More Mental Health Providers Can Now Prescribe Medication, and It's Working
Getting mental health treatment in America has long been a frustrating experience. You might start with a psychologist for therapy, but if you need medication for depression or anxiety, you typically have to wait weeks or months to see a psychiatrist. With a severe shortage of psychiatrists nationwide, this wait can be dangerous for people in crisis.
But some states have found a solution: allowing specially trained psychologists to prescribe psychiatric medications. New research suggests this approach is helping more people get the care they need without compromising safety.
The Current Mental Health Crisis
Nearly one in four American adults experiences mental illness each year, yet less than half receive treatment. The biggest barrier isn't just cost or stigma anymore—it's simply finding available providers. Patients seeking medication often face a two-step process: first seeing a psychologist, then waiting weeks or months for a psychiatrist appointment to get prescriptions.
This delay can be particularly harmful for people with severe depression, anxiety, or other conditions requiring immediate medication intervention.
A New Approach Takes Hold
Six states have changed their laws to allow psychologists to prescribe psychotropic medications after completing additional training. New Mexico led the way in 2002, followed by Louisiana, Illinois, Iowa, Idaho, and Colorado. These psychologists must complete two to four years of specialized coursework in clinical psychopharmacology plus additional practical training.
The change hasn't happened without controversy. Some medical organizations worry that psychologists don't have sufficient medical training to safely prescribe psychiatric medications. Others feared patients would abandon psychiatrists entirely, potentially receiving lower quality care.
What the Research Found
A comprehensive study analyzing data from 2000 to 2019 reveals that these concerns may be unfounded. Researchers examined what happened in states that expanded prescriptive authority for psychologists compared to states that didn't.
The results show that allowing psychologists to prescribe medication led to more mental health practices opening their doors. Psychology offices increased by about 0.8 locations per 100,000 residents, while counseling services also saw growth. Importantly, the number of psychiatrist offices remained stable, suggesting that psychologists and psychiatrists work as partners rather than competitors.
This means patients gained access to more mental health resources overall, rather than simply shifting from one type of provider to another.
Safety Concerns Addressed
Perhaps most importantly for patient safety, the study found no increase in suicide rates after states implemented these policies. Suicide rates serve as an important measure of mental health outcomes, particularly for the most severely affected patients who cannot wait months for treatment.
Some states, particularly New Mexico and Illinois, actually saw decreases in suicide rates, though results varied by location. Overall, the data suggests that care quality remained consistent when psychologists gained prescribing privileges.
Mental health needs have only intensified in recent years. The COVID pandemic increased rates of depression and anxiety while simultaneously straining an already limited mental health workforce. Traditional solutions like training more psychiatrists take years and face significant bottlenecks, including limited medical residency positions.
Expanding scope of practice for psychologists offers a faster path to increasing treatment capacity. Psychologists already provide the majority of mental health counseling in the United States and often have closer relationships with patients than psychiatrists, who may focus primarily on medication management.
The research provides reassurance for policymakers considering similar legislation. Rather than creating a race to the bottom in terms of care quality, expanding psychologist prescriptive authority appears to create a win-win situation: more providers available to help patients, with no apparent compromise in safety or outcomes.
For patients struggling to access mental health care, these findings suggest that having a psychologist prescribe needed medications could be just as safe and effective as waiting months to see a psychiatrist. As mental health needs continue to grow across the country, this approach may offer a practical solution to help more people get timely, appropriate treatment.
The study's authors note that expanding psychologist scope of practice should be considered as states work to address ongoing mental health workforce shortages, particularly in rural areas where psychiatric services are often unavailable.
Shoulders, A., & Plemmons, A. (2025). Supply of mental health practices after prescriptive authority expansion for psychologists. Contemporary Economic Policy, 43(1), 116-134.
