Monday, April 3rd, 2023 — The above article crossed my desk about a month ago — and it concerned me. I did a bit of research over the past few weeks which lead me to write this post. Let me give you a bit of background first, and then we can discuss my concerns.
On Friday, March 3rd, Colorado Governor Jared Polis signed House Bill 23-1071 into law, which allows psychologists to prescribe mental health medication. According to the Denver Post, this bill "creates a process for psychologists who want to prescribe." These individuals would have to "complete a master's degree in clinical psychopharmacology, pass an exam and work under a physician's supervision for at least a year." Other states have passed similar bills in the past including Idaho, Illinois, Louisiana, and New Mexico.
Colorado psychiatrists and pediatricians apposed the bill, "arguing that psychologists wouldn't have sufficient knowledge of prescribing and that allowing them to do so could fragment patients' care." Those in support of the bill claimed that it would increase patients' access to treatment allowing them to visit one professional for their counseling and medication needs.
One of our core focuses here at Easing Anxiety is the overprescribing of psychiatric medication — in particular benzodiazepines and Z-drugs. Thousands of individuals suffer every day from the severe complications of these medications including physical dependence, withdrawal, and BIND (benzodiazepine-induced neurological dysfunction). Most of these prescriptions come from general practitioners who don't have the advanced training that psychiatrists are required to have. We are concerned that adding psychologists to that list may add fuel to the fire, increasing the potential for suffering from the overprescribing of psychiatric medication.
Psychologists currently have access to some of the most proven treatment protocols for anxiety, depression, and many other mental health disorders. This includes cognitive behavioral therapy (CBT), which is the leading treatment for anxiety and depression. In a Psychology Today article titled "Why CBT Beats Medication in the Treatment of Depression," the author refers to a 50-year retrospective study on cognitive therapy (Hollon 2020). Referring to the findings, he summarized that people who " talk through their depression with a mental health professional are more likely to (1) reduce the duration of depressive episodes and (2) to address the root cause of the depression, making relapse less common." He added that these patients were half as likely to relapse following treatment as patients treated with antidepressant medications.
By their estimates, [depression] patients treated to remission with talk therapy are half as likely to relapse following treatment as patients treated with antidepressant medications. — Mark Travers, "Why CBT Beats Medication in the Treatment of Depression," Psychology Today
Psychologists are the primary practitioners of CBT and other beneficial therapies. Adding medication prescribing may increase access to psychiatric medication for some, but we need to ask ourselves — is that necessarily a good thing? Although I do understand the need for psychiatric medications in certain situations, I also believe that prescribing these medications should be limited to those with more advanced education and understanding of medicine.
It will be some time until the first Colorado psychologists finish the required education to be able to prescribe medication. I hope I am wrong, and that this law does not lead to increased dependency and suffering. Unfortunately, I can't see how that will happen.
We welcome your comments below.
"About Prescribing Psychologists." American Psychological Association. Last updated January 2022. Accessed April 3, 2023. https://www.apaservices.org/practice/advocacy/authority/prescribing-psychologists.
Colorado House of Representatives. "House Bill 23-1071." https://leg.colorado.gov/sites/default/files/documents/2023A/bills/2023a_1071_enr.pdf.
Hollon, S.D., DeRubeis, R.J., Andrews, P.W. et al. Cognitive Therapy in the Treatment and Prevention of Depression: A Fifty-Year Retrospective with an Evolutionary Coda. Cogn Ther Res45, 402–417 (2021). https://doi.org/10.1007/s10608-020-10132-1.
Travers, Mark. "Why CBT Beats Medication in the Treatment of Depression." Psychology Today. February 26, 2021. https://www.psychologytoday.com/us/blog/social-instincts/202102/why-cbt-beats-medication-in-the-treatment-depression.
Wingerter, Meg. "Colorado psychologists gain authority to prescribe mental health medication." Denver Post. March 3, 2023. https://archive.ph/RDM6D.