Psychiatrist shortage hot topic again at legislature - Hawaii News Now - KGMB and KHNL

Psychiatrist shortage hot topic again at legislature

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HONOLULU (HawaiiNewsNow) -

Clinical psychologist Jill Oliveira Gray treats patients suffering from mental health disorders.

State law forbids her from prescribing mental health medications, which is currently something only psychiatrists, not psychologists, can do.

Problem is there's there's a psychiatrist shortage.

"It's a supply and demand problem," said Oliveira Gray. "There are simply not enough psychiatrists to meet the mental health needs, not only in our state, but across the nation."

Oliveira Gray wants lawmakers to let psychologists with additional training prescribe psyche medicines on a very limited basis.

But psychiatrist Jeffrey Akaka said that the suggested training wouldn't be enough to qualify them.

"Why would you want someone who had no chemistry, no biology, never even took the test to get into medical school, make up their own classes and make up their own tests to practice medicine?" said Akaka. "There's a reason it takes eleven years." 

But psychologists and psycho-pharmacology experts say the curriculum is extremely rigorous.

With the psychiatrist shortage, primary care physicians wind up prescribing most mental health medications, especially in rural areas where the psychiatrist shortage is being especially felt.

"They're being unfairly burdened with the lack of psychiatrists our there to meet the need and prescribe some very common psycho-tropic medication," Oliveira Gray said.

"We've got other ways of fixing this problem," Akaka said. "All of them depend on giving more support to family physicians, to family practices, which is where the patients go."

Akaka believes that if case managers and family physicians oversaw mental health patients' primary needs, psychiatrists would be freed up to act as consultants. 

"A psychiatrist can take care of 15 or 20 patients in the morning instead of three or four," he said.

But a collaborative care system could take years to implement.

"Part of the reason we want prescriptive authority for psychologists to happen sooner than later is that it's a solution that can be implemented now, at virtually no cost to the state," said Trisha Kajimura, executive director of Mental Health America of Hawaii.

The Department of Defense and four other states allow psychologists to prescribe mental health medications to patients.

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