After passing the Colorado House of Representatives by a vote of 56–6, the Colorado Senate, last week, unanimously approved HB 1071, which allows licensed, doctorate-level clinical psychologists who undergo additional training to prescribe psychiatric medications to their mental health patients. The House today approved a few changes made in the Senate and sent the bill to Governor Jared Polis for his signature. Governor Polis has expressed support for the proposal and is expected to sign the bill into law within the next ten days.

As I explained in my policy brief, prescribing psychologists—or RxPs—have provided medication-assisted psychotherapy and talk therapy to people with mental health problems in the military and other federal agencies since the 1990s. The territory of Guam removed barriers to RxPs in 1999. New Mexico became the first state to remove the obstacles in 2002. Since that time, Louisiana, Iowa, Illinois, and Idaho have done the same. Each state requires clinical psychologists to receive graduate-level clinical psychopharmacology training, complete a postgraduate clinical practicum, and pass the national standardized Psychopharmacology Exam for Psychologists (PEP).

Mental Health America’s 2022 State of Mental Health in America report found that Colorado has the highest prevalence of adult mental illness among the 50 states and the District of Columbia. Colorado’s legislature passed the RxP bill to help mitigate the growing difficulties people with mental health problems encounter seeking mental health services.

In most states, clinical psychologists with doctorate degrees must refer patients who need medication to licensed prescribers—usually psychiatrists. But nowadays, roughly 50% of psychiatrists don’t take insurance, and it can be difficult and costly for patients to see psychiatrists. And there are many areas of the country where people must travel miles to see a psychiatrist. Psychologists can also refer their patients to any health care practitioner licensed to prescribe psychiatric meds, including primary care practitioners or even general surgeons like myself, if a psychiatrist is unavailable.

By removing barriers to psychologists prescribing, states can increase the workforce of mental health professionals who can integrate pharmacotherapy with talk therapy, thus increasing access and reducing cost and inconvenience for people seeking mental health care.

As I point out in my paper, the evidence shows that RxPs prescribe as safely as—and possibly more conservatively than psychiatrists. They also tend to continue talk psychotherapy with their patients, whereas recent research shows less than 11% of psychiatrists engage in talk therapy these days—most only do pharmacotherapy.

Not surprisingly, members of the medical profession opposed expanding the scope of practice of trained and qualified clinical psychologists to include prescribing mental health meds. Opponents included the Colorado Medical Society, the Colorado Chapter of the American Psychiatric Society, the American Academy of Pediatrics, the Colorado Radiologic Society, and the Colorado Chapter of the College of Emergency Physicians.

Organizations supporting the bill included the Colorado Psychological Association, the Colorado Counseling Association, the Colorado Consumer Health Initiative, and the American Association of Retired Persons.

On February 1, 2023, I testified before the Colorado House Public and Behavioral Health and Human Services Committee on the benefits of removing barriers to prescribing psychologists. That committee was the first to hold hearings on HB 1071. The committee passed the bill 10–1, with one abstaining.

Colorado is now poised to become the sixth state to allow patients access to prescribing psychologists. Legislation is also progressing in several states, including Arizona, Hawaii, and Washington.

As America’s mental health problems continue to mount, efforts to allow patients access to RxPs are gaining momentum, overcoming resistance from the entrenched incumbents opposed to expanding clinical psychologists’ scope of practice.