Skip to main content

RxP is common sense for IL

The pushback against psychologists prescribing medications in IL has genuinely surprised me. There was the psychiatrist on Chicago Tonight the other night. A steady stream of very vocal psychologists complaining about "patient safety" in various news outlets. Enough that sponsor of SB2187, Senator Don Harmon, published a response in our local paper.  And members of the general public complaining about a variety of perceived wrongs, dangers, what have you. (Disclosure--I have a degree in psychology but long ago distanced myself from the field for a variety of reasons.)

For those of you unfamiliar with the topic (RxP), the idea is that licensed clinical psychologists should be able to get extra training and pass an exam to prescribe "psychoactive and ancillary medications." We're not the first state to try this...New Mexico and Louisiana already have it. The US Military has it...without a single malpractice case in 20 years. 

To most in the psychology community, this is common sense reform.  Something like 60-70% of surveyed psychologists agree with the idea of this being an option. Though only 25% of IL psychologists surveyed expressed interest in actually doing it. But, contrary to the naysayers, RxP makes sense from the patient perspective. Nobody is forcing psychologists to prescribe. Nobody is forcing patients to see or take Rx from a prescribing psychologist. But the key is that the choice is there. If you don't like the idea, don't participate. 

But you can't have it both ways. We can't simultaneously complain that the mental health system in this nation is broken and then complain about an attempt to improve access, give patients options, expand the market choices, and complain about the hidden dangers when we also complain about the hidden dangers with the lack of care.

Especially in IL where we are constantly debating regulation and over-regulation, I find the outcry over RxP to be nothing new. The troubling thing for me is that the criticism is coming from overly-educated people with titles around their names who can use their intellect to elevate their opinion to make it sound more important than it is. It doesn't matter if you have a PhD if you're both outnumbered and in the wrong. You are, of course, entitled to your opinion. I have mine.

The reason this bill should pass and that RxP is the right thing is that nobody is coercing you. It's an option we should give a chance to work. If a decade from now you can produce scientific research that RxP isn't helping, hasn't worked, or has put lives in danger then by all means bring that research forward. But the onus is on the critics here to prove the dangers and boogeymen that they are haunting the discussion with. It's your burden to prove this is such a bad idea, what your colleagues are asking.

The sad part here is that the psychiatrists, psychologists, the entire mental health community, should probably be unanimously cheering this proposal and they aren't. I believe some of the critics genuinely feel patient safety is at risk. The critics are acting out of a sense of duty in that regard. But ask yourself, don't I also have a duty of care toward my patients? By opposing RxP for IL, you're essentially telling your patient that you know better. You're not a partner in their care, you're an opponent. And isn't that how it was in the old days? Aren't we past that kind of patriarchal attitude towards mental health?

I'm not surprised by political opponents to something in IL. What surprises me is that it is coming from an educated group of people who should know better. It's not "shame on you." Like I said, I think you are acting out of a sense of doing the right thing. But it makes me sad that people who sat through some of the same classes as me wouldn't have a more open mind. It's the closed minds that get me. Not a trait you should look for in a psychologist.

Anyway, if you want to know more about the proposal for RxP in IL, check out the material from the Illinois Psychological Association. The RxP Difference: Answering the Crisis in Mental Health Care