Letting Wisconsin psychologists prescribe drugs would improve access to mental health care, especially in rural areas, according to backers of a bill that would give  psychologists the new authority.

But psychiatrists and others say the measure would endanger patients. The medical training psychologists would have to get under the proposal isn’t enough for them to safely prescribe drugs that can cause serious side effects or be abused, opponents say.

Louisiana and New Mexico are the only states that let psychologists prescribe drugs. The Oregon House passed similar legislation this month.

State Sen. Judy Robson, D-Beloit, a nurse, introduced the bill last month.

Psychologists, who do not have medical degrees, provide mental health therapy and counseling sessions. Psychiatrists, who have medical degrees, treat mental disorders, mostly with drugs.

Psychologists generally refer patients who need medications to psychiatrists or family physicians so they can get drugs. Many of the patients continue to see the psychologists.

Baraboo psychologist Tom Hayes said psychiatrists don’t want to let psychologists prescribe drugs because they are trying to protect their profession, even though psychiatrists are scarce in places like southwestern Wisconsin.

“We’re invading some of their turf, and things are getting testy,” Hayes said.

Dr. Jerry Halverson, a UW Health psychiatrist and board member of the Wisconsin Psychiatric Association, said the 450 hours of medical training psychologists would have to get to prescribe drugs under the bill is a far cry from the 10,000-plus hours psychiatrists receive.

“Any way you look at it, this is a shortcut,” Halverson said.

Groups representing nursing homes, halfway houses, counties and people with disabilities are among those that support the bill. Emergency physicians, family physicians and other doctor groups have joined psychiatrists in opposition.

The Wisconsin chapter of the National Alliance for the Mentally Ill also opposes the bill, said Jennifer Lowenberg, the group’s advocacy specialist.

The alliance represents people with serious mental conditions such as bipolar disorder, major depression and schizophrenia, Lowenberg said.

“These are very complex illnesses,” she said. “We really feel like they require someone with a solid medical training.”

Randall Dorn, a Watertown resident with depression, supports the bill. He said he has had four psychiatrists over nine years because they moved away or he dropped them after they prescribed drugs that left him sleepless or in a stupor.
Dorn, 57, said he wishes Joe Marceil, his psychologist, could prescribe medications. “He knows all the things I’ve gone through,” he said.

Stephen Seaman, a psychologist in Fort Atkinson, said his patients who need medications often have to wait five to seven weeks to see the few psychiatrists in the area.

Family physicians are willing to prescribe common drugs for depression, but they are uncomfortable prescribing other drugs for depression or drugs for other mental conditions, Seaman said.

Seaman, Marceil and Hayes are among seven psychologists in the state who have completed a master’s program in psychopharmacology, which includes courses in biochemistry and anatomy, Marceil said.

Such training, along with passing an exam and working under the supervision of a physician for a year, would qualify them to prescribe drugs for mental illnesses under the bill.

Halverson, the UW Health psychiatrist, said the training doesn’t adequately prepare psychologists to be aware of dangerous interactions between drugs for mental illnesses and drugs for other conditions, such as heart disease.
The training also doesn’t equip psychologists to monitor patients on pain and anxiety medications, which can be abused, he said.

Halverson acknowledged that Wisconsin has a shortage of psychiatrists. But there are better solutions to the problem, he said, including telemedicine, increased consultation with family physicians and forgiveness of medical school debt for psychiatrists who move to rural areas.

Dr. Alan Schwartzstein, a Dean Health System family physician who is on the board of the Wisconsin Academy of Family Physicians, said there’s no evidence that psychologists would move to underserved areas of the state more than psychiatrists have.

Wisconsin has 1,707 licensed psychologists and 1,065 licensed psychiatrists, according to the state Department of Regulation and Licensing.

Most of them are in large cities. Most rural parts of the state don’t have enough mental health providers, according to the federal Health Resources and Services Administration.