Gov. Phil Scott signed a bill into law this week that will give psychologists with doctoral degrees the ability to prescribe mental health medications.
Vermont is following in the footsteps of a small handful of states who have expanded prescribing authority, which is typically reserved for psychiatrists, in hopes of alleviating provider shortages, particularly in underserved areas.
“Mental health, like physical health, is an area where the need outpaces the number of available qualified providers,” the Republican governor said in a letter to lawmakers upon signing H.237. “We must try creative approaches to address the issues of access and cost Vermonters face in our current health care system.”
But the move, which has been debated in Montpelier for years, is not without controversy.
The Vermont Medical Society opposes the push to expand prescribing authority, as does the Vermont Psychiatric Association. These provider groups, whose members can already prescribe drugs, argue that psychologists lack the medical training necessary to safely dispense medications.
They’ve also claimed that in the states that previously expanded psychologists’ power, access hasn’t measurably improved. Few psychologists have actually sought this enhanced authority, they argue, and so creating new licensing systems won’t be worth the investment if few providers sign up.
“Creating another class of prescribers is an outdated idea that, at the bottom line, is wasteful of State resources,” Evan Eyler, an associate professor of psychiatry and family medicine at the University of Vermont, told lawmakers.
But the Vermont Psychological Association has countered that the states that went before Vermont show the approach is safe. They’ve pointed to research indicating that patients receiving drugs from psychologists haven’t had worse outcomes than those treated by psychiatrists.
Under the new law, psychologists who seek a license to dispense drugs will need to complete postdoctoral training in psychopharmacology, pass a certifying exam, and complete a clinical rotation for at least 14 months.
They also won’t be able to prescribe medications to minors, those who are over 80 years-old and people who are pregnant.
It'll be at least 2029 before a new licensing system is in place. Scott, in his letter to lawmakers, also urged the regulatory body that will be charged with licensing to consult with the Vermont Department of Mental Health over rulemaking.
He also suggested more frequent reporting on how the effort is going, including assessing clinical outcomes of patients being treated by psychologists with these enhanced powers.
