Prescriptive authority for psychologists and the public sector: Serving underserved health care consumers.

Abstract

In a changing health care environment, civilian and military health care consumers served by public sector health care professionals face many obstacles in accessing services. Barriers to treatment may be geographical, bureaucratic, financial, and/or social for different populations. The exigent nature of combat and its psychological sequalae are a critical consideration as well. Consequently, “serving the underserved” has been explicitly at the core of organized psychology's prescriptive authority (RxP) initiative since its inception. This article provides an overview of the mental health care needs of underserved health care consumers from several perspectives: active duty military and veterans, prison inmates, Canada, and individuals in rural communities lacking qualified medical mental health practitioners. RxP advocates must demonstrate its value in a cost-conscious environment, and the profession should support continued efforts at building RxP capacity in the public sector. Ultimately, the RxP initiative is consistent with a competence-based health care regulatory system.

Predoctoral prescriptive authority training: The rationale and a combined model.

“…A broad range of civilian public sector agencies would benefit from the presence of prescribing psychologists. Since the early 1990s, beginning with the Department of Defense Demonstration Project, the military has supported RxP and now deploys prescribing psychologists from civilian training programs as well as those trained in the Department of Defense Demonstration Project (Ax et al, 2008). Younger practitioners might provide prescribing services to patients in underserved areas as part of their postdoctoral supervision and/or as part of a tuition forgiveness arrangement offered through various federal agencies, including the loan repayment program available to psychologists and other health care providers, through the National Health Services Corps (U.S. Department of Health & Human Services/Health Resources and Services Administration, n.d.).…”

“…The Division 18-Alliant partnership has been undertaken between Division 18 (Psychologists in Public Service) of the American Psychological Association and Alliant International University to train 100 public-sector psychologists for RxP. Funds have been raised to train more than 20 psychologists as of this writing (Ax et al, 2008). The Division 18-Alliant project was undertaken for the express purpose of increasing access to care for underserved mental health care consumers.…”

Limited prescription privileges for psychologists: Review and implications for the practice of psychology in the schools

“…Ax et al (2008) point out that many consumers in the public sector are chronically underserved by current health care systems. In particular, they focus on the shortage of psychiatrists available to provide prescriptions and medication monitoring in the military, the Veterans Health Administration, and the state and federal prison systems.…”

The Normative Nature of Aggressive Intrusive Thinking Among an Underserved Incarcerated Population Compared With a Student Sample

“…Among incarcerated individuals, reports suggest that as high as 71% have a mental illness, with 16% to 24% exhibiting high levels of severity (Ax et al, 2008;Dumont, Brockmann, Dickman, Alexander, & Rich, 2012;Dumont, Gjelsvik, Redmond, & Rich, 2013). Despite the high prevalence of mental illness within jail and prison populations, incarcerated individuals often lack accessibility to mental health care that is appropriate for their unique psychosocial challenges, thus identifying these individuals as a medically underserved population.…”