Illinois’ flawed RxP bill merely window dressing
Several GateHouse Media Illinois newspapers have joined other Illinois newspapers in opposing Senate Bill 2187, also known as the RxP bill, which would give drug prescription rights to some psychologists who undergo a minimal amount of medical training to be able to do so.
This is an important piece of legislation that we suspect few Illinoisans understand because it involves a bit of inside baseball involving psychologists and psychiatrists.
Currently in Illinois, psychiatrists are the only trained mental health professionals who may prescribe psychotropic drugs to patients. That includes antipsychotics, antidepressants, anti-anxiety and anti-panic medication, mood stabilizers and more.
This is for good reason. Psychiatrists undergo the same 12 years of medical training as physicians, but their specialty is diagnosing and treating mental illnesses, whereas other doctors might specialize in podiatry or obstetrics. Psychiatrists, like other physicians, study chemistry, pathology, pharmacology and more in medical school. They rotate through specialities, such as internal medicine and pediatrics, and they go through a residency.
Psychologists, who also provide critical services to the mental health community, earn valuable advanced degrees in psychology. They are counselors and therapists who spend time with people and help them with such problems as depression, addiction, stress, anxiety, anger, behavioral disorders and relationship issues. They have important skills that psychiatrists don’t, but a comprehensive understanding of the human body and psychotropic drugs aren’t among them.
In areas of Illinois, including poor, rural and inner-city communities, there is a well-documented shortage of mental health professionals available to assist patients who desperately want or need treatment.
A 2011 report by the Illinois Hospital Association admonished that in some parts of Illinois mental health services simply do not exist for anyone. In other parts of the state, services are severely limited. Jails, prisons, hospital emergency departments and homeless shelters are left to deal with the problems that tend to develop from a lack of mental health treatment and services.
Between fiscal years 2009 and 2012, Illinois reduced funding for mental health services by $187 million, or nearly 32 percent, according to a report by the National Alliance on Mental Illness, which is opposed to the RxP legislation. Only California and New York had larger funding cuts during that period.
Proponents of S.B. 2187 say the ability of mental health patients in underserved areas of the state to receive medication from psychologists will solve the problem of access.
We disagree. Illinois’ loathsome underfunding of mental health services and the resulting access issues won’t be addressed in any meaningful way by this legislation. Illinois needs comprehensive reform and a financial commitment by state leaders to address the burgeoning mental health crisis.
And on the treatment side, a more integrated approach to health care among physicians, mental health professionals and others is needed.
Only two states, Louisiana and New Mexico, allow psychologists to prescribe medication. Attempts to legalize it in other states — many of which have mental health funding crises of their own — have failed, and for good reason. The risk to patients is too great.
S.B. 2187 would give mental health patients easier access to potentially harmful psychotropic drugs but with inadequate supervision by trained medical professionals who understand deadly drug combinations, can recognize side effects and problems or have an established medical relationship with the patients in question.
The House Human Services Committee was scheduled to discuss the RxP bill May 7. A recently filed amendment to the legislation makes numerous changes and concessions that fail to adequately address the issues of treatment access and patient safety — an indicator to us that this is desperately flawed legislation.
Illinois’ poor and underserved mental health patients, who have suffered from deep cuts to state services and programs, deserve better than what the RxP bill delivers.
— GateHouse Media Illinois