As a community pediatrician, I see and treat children daily with behavioral health needs and who lack access to mental health resources. Like our elected officials, pediatricians are committed to finding the right solutions to address Colorado’s children’s mental health crisis, and as clinicians, we’re guided by the Hippocratic Oath “First, do no harm.”
When it comes to what’s safest for Colorado kids, the obvious risks and consequences of what’s been introduced recently House of Representatives 1071 – What would Allowing psychologists to prescribe powerful psychotropic medicationsS – means that it is not an appropriate solution for children, adolescents and young adults.
Currently, only medically trained professionals – physicians, psychiatrists, or nurse practitioners
Physician assistants, for example, can prescribe these medications. If HB 1071 passes,
Psychologists will be the only non-medically trained prescribers in Colorado.
HB 1071 moves Colorado away from collaborative care models where both clinicians and psychologists play a leading role in supporting children and families. This would isolate from behavioral health care, separating the child’s health, medical, and behavioral needs. This runs counter to years of work by pediatric professionals to integrate patients’ physical and mental health care needs.
Pediatricians are highly respected and rely on the expertise and advice of our psychology colleagues. In fact, they lead the care team around the diagnosis of behavioral health disorders and therapeutic interventions. However, the many medical considerations for prescribing and treating a child on psychiatric medications–weight, blood pressure, metabolic panels, organ systems, side effects, and interactions with other medications–are safely monitored and evaluated by medically trained professionals.
Therefore, prescribing powerful psychotropic medications for children, which affect the mind and body, must be done in the context of a “medical home,” an evidence-based approach where the full picture of a child’s health is recognized, considered, and evaluated. .
Pediatricians are very comfortable prescribing and administering medications to diagnose anxiety, depression, sleep disorders, and ADHD. For more complex medication needs, pediatricians refer patients to local child psychiatrists or use programs such as the Colorado Child Psychiatry Access and Counseling Program, which exists to support medical practices seeking child psychological counseling for medication administration, whether in moments of crisis or for a prolonged period. . Patient care on the run.
Instead, families struggle to access counseling and treatment, particularly in disadvantaged areas.
Limitation authority is the last prerogative granted to a physician. It is the culmination of understanding the human body, applying medicine to each individual, and balancing benevolence and harmlessness in clinical decision-making.
Even with the training requirements included in the bill, a prescribing psychologist would be the least trained professional with a mandatory authority in Colorado, including any physician, nurse practitioner, or physician assistant. Psychologists lack the comprehensive medical training and experience to properly care for the complex nuances of side effects and adverse reactions that accompany prescribing and canceling medications to children.
Addressing the children’s mental health crisis requires access to more mental health professionals and therapeutic interventions, not more prescribers. In fact, adding more prescriptions could mean fewer mental health professionals available to provide counseling, assessments, and treatment support that work alongside medications. And more prescribers who accept cash-only payments will not help patients who lack the means to pay out of pocket for care, exacerbating existing inequalities among children who need mental health care.
Over the course of 30 years, policymakers across the country have rejected more than 200 bills to allow psychologists to prescribe psychiatric medications. Today, only five states allow such a practice, which indicates that this proposal does not meaningfully increase access to care.
We cannot process our way out of the mental health crisis we are facing, especially for our youth, and I am asking the Colorado State Legislature to deny HB 1071.
Instead, we need to ensure statewide, timely and affordable access to mental health professionals who provide therapeutic support, expand existing integrated behavioral health programs and invest in solutions that we know make a real difference for children.
Cassie Littler, MD, FAAP, is president of the American Academy of Pediatrics – Colorado Chapter, which represents nearly 800 pediatric professionals across the state.
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