The American Psychiatric Association has issued the following news release:
>
> APA Urges Hawaii Governor to Protect Patients by Vetoing Psychologist
> Prescribing Bill
>
> The American Psychiatric Association (APA) joined local medical and patient
> advocates in urging Hawaii Governor Linda Lingle to protect patients by
> vetoing Senate Bill 1004 CD 1. The controversial bill would permit
> psychologists-who are not medically trained-to prescribe psychotropic
> medications. The Hawaii Senate narrowly voted 13 - 12 on final passage of
> the bill, while the House approved the bill with only a seven-vote majority.
>
> Under current law in Hawaii and 47 other states, psychologists are
> prohibited from prescribing any and all medications. S.B. 1004 CD 1 would
> eliminate current legal protections that prohibit psychologists in Hawaii
> from prescribing controlled substances. In the last ten years, 22 states -
> some multiple times - have considered and rejected similar proposals. During
> the 2007 sessions alone, legislators in California, Georgia, Illinois,
> Mississippi, Montana and Tennessee have wisely rejected similar legislation.
>
> In a letter today to Gov. Lingle, APA President Pedro Ruiz, M.D., wrote, in
> part:
> "The FDA has recently taken several actions that underscore the importance
> of medical training when prescribing medications, such as antidepressants
> and stimulants. For example, in October 2004, the FDA directed
> pharmaceutical companies to label all antidepressant medications distributed
> in the U.S. with a "black box" warning that the medications "increase the
> risk of suicidal thinking and behavior
> (suicidality) in children and adolescents with major depressive disorder
> (MDD) or other psychiatric disorders." The warning further states that the
> increased risk of suicidal thinking and/or behavior in a small proportion of
> children and adolescents is most likely to occur during the early phases of
> treatment. The FDA did not prohibit use of the medications in youth, but
> called on physicians and parents to closely monitor children and adolescents
> who are taking antidepressants for a worsening in symptoms of depression or
> unusual changes in behavior.
>
> "Psychotropic medications used to treat mental illnesses are among the most
> powerful in modern medicine. Used properly, they can offer remarkable
> benefits to patients struggling with severe brain illnesses.
> With these benefits come real risks. These medications have potentially
> disabling and deadly side effects if improperly prescribed and can cause
> convulsions, epilepsy, heart arrhythmia, blood disease, seizures, coma,
> stroke and death.
>
> "Mental illnesses-schizophrenia, major depression, bipolar disorder,
> childhood autism, and post-traumatic disorders, to name some of the most
> prevalent-are serious disorders. They are illnesses involving abnormalities
> in brain chemistry, many with strong genetic components, affecting the very
> essence of being human: our capacity to think, to reason, to judge reality,
> and to control our emotions and behavior. S.B.
> 1004 CD 1 would put people with these illnesses at risk.
>
> "Without a doubt, limited-licensure health care providers play an integral
> role in the delivery of health care in this country. Efficient team-based
> care cannot exist without collaboration among physicians, nurses, and other
> limited-licensure providers, including psychologists.
> However, problems arise when limited-licensure providers seek practice
> expansions, by legislation, that are not commensurate with their education
> and training.
>
> "The training required of certified psychologists under this measure in no
> way provides an adequate substitute for the extensive training required of
> licensed psychiatrists and other physicians. To be licensed as a physician,
> a person must have more than 4,000 classroom hours of medical school, and a
> one-year internship within a medical selling. In addition, psychiatrists and
> other specialist physicians must have at least four years of residency. The
> training required in S.B. 1004 CD1 for certification involves only a
> fraction of the medical school classroom hours, and therefore may place
> patients at risk.
>
> "Diagnosing illness and prescribing medication to treat it is based on a
> medical model of care, not on a psychological construct. This demands
> full-time, thorough, medical education and training in order to practice
> safely and effectively. Those responsible for treating a patient's
> psychiatric illness must be frilly capable of assessing the patient's
> overall medical condition. Half of all patients taking a brain medication
> have another major illness that requires medication. While the potential for
> drug interactions, alone, is cause for grave concern, it is important to
> note that all of these medications are broken down by the liver and the
> kidneys and flow through the same blood stream. Under no circumstances are
> psychologists trained to understand, assess and monitor a patient's medical
> condition as a whole.
>
> "We hope you would agree that the people of Hawaii deserve a higher standard
> of medical care than would exist under this bill. On that basis we urge you
> to reject this rush to judgment and to protect all Hawaii residents by
> vetoing S.B. 1004 CD 1. Thank you for considering these urgent comments."
>
> About the American Psychiatric Association:
> The American Psychiatric Association is a national medical specialty society
> whose more than 38,000 physician members specialize in diagnosis, treatment,
> prevention and research of mental illnesses including substance use
> disorders. Visit the APA at
www.psych.org and
www.HealthyMinds.org
>
