April 23, 2008 06:18 pm
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By Wally Kennedy
wkennedy@joplinglobe.com
Virginia Gaston takes care of six foster children. At least half of them need some type of medication for seizures, depression or anger management.
Gaston travels from her home in Aurora to a local psychologist for the counseling and therapy they need, but their psychologist, Dr. Brian Petrovich, can not prescribe medications for them.
“If the psychologist who sees my children could prescribe medications, it would save our family time and money,” she said. “It would keep the children in school and it would allow for immediate medication for children who need it.
“In order for our kids to receive medication, we must make an appointment with a psychiatrist in a larger city an hour away with an office who cannot fit us in for perhaps a month or more, take the children out of school, put enough gas in the car to get us there, and see a doctor that does not know our children as well as our own counselor for a 15-minute office visit.”
To say that Gaston is frustrated is an understatement.
Her frustration is growing. She used to be able to take her children to Carthage, Springfield or Joplin. The doctor she had been taking her children in Carthage has resigned. The practice she went to in Springfield, she says, no longer accepts patients for Lawrence County.
“The system is not working. It is failing. I cannot get timely and appropriate care for my children,” she said. “It was difficult before. It is now even more constricted.”
Legislation introduced in this session of the Missouri Legislature could provide some relief to the children served by Gaston.
A new grassroots coalition has formed in support of House Bill 1739 and Senate Bill 917. The legislation would grant prescriptive authority for psychotropic medications to highly trained psychologists. Under current law, patients who see a psychologist for diagnosis and treatment of mental-health disorders must also go to a physician or a psychiatrist if they require medications.
The legislation would grant prescription privileges to licensed, doctoral psychologists who complete two additional years of psychopharmacology training and pass a national exam. They also would need to maintain an ongoing relationship with a physician.
The legislation is supported by the Missouri Coalition of Children’s Agencies, Missouri Boys and Girls Town, the Missouri Psychological Association, and Missouri Families for Access to Comprehensive Treatment (MOFact).
Thomas Parquette, state director of MOFact, suffers from bi-polar disorder and depression.
“We have a serious problem in Missouri,” he said. “Mental health is not getting the level of attention it should. The root of the problem is access to treatment.
“Rural areas do not have a sufficient number of psychiatrists. There are 356 licensed psychiatrists in Missouri and some of them are teaching in colleges. Most of them work in Kansas City and St. Louis. There are 1,800 psychologists across the state.
“If this legislation passes, possibly 1,200 of those psychologists could prescribe medications for depression and anxiety in probably two to three years. What this would provide is seamless, comprehensive care to patients that would save them a lot of money in the process. Two appointments cost more money.”
George Salaky, a Monett resident who is a patient of Dr. Petrovich, said, “I see him once a week for 50 minutes to an hour. He’s the one who gives me the coping and living skills. In my case, the old stuff didn’t work anymore. I see my psychiatrist once every two to three months for 15 minutes for medication adjustments. In a dire emergency, they can squeeze me in.”
Salaky said his condition improved when he came to Missouri.
“In California and Texas, I was shuffled through the system. Things got a lot better here, but it took a couple of years to find a medication that really worked for me.”
Said Petrovich: “The biggest problem we face right now is that the children have no place to go. A psychiatrist sees them for 10 minutes a month. We see them for an hour each week. This legislation would let those who know them best and who work the closest with them to adjust their meds weekly.”
Other states
Two states, New Mexico and Louisiana, and U.S. territory of Guam have passed laws to allow psychologists to prescribe medications to patients, according to the Missouri Psychological Association.
The United States Department of Defense has been using appropriately trained psychologists to prescribe medications without incident since 1994.
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