The American Psychological Association (APA) hailed the enactment of a law making Iowa the fourth state in the country to authorize licensed clinical psychologists with advanced specialized training to prescribe certain medications for the treatment of mental health disorders.

“This is a landmark decision that will improve access to a wide range of mental health services,” said Katherine C. Nordal, PhD, APA’s executive director for professional practice. “Increasing access to mental health care is critical given the increase of major depressive disorders among Iowa’s youth and the number of people over 65 experiencing a diagnosable mental illness.”

Who can do it

Signed into law by Iowa Republican Gov. Terry E. Branstad, this measure grants prescriptive authority to Iowa licensed psychologists who have successfully completed a post-doctoral master of science degree in clinical psychopharmacology, a supervised practicum in clinical assessment and pathophysiology, and passed a national examination. These requirements are in addition to the education and training required to become a licensed psychologist – an average of seven years of graduate education beyond the four years of undergraduate work, and several years of supervised clinical training.

Psychologists in Iowa will also need to complete a two-year conditional prescribing period under a licensed physician's supervision to be eligible for independent prescriptive authority. For psychologists who treat special populations such as children, the elderly or people with comorbid physical conditions, this will include completion of a year of supervised conditional prescribing. Prescribing psychologists must maintain a collaborative relationship with the patient's physician. The law also directs the state board of psychology to work with the state medical board in drafting the implementation rules.

Better access to mental health care

Elizabeth Lonning, PsyD, of the Iowa Psychological Association, lauded the governor’s action. “Signing this legislation into law is a great step toward increasing accessibility to mental health care for all Iowans, many of whom currently have to wait months or drive long distances to receive treatment,” she said.

“We also want to thank Senator [Joe] Bolkcom and Representative [Linda] Miller for sponsoring this legislation, and all the legislators who voted in support of this bill.”

Two-thirds of counties in Iowa do not have a single psychiatrist, making it difficult for patients in need of medication for mental health disorders to receive it from a psychiatrist. It can take months to get an appointment. Even if they are able to find a doctor with available appointments, patients may have to drive an hour or more to get care, particularly if they live outside of major urban areas such as Des Moines or Iowa City. This new law will directly address these access issues by increasing the number of available providers to prescribe medications. 

A 2014 annual report of health in Iowa issued by the Iowa Department of Public Health revealed that 18.7 percent adults in the state reported having a depressive episode. According to a 2014 report from the Substance Abuse and Mental Health Services Administration covering 2009-13, 51.2 percent of adolescents and 50.7 percent of adults in Iowa with depression and/or a major mental illness did not receive treatment.

New Mexico was the first state to pass a prescribing law for psychologists in 2002. Louisiana followed in 2004 and Illinois in 2014.