The prospect of prescription privileges for psychologists is more risky, radical, and complex than it may seem at first blush. That's why legislators should oppose SB 428. Unlike current prescribers, only about 7 percent of psychologists ever take the undergraduate prerequisites required of all other prescribers, such as chemistry, organic chemistry, biology, biochemistry, etc. that provide the scientific understanding for the impact of medications on the human body.

As it examined psychologists' potential roles related to psychopharmacology, the American Psychological Associations' own Task Force, called for such prerequisites. Unfortunately, the training models that the APA ultimately developed, that are the general basis for current training in psychopharmacology, ignored the recommendations of its own experts and deleted the prerequisites. Some training is now largely online. It is no wonder then that many psychologists themselves oppose psychologist prescribing, primarily due to concerns about patient safety based on gaps in psychologists' training — even with the additional training they may pursue after their doctorate.

Other health professionals are also concerned about psychologist prescribing. However, this should not be seen as a simple turf battle: It is because of legitimate concerns that the proposals for training psychologists to prescribe are too narrow and abbreviated.

The International Society of Psychiatric-Mental Health Nurses position statement asserts, "nurses have an ethical responsibility to oppose the extension of the psychologist's role into the prescription of medications'" due to concern about psychologists' inadequate preparation, even if they were to get some additional training. When it comes to prescribing psychoactive medications that have a range of potential therapeutic and adverse effects on the human body, including interactions with other medications, shortcuts to training are ill advised.

Psychologists who wish to prescribe lack the scientific foundation of all current prescribers, but could obtain it by getting the full training required for physicians, nurse practitioners, and physician assistants. A better plan for meeting unmet mental health needs is to promote collaborations between psychologists and prescribers, rather than to permit lesser-prepared psychologists to prescribe. After all, the more medically complex a patient may be, the greater the potential risks that something missing from psychologists' training may result in otherwise avoidable problems. It is no wonder that consumer groups, such as the National Alliance for the Mentally Ill, have not supported psychologist prescribing.

A demonstration project in the military based on a mere 10 prescribing psychologists found that psychologists were "weaker medically" than psychiatrists and compared their medical knowledge to students rather than physicians. Nevertheless, advocates of psychologist prescribing refer to the DoD study as if it "proved" psychologists should prescribe based on a less intensive training model than any other prescribing professionals. The training that the DoD psychologists received actually exceeds that which is proposed in legislative initiatives now being considered by a considerable measure in terms of its scope and organization.

A more promising means for enhancing the mental health services available to citizens would be to dedicate efforts to better integrating mental health professionals, including psychologists, into the healthcare system, such as in primary care settings, where they could collaborate with other providers (who are prescribers) in the care of people who may need medications and psychological services. The barriers to such care have been detailed in a recent report by the U.S. Department of Health and Human Services, Reimbursement of Mental Health Services in Primary Care Settings. Overcoming the barriers to such care is an objective upon which psychologists agree with each other, and with other health professionals, and is clearly in the public interest. It would improve the quality of mental health care available in urban and rural areas.

A recent article in the American Journal of Law & Medicine entitled, "Fool's Gold: Psychologists Using Disingenuous Reasoning To Mislead Legislatures Into Granting Psychologists Prescriptive Authority" critiques the rationales that advocates of prescription privileges use to promote their cause. Before supporting this controversial cause, I urge legislators, the media, and all concerned with the public health to take a closer look at this issue.

William Robiner is a professor and director of health psychology at the University of Minnesota Medical School. He wrote this commentary for The Advertiser.