During the February, 2015 Council of Representatives meeting, Beth Rom-Rymer received a well-deserved Presidential citation from APA President Barry Anton. It had been a decade since Louisiana's Jim Quillin, John Bolter, and colleagues were successful in persuading Governor Kathleen Blanco to sign HB 1426 into public law on May 6, 2004. Describing the innovative Illinois law, Beth opined: "We believe that our law, Public Act 98-0668, that gives independent prescriptive authority to licensed clinical psychologists with advanced, specialized training in Clinical Psychopharmacology, is an incredibly important step forward in the provision of comprehensive, integrated mental health care for all Illinois residents. The training, beyond the doctoral degree in psychology, includes seven basic science undergraduate courses; a Master's degree in Clinical Psychopharmacology with a capstone exam; and a series of nine medical rotations over a period of several months. There is no 'conditional prescribing period' once the criteria for training and education have been met. There are monthly collaborative meetings between the licensed prescribing psychologist and a physician of his/her choosing. Psychologists and psychiatrists are now working, side-by-side in Illinois, to create training opportunities for prescribing psychologists and to provide high caliber healthcare to their patients. We, indeed, are thrilled with this terrific success for the provision of comprehensive, mental health care by prescribing psychologists in Illinois."
A Significant Shortage of Providers: Morgan Sammons recently brought to our attention The Wall Street Journal article rhetorically asking: "Where Are the Mental-Health Providers?" Noting that: "The shortage of mental-health providers in the U.S. has long been considered a significant problem. But it is becoming more acute as people are encouraged to seek treatment, or find that they are able to afford it for the first time as a result of new federal requirements that guarantee mental-health coverage in insurance plans. That's prompting a sea change in attitudes among mental-health advocates, who are starting to look at solutions that are broader than just training more psychiatrists."
Former APA Congressional Science Fellow Sandra Wilkniss points out that President Obama's Patient Protection and Affordable Care Act (ACA) provides one of the largest expansions of mental health and substance use disorder coverage in a generation. She has consistently urged psychology to appreciate the magnitude of change occurring as the nation's health care system moves steadily towards integrated, interdisciplinary care – and thus away from its historical reliance upon fee-for-service, independent practice.
A similar perspective was expressed in this year's budget request for the Substance Abuse and Mental Health Services Administration (SAMHSA) which noted that addressing mental health and substance abuse is critical to the health of individuals and families. Prevention, treatment, and recovery support services for behavioral health are essential components of health service systems. Behavioral health remains one of America's most pressing needs, yet it is also one of the most undervalued and least-addressed. The ACA, in conjunction with the Mental Health Parity and Addiction Equity Act, has the potential to create or enhance access to coverage for behavioral health services for 62 million Americans, nearly one-fifth of the nation's population. The current behavioral healthcare infrastructure and workforce, however, will need additional capacity to absorb the influx of patients who now will have the coverage to seek treatment. Behavioral health can, and should, be addressed as a public health issue by ensuring that the programs and policies focus on these tenets: Behavioral health is essential to health; Prevention works; Treatment works; and People Recover. And, APA's Heather O'Beirne Kelley, who heads up APA's Military & Veterans Policy (MVP) team, has been working with various Veterans organizations in furtherance of the establishment of prescription authority (RxP) for appropriately trained and certified psychologists in the Veterans Administration (VA), matching that which DoD has granted for 17 years.
Invigorating Renewed Interest: During Beth's consultations with an increasing number of state psychological associations which have developed renewed interest in the prescribing psychologist (RxP) agenda, as a direct result of her legislative success, she emphasizes that: "Prescribing psychologists will significantly increase the number of mental health professionals in Illinois who will be providing comprehensive, integrative mental health care. The number of psychiatrists in Illinois is 1200 and dropping, as psychiatrists retire. The number of licensed clinical psychologists in Illinois is 5,000 and rising. At least 40 Illinois psychologists are currently in training in Clinical Psychopharmacology. As Illinois graduate programs in Clinical Psychopharmacology proliferate, hundreds of psychology undergraduate and graduate students will be doing their training to become prescribers and the number of psychologist prescribers will exponentially increase." Bob McGrath, Director of the Fairleigh Dickinson University RxP training program, estimates that nationwide 1,700 colleagues have already completed their advanced psychopharmacology training.
Who will be the next generation of Prescribing Psychologists? Two of Beth's protégés:
* Karla Torres is an Early Career Psychologist who is Director of Behavioral Health and Pastoral Care at the Lawndale Christian Health Center, a Federally Qualified Healthcare Center (FQHC), that serves a largely Hispanic and African American population on the west side of Chicago. This FQHC has had great difficulty accessing psychiatrists and has great appreciation for her training in clinical psychopharmacology. She has almost completed her training for the M.S. degree in Clinical Psychopharmacology from Fairleigh Dickinson University and is looking forward to completing the other components of her training over the next few years. She was one of the key psychologists who worked hard with legislators as the Illinois Psychological Association sought to pass their bill in 2013 and 2014.
* Rosemarie Kugler is a civilian senior psychologist who is practicing on a military base just outside of St. Louis, Missouri. She lived and practiced, most of her life, in the southwestern tip of Illinois. She had taken all but one of the seven required science courses as an undergraduate over 40 years ago. She completed her training in Clinical Psychopharmacology, from Alliant International University, just two years ago, and recently took the PEP. She is hoping to do her series of medical rotations in a medical center setting and an FQHC in southern Illinois and become a prescribing psychologist as soon as possible. Aloha,
Pat DeLeon, former APA President – Missouri Psychological Association – February, 2015
