind

More states may opt to allow psychologists with appropriate psychopharmacological training to prescribe medications in the future. If your state is not among the five that currently allow psychologists to prescribe, you will need to see a doctor or psychiatrist to get a prescription for such medications. In many cases, your primary care doctor and mental health professional may work together to ensure that you receive appropriate care, including medications, therapies, and other interventions, to properly address your symptoms.