The primary reason people are against mid-levels is because of job security. Claims of "patient safety" are merely a cover for turf/scope of practice issues. Which is not to say that there may or may not be patient safety issues (many NPs are terrible, but there are good ones too). There are many terrible psychiatrists who pose a threat to patient safety and you never hear psychiatrists up in arms about them. prescribing psychologists is a separate issue to some extent as there are so few of those they do not currently pose an existential threat to psychiatrists. In fact many psychologists argue that prescribing psychologists pose an existential threat to the field of psychology by fundamentally changing the role of psychologists for the worst. I am against psychologists prescribing because I don't believe we need more people pushing toxic drugs, there is already lack of availability of good quality evidence-based psychotherapy, the psychopharm programs that exist are all garbage and totally inadequate, and only the worst psychologists seem to be interested in prescribing.
BTW, psychiatrists and PCPs are losing their jobs to NPs all the time. they are usually cheaper, more easy to manipulate, and they generate more money for hospital systems because they order consults on everyone and lots of unnecessary investigations which is $$$$ for hospitals. Many employers prefer NPs to psychiatrists. Also there are many psychiatrists in private practice who hire NPs because they can be a money maker. My own academic institution has taken the unfortunate step of employing NPs instead of psychiatrists for some positions. I think NPs can have their place, but they need to know their place, be open to supervision, they need to have a good amount of experience, the more years of psych nursing experience the better, dual FNP/PMHNP trained ones are better, and you need to train them in your mold and they should a specific role and not be left to see a large undifferentiated patient population. The bad ones are fresh out of training, arrogant, don't know what they don't know, don't want to be supervised, having little or no RN experience, think they are just as good if not better than psychiatrists, and want to be called "doctor." going to a name brand institution is no guarantee of quality, in fact many of the worst ones seem to think their DNP from yale/ucsf/hopkins/penn/insert name-brand institution means they know what they are doing and makes them dangerous. and of course 23 states have total independent practice for NPs so they don't need supervision. In oregon they even bill the same as psychiatrists and family physicians.
