National Alliance on Mental Illness
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Prescribing Privileges for Psychologists: NAMIs Advocacy Goals and Strategies

The contentious debate on prescribing privileges for psychologists is obfuscating serious underlying problems with lack of qualified mental health professionals that are growing worse by the day. It is critically important that we carefully assess the experience of the New Mexico law and support a comprehensive effort to address the lack of qualified mental health professionals and its impact on accessibility to mental health treatment.

Addressing the Workforce Shortage Crisis

Staff recommend several measures for addressing general workforce shortages in the mental health field that have been included in recent testimony submitted byNAMI to President’s New Freedom Commission on Mental Health:

  • Providing scholarships or stipends to psychiatrist trainees, psychologist trainees, and other mental health professional trainees who commit toproviding services to people with mental illnesses in under-served regions or sectors;
  • Establish and expand loan forgiveness programs for psychiatrists, psychologists and other mental health professionals who serve for particular periods in under-served regions;

  • Reducing stigma within the medical profession towards mental illness and psychiatry in general and thereby attracting more young medical students to specialize in psychiatry and/or psychopharmacology:

  • Paying adequate wages to case managers, counselors, and other important but traditionally inadequately compensated mental health professionals to retain qualified and dedicated individuals in the field; and
  • Employing consumers and family members in a variety of professionals capacities in the mental health field whenever possible.
  • Additionally, if the American Psychological Association is correct that 70% of psychotropic medications are today prescribed by general practitioners, it will be important to carefully examine the training and knowledge of these physicians about mental illnesses, psychopharmacology and interactions between psychotropic and other types of medications.

The following recommendations for addressing workforce shortages in the mentalhealth field provided by the National Association of County Behavioral HealthDirectors should also be considered.

  • The Substance Abuse and Mental Health Services Administration (SAMHSA) should conduct a comprehensive study to define the nature and extent of mental health workforce shortages across the country. This study should be organized by regions of the country to account for the variability in the availability of mental health professionals across the country.
  • Expand the existing mental health professional shortage designation program to include service within any public sector agency providing services to Medicaid beneficiaries.
  • Increase the number of psychiatrists permitted under the Medicare Graduate Medical Education Program and extend the Board Eligibility period for residents and fellows from five to six years.
  • Review the Need for the Development of a Public Mental Health Leadership Development Program. This is particularly important because many of today’s leaders in the field are aging out. There is a need for a sustained process for developing new leaders within the public sector mental authorities over an extended period of time. The program should not only teach and support leadership development but must also incorporate sector values within new leaders. Such a leadership development program should provide senior mental health leaders with a learning laboratory to assist them in creating and mapping the future of public mental health services in the U.S.

This information is summarized from the Prescribing Privileges Task Force Report and Recommendations to the NAMI Board of Directors, December 2002.

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