The Washington Post recently reported on the critical shortage of mental health providers. While there was a great demand for mental health services even before the COVID pandemic, the pandemic and the public health responses to the pandemic exacerbated the situation by increasing stress, isolation, loneliness, and despair and, at the same time, reducing access to mental health services.
According to The Post, Jeffery Huffman, clinical director of Massachusetts General Hospital’s department of psychiatry, said, “the demand for mental health care has been ‘so unprecedented’ that the hospital doesn’t have enough staff to keep up.” In fact, this past summer, over 880 people were on MGH’s wait list for psychiatric services. The article then describes various ways mental health practitioners are trying to cope with the demand, including recruiting clergy, school guidance counselors, and even soccer coaches to the mental health team.
The “American Rescue Plan,” passed by Congress in 2021, provides $5 billion to help states expand the mental health workforce. But one step state lawmakers can take now to help improve access to mental health services doesn’t need federal taxpayer dollars. State lawmakers can expand the scope of practice of clinical psychologists who have clinical psychopharmacology training to allow them to prescribe mental health medications.
In the 1990s, the Department of Defense embarked on a program to train doctorate-level clinical psychologists in clinical pharmacology to prescribe medications to their patients without referring them to psychiatrists. The program was so successful that the U.S. Public Health Service and the Indian Health Service adopted the idea. So-called “prescribing psychologists” or “RxPs” provide mental health services in those federal agencies today. Today, five states plus the territory of Guam allow prescribing psychologists to practice in their jurisdictions.
Allowing RxPs to provide mental health services will not completely solve the shortage of mental health providers. But it would help reduce the backlog of psychiatry appointments and expand the range of services that clinical psychologists can offer mental health patients, particularly in areas where psychiatrists are scarce.
For more information, you can read my Cato briefing paper on the topic. And a few weeks ago, I moderated an online forum on the issue that you can view here.