Colorado Prescribing Psychology (RxP)

Dear CPA Community, My name is Jin Lee, and I’m the chair of the prescribing psychology (RxP) Task Force.

Prescriptive authority is granted for licensed psychologists with advanced training in clinical psychopharmacology, and five states have passed legislation allowing for this expansion in psychology practice. Many other states are in the process of pursuing prescriptive authority legislation.

I am very excited to announce that, as of 3/3/2023, Colorado became the sixth state to grant specially trained psychologists to prescribe psychotropic medications. We introduced the bill HB23-1071 on 1/19/2023, and within 6 weeks, the bill was signed into law.

Are you interested in becoming a prescribing psychologist? Please contact me at [email protected].

 

BACKGROUND

Colorado is in a serious mental health crisis, with a high prevalence of mental health issues in Coloradans and a significant shortage of mental health professionals statewide. For example, nationally, Colorado ranks third for lowest access to mental health services, has the second highest percentage of adults with substance use disorder, and has the third-highest percentage of adults contemplating suicide. Since the COVID-19 pandemic, rates of mental health issues in Coloradans have increased, with nearly 50% of Coloradans experiencing symptoms of anxiety and depression, and a more than a 50% increase in Coloradans calling or texting a crisis hotline.

RxP FAQ's 

1. What is a Prescribing Psychologist (RxP)?

  • A licensed psychologist who has received advanced training and has a licensure to prescribe psychotropic medication. This licensed psychologist is able to operate independently (does not require supervision to practice)
Fun Fact: APA has recognized RxP as a Specialty, and the APA DIvision 55 Society of Prescribing Psychology is in the process of pursuing a board certification status through the American Board of Professional Psychology (ABPP).
 

2. What is this advanced training?

  • 2-year Postdoctoral Master’s Degree in Clinical Psychopharmacology (MSCP) AND
  • Pass a National board exam – Psychopharmacology Exam for Psychologists (PEP) AND
  • 6 months - 3 years of physician supervised Practicum depending on the state
E.g., in New Mexico, psychologists will see at least 100 diverse patients and spend a minimum of 400-hour related to prescribing psychotropic medications.

3. Do any states currently allow RxP?

As of 2020, five states passed the RxP legislation:

  • i. New Mexico (2002)
  • ii. Louisiana (2004)
  • iii. Illinois (2014)
  • iv. Iowa (2016)
  • v. Idaho (2017)
Fun Fact: the following federal agencies permit prescribing psychologists:
  • vi. Department of Defense (Army, Navy, Air Force)
  • vii. US Public Health Service Corps
  • viii. Indian Health Services

4. Is this safe?

  • YES! Psychologists have been prescribing safely for nearly 30 years.
  • Department of Defense began RxP in 1991, and there have been no reported instances of inappropriate or harmful prescribing by RxPs. 

5. Do I have to prescribe psychotropic medication if RxP is passed in Colorado?

  • No! Prescribing psychology is one of many subspecialties within psychology, such as neuropsychology, forensic psychology, child psychology, health psychology AND you cannot become a RxP without additional training (as noted above)

6. Would my liability insurance go up with RxP addition?

  • No! RxPs would have their own liability insurance bracket, and this would NOT impact psychologists who don’t prescribe medications.

7. How would RxP in Colorado really improve access?

  • Colorado is ranked 48 out of 50 for adults with unmet mental health needs and ranked 42 for adolescents (The State of Mental Health in America)
  • Nearly all counties in Colorado have a significant shortage of mental health professionals (Rural Health Information Hub)
  • Colorado has fewer available psychiatry service per capita.The national average of available psychiatry service is 8.9 psychiatrists per 100,000 people. (Insight Regroup)
  • Because of the significant shortage of prescribers, the primary care physicians in Colorado are the largest group of health care professionals who prescribe psychotropic medications.
  • Each year, about 9,000 individuals go to University of Colorado ER for mental health crisis. (The Denver Post)