Psychologists working in Colorado will soon be eligible to apply to prescribe mental health medications to their patients, thanks to House Bill 1071 from Colorado Springs' Rep. Mary Bradfield.
Currently, if a psychologist providing therapy or counseling decides their patient needs medication such as antidepressants, they must refer the patient to a psychiatrist or medical doctor to get a prescription. But due to a lack of prescribers in Colorado, this process can take months to complete and forces patients to pay for care twice.
The bill will make the more than 3,000 licensed psychologists operating in Colorado eligible to apply to prescribe themselves. In comparison, there are only around 600 psychiatrists currently operating in Colorado.
"This is the first step for the betterment of mental and behavioral health conditions for people in Colorado," Bradfield, R-Colorado Springs, said.
Gov. Jared Polis signed the bill into law on Friday. It will officially take effect in August, 90 days after the general assembly adjourns.
The bipartisan-sponsored bill was unanimously approved by the state Senate and passed the House in a 56-6 vote earlier this month, following weeks of debate among lawmakers and mental health professionals regarding whether letting psychologists prescribe medications would lower the standards of mental health care.
To become a prescriber under the bill, a Ph.D.-holding psychologist would have to get a master’s degree in clinical psychopharmacology, pass a national psychopharmacology exam, complete 750 hours of prescribing practice under a supervising physician, be approved by the state boards of psychology and medicine, and complete 40 hours of continuing education in psychopharmacology every two years. In addition, the psychologist would have to maintain their current psychology license, malpractice insurance and psychology-based continuing education.
Despite these requirements, opponents raised concerns about allowing non-medically trained psychologists to prescribe medications, saying they do not understand how medications impact the body or how physical illnesses can manifest as mental health issues.
“Psychiatric medications affect all of the body’s systems,” said Dr. Nadia Haddad with the Colorado Psychiatric Society while testifying against the bill. "The mind does not exist in a vacuum. … Psychiatric medications can cause fatal heart arrhythmias, diabetes, high blood pressure, thyroid problems, liver and kidney issues."
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Proponents defended the qualifications of prescribing psychologists and emphasized that they would be required to collaborate with a patient’s primary physician and explicitly agree that the prescription is appropriate before it is administered to the patient.
Some also argued that psychologists know their patients' needs better than psychiatrists, as psychologists often meet with patients on a weekly basis for up to an hour at a time, while psychiatrist appointments can be as short as 15 minutes and occur every few months.
Bill sponsor Rep. Judy Amabile, D-Boulder, said she has experienced the ineffectiveness of the current system firsthand. Amabile said her adult son suffers with serious mental illness and was forced to wait eight weeks for his first psychiatric appointment. Feeling unable to wait, he went to a primary care doctor who was unaware of his diagnosis and was prescribed the wrong medication, causing him to end up in the hospital.
"It is about access to care and quality of care," Amabile said. "If you can have the same person who you're meeting with frequently, who really knows you, who has an in-depth understanding of your disease also be the person who manages your medications, then you're going to get better care."
This bill comes as the 2022 State of Mental Health in America report ranked Colorado as the worst state in the country for adult mental health. The year before, Children’s Hospital Colorado declared a state of emergency for youth mental health, as suicide became the leading cause of death for Colorado children ages 14-19.
Psychologists can already prescribe mental health medication in five states — New Mexico, Louisiana, Illinois, Iowa and Idaho — as well as in the U.S. military. In New Mexico and Louisiana, deaths by suicide were reduced by between 5% and 7% since psychologists were granted prescriptive authority, according to Healthier Colorado.
Nationally, there are around 250 prescribing psychologists currently operating. From 2005 to 2021, there were only 14 board complaints against prescribing psychologists — half of which were dismissed and only two of which resulted in payments to the plaintiffs, according to Trust Risk Management Services, which provides liability insurance for psychologists.
"I'm very excited by this bill," Polis said. "It saves money, improves access, improves quality. ... This bill will give us more tools to help people experiencing severe mental health crises."
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