Prescriptive Authority (RxP)
Beth Rom-Rymer is a former president of the Illinois Psychological Association (IPA) and will be running for the APA presidency this election cycle.
The prescriptive authority (RxP) movement in Illinois began in the early 1990’s. Many of our clinical psychologists had the foresight and acumen to know that psychologists’ prescribing would be an exciting and clinically significant expansion of our scope of practice. Our patients, who were being prescribed second generation, more effective psychotropic medications, by their PCPs or by their psychiatrists, could benefit from working with psychologists who have the specialized knowledge to treat them with both medications and psychotherapy. After all, it was in 1992 that a small cadre of military psychologists had begun an experimental training program in clinical psychopharmacology to become prescribers in the military. And, it was in the early 1980s that the highly decorated WWII veteran, Hawaiian senator Daniel K. Inouye discussed the potential impact of prescribing psychologists with the psychologists of the Hawaiian Psychological Association.
Prescriptive authority became a high priority for IPA, under the leadership of IPA executive director, Terry Koller, Presidents Armand Cerbone and, then, Marlin Hoover, in the early 2000s, when Marlin completed his training to become a prescribing psychologist and both New Mexico (2002) and Louisiana (2004) had passed their RxP legislation. Although there were frustrating legislative hearings in those years, I brought my national experience in advocating for RxP and inherited the enthusiasm for RxP legislation in 2011, when I was elected IPA president. After an extensive statewide movement that saw 640 Illinois psychologists participating in legislative lobbying and the engagement of third party stakeholders, including the Illinois Police Chiefs’ Association, the Illinois Sheriffs’ Association, University professors, and social service agencies, on issues surrounding improved access to mental health care, the Illinois legislature passed our legislation on May 30, 2014. Gov. Pat Quinn signed our legislation into law on June 25, 2014.
It took three years for our legislative rules to be approved on Oct. 15, 2017. Our first prescribing psychologist, Terry Soter, was licensed on July 19, 2019. Just after our 2020 APA annual convention, two more Illinois psychologists were licensed to prescribe: Monika Neale and Brandi Boan. Significantly, both Monika and Brandi were the first Illinois psychologists to compete all of our prescribing licensure requirements, as clinical psychologists. Terry, also a clinical psychologist, had completed some of his licensure requirements while he was training for his medical degree (although never sought licensure as a physician). Monika is both a clinician and an assistant professor of psychology at National Louis University, with a focus on children, adolescents, and young adults, with outreach to inner-city youth. Brandi grew up on a farm in rural Kendall County in Illinois and provides mental health care to those in areas with poor access to comprehensive care. She has an interest in policy development that furthers broader access to care in the hard-to-reach rural communities of Illinois.
It is with great pride that we have arrived at this point. But, this is only the beginning. With our current training of psychology graduate students in clinical psychopharmacology, and the ongoing training of older, practicing clinical psychologists, my expectation is that Illinois prescribing psychologists will more than double access to comprehensive mental health care for our Illinois communities. Within 20 years, I predict that we will have more than 1,000 prescribing psychologists in Illinois. And, so, our revolution in healthcare is on its way!
PSYPACT
Alex Siegel, ASPPB director of professional affairs, reports 15 states have adopted the Psychology Interjurisdictional Compact, with active legislation pending in seven additional jurisdictions.
Enactment of PSYPACT will allow licensed doctoral psychologists in a Compact state to provide interjurisdictional electronic services to patients in another Compact state, without being licensed in that distant state. As the states begin to open up for business, one must expect that current interjurisdictional pandemic-related Executive Orders will expire or not be renewed. We would rhetorically ask: Does your state’s leadership appreciate the importance of providing ready access to psychological care by embracing this national evolution? “Blue Bayou, Where the folks are fun”—Linda Ronstadt. Aloha!