Should Psychologists Prescribe Medication?admin / December 26, 2018
Psychologists and psychiatrists are important professionals that the society depends on for several concerns. Whereas psychologists are concerned with offering psychological therapy to mentally disturbed persons, physicians offer both curative and social treatment for various diseases (Harding, 2002). The training underwent also differs considerably.
Psychologists undergo a more theory-based training as opposed to a practical medicine-based training. The fact that both professionals are important in the mental healthcare is true. However, endless debates that aim at empowering psychologists to prescribe medication are common (Harding, 2002). The journal ‘Should Psychologists Prescribe Medication’ gives supporting views by Robert Resnick. On the contrary, William Robiner opposes the idea. This paper critically examines the position held by the two authors.
Robert Resnick asserts that the available psychopharmacological aid is limited. On the contrary, the mental health cases have drastically increased. It is reported that over 450 counties in America lack psychiatrists in residence. How then will mental problems be addressed in such counties?
It is true that granting prescription privileges to psychologists will reduce this patient-psychiatrist deficit. In addition, psychological medical prescription will ensure that quality mental healthcare is offered in time (Resnick & Robiner, 2003). Cost reduction is also assured because only one profession is involved.
Robiner is correct when he asserts that the mode of training between a psychologist and a psychiatrist differs. Psychiatrists undergo intense medical training in a medical school. Subjects such as biology, chemistry and pharmacology are taught at the undergraduate, graduate and doctoral levels of training.
Psychologists on the other hand do not undergo this kind of training at all levels of training (Resnick & Robiner, 2003). The lack of medical training provides a platform for increased collaboration between the psychologists and the psychiatrists. This is the best tool for increased efficiency in service delivery.
Resnick is of the view that psychologists should be given prescription privileges too. He argues that psychologists are more informed on mental health issues than other non-psychiatry professionals.
The realization that 85% of mental prescriptions are written by the non-psychiatry professionals is criticized. He is of the opinion that granting psychologists the power to prescribe would offer better choices and informed referrals. The need to have psychologists prescribe will be solved by training more professionals (Resnick & Robiner, 2003).
The success of the Psychopharmacology Demonstration Project (PDP) is a good example of early training programs. Robiner on the other hand is of the view that most patients find more comfort in sharing their mental problems with physicians than with psychologists. It is for this reason that prescription privileges are enjoyed by the psychiatrists.
The duplication of the PDP success is uncertain (Resnick & Robiner, 2003). Robiner is of the opinion that the military psychologists were exposed to a specific group of patients and conditions. He therefore doubts the practicality of the same in more diverse conditions.
Resnick’s Strengths and Weaknesses
Resnick argument is cemented by the fact that he uses a previous case to support his position. The success of the PDP is an important development. In fact the same approach can be used to address the prescription debate. The fact that he advocates for the bridging of the patient-professional gap is clear.
He emphasizes on the need for psychologists to undergo medical training, just as the ten military psychologists did. He also insists that revoking previous prescriptions is also a means of giving medical prescription. Resnick’s argument is however limited in scope. It is true that New Mexico was the first state to grant prescription privileges to psychologists (Resnick & Robiner, 2003).
He affirms that 32 more states are on the way to adopting laws that grant prescription rights. He fails to give the time frame required to achieve this. In addition he fails to specify the medical concerns within the jurisdiction of the psychologists and psychiatrists as far prescription rights are concerned.
Robiner’s Strengths and Weaknesses
Robiner asserts that training 10 psychologists under specific and customized conditions should not be viewed as an obvious case under general conditions.
It is true that diverse mental problems are encountered. Assuming the PDP success would be duplicated in other training programs is wrong according to Robiner. In addition he presents a report by the American College of Neuropsychopharmacology that revealed that PDP graduates were indeed weak both medically and psychiatrically.
They were indeed supervised by physicians. Most psychologists have admitted receiving improper pharmacological training (Resnick & Robiner, 2003). How can proponents of psychologists prescription purport that the latter can medically prescribe yet the psychologists admit incompetency? Robiner provides enough literature that proves that the quality of mental health care will be compromised.
It is clear that there exists a great discrepancy of training between the psychologist and the psychiatrist. Medicine-based training model is adapted by the latter while the former adopts a theory-based model. Subjects such as biology, chemistry and pharmacology are taught in medical schools (Resnick & Robiner, 2003).
This discrepancy widens from the under graduate to the graduate training levels. Regulatory and legal issues are well captured. The granting of prescription privileges would mean restructuring of the regulatory systems. The claim that psychologists may reject offers to work with undeserved groups is unfounded.
Credibility of the Authors
Both Resnick and Robiner are appreciating the fact that psychologists are equally important in mental healthcare sector. Resnick however is limited in scope. He assumes that psychologists can also give prescriptions as physicians do. He fails to consider the negative health risks, legal effects and ineffective care associated with the move.
He applies economic reasoning to assert that if psychologists offer medical prescription, the patient can save more. He fails to understand that indeed, he/she may end up paying more due to incorrect prescriptions. He also fails to conduct intensive review of existing research to support his position. Robiner’s argument is well supported. He is clear of the fact that medicine is a growing field that requires regular knowledge updates.
He insists that the training methods adopted by the psychologists may have far reaching consequences to patients if prescriptions are given by psychologists. His argument covers a wide scope to include the legal, quality management and efficiency of mental health care. The fact that he calls for collaboration between the psychologists and psychiatrists is a clear attestation that he values the roles played by each.
The information provided by Robiner indicates that proper literature review was conducted. Robiner is categorical of the fact that psychologists and psychiatrists should work together for the good of the mental patients. He is well aware of the risks posed by psychoactive drugs.
The prescription privileges enjoyed by psychologists would be cause of serious mental and other health complications. The PDP success cannot be solely relied upon for the effective medical prescription in diverse mental problems (Resnick & Robiner, 2003).
The medical profession is sensitive field that requires mastery of the human anatomy. The understanding of how different types of medicine react in the humans is vitally important. The knowledge and training discrepancy that exists between psychologists and psychiatrists is a matter of concern.
It is difficult for a psychologist to understand which medicine is obsolete and which should be used under certain conditions. Rendering them incompetent to prescribe medicine is important. In this regard the state governments should not give psychologists prescription rights.
The American Medical Association, the American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association and the American Society for Geriatric Psychiatry have opposed efforts to empowering psychologists offer medical prescription (Harding, 2002).
These associations have asserted that psychologists are not medically trained to offer prescription. Patients’ safety is the prime consideration in medical prescription. Psychologists are at a higher risk of administering the wrong prescription because they lack the medical knowledge (Harding, 2002). The theory-based model training by psychologists is useless in medical prescription.
Medically trained professionals are superior to psychologists as far as medical prescription is concerned. The fact that psychiatrists undergo fulltime four-year training in biochemistry, pharmacology, physiology and diagnosis is worthwhile to note (Harding, 2002).
In addition, they undergo a full-time tree year postgraduate psychiatric training. Practical prescription of drugs is performed during this time. The part-time one year psychopharmacological course undergone by the psychologists is insufficient and incomparable to that of a psychiatrist. Psychologists should therefore not prescribe medication.
Harding, R. K. (2002). New Mexico Psychologists Prescribing Law: Bad Medicine for Patients. American Psychiatric Association Media Advisory.
Resnick, R. & Robiner, W. (2003). Should Psychologist Prescribe Medication? British
Psychologist Society. The Psychologist, 16 (4), 251-264.