Editorial: Back to the drawing board on mental health prescriptions

The Illinois House Human Services Committee passed along legislation Wednesday that has attracted little attention outside of medical circles, but whose consequences for the general population, and especially for individuals with mental illness, could be serious and distressing.

Known as RxP, the legislation would extend to doctorate-level psychologists the authority to write prescriptions for psychotropic medications. Currently, only licensed psychiatrists, medical doctors and certain other highly trained medical professionals have this authority. And that's for good reason. It takes years of specialized study to enable someone to know how each of hundreds of drugs performs in the human body, how specific drugs interact with other medications and what specific health conditions call for them. These are not substances to be dispensed lightly.

Indeed, it may well be argued that even with the restrictions already in place, too many people get too many prescription drugs too easily. That debate alone indicates the need for special care before expanding the field of people with authority to prescribe. Add to it the increasing problem of addiction to prescription drugs, and an unmistakable alarm warns to proceed with extreme caution.

That is not the approach of Senate Bill 2187, the legislation under consideration in the House. Although proponents contend the bill lays out a regimen of years of rigorous study followed by close supervision, a scratch beneath the surface finds legitimate, important questions about the actual duration of the training and about what qualifies as "rigorous" study or "close supervision."

It's important to acknowledge that the foundation of RxP isn't merely the desire of psychologists to have more authority. There is a documented need in rural parts of the state for greater access to prescriptions for mental illness, and even in the suburbs and the city of Chicago where psychiatrists and other medical doctors are plentiful, the complications of finding the right care result in many individuals with mental illness failing to get treatment they need. Too often, these individuals wind up in prison or expensive institutionalized care - or, considering the hundreds of millions of dollars cut from state mental health programs in recent years, simply left to fend for themselves.

Of all groups, the National Alliance on Mental Illness is perhaps most closely familiar with this need, and even it recognizes the shortcomings of this bill. NAMI Illinois wisely recommends that, instead of this inadequate bill, psychologists, psychiatrists and other scientists join together to develop a coordinated, scientific plan of study and internship to ensure the needs of the mentally ill are met and met safely.

There is a need for greater access to prescriptions and mental health care. It may be that psychologists can contribute to the solution. But SB 2187 is not the blueprint for reaching that goal.