At present more than 370,000 veterans call Colorado home. While Colorado ranks 19th in the nation for veteran population, it sadly outpaces the nation in veteran suicide deaths. Currently, 1 in 7 suicides in Colorado is a veteran. This tragic and alarming trend does not have to continue.
I am fortunate to have the unique opportunity to serve as a prescribing psychologist and provide psychotherapy and medication management services for active-duty service members on a daily basis. The foundation of each of our clinical encounters centers upon building rapport, identifying the individual’s desire for therapy, and meeting each person in the midst of their present emotional state.
Some patients benefit greatly from traditional psychotherapy, and we spend our time talking through their concerns, processing emotions, considering how their thoughts and/or actions may be impacting their emotional state, developing problem-solving strategies, and identifying coping skills to address their symptoms.
However, others may be so debilitated by the extent of their anxiety, depression, Bipolar Disorder, PTSD, OCD, etc., that they are unable to effectively engage in or benefit from therapy. This is where the augmentation of psychotherapy with psychopharmacology has the potential to facilitate life-changing improvements in the patient’s behavioral health.
The utility of medicine-prescribing psychology is the unique capacity to synthesize a detailed knowledge of our patients’ emotional state, past experiences, current stressors, and coping capacities in the presence of well-established, trust-enhancing rapport. This dynamic allows for collaboration between the patient and psychologist and emphasizes the patient’s ultimate autonomy regarding any psychotropic-related decisions.
Moreover, this alliance facilitates the opportunity to address the patient’s medication needs and related questions, discuss expectations of use, possible side effects and any potential safety warnings, perform potential interaction checks with other medications currently being taken, consider which labs may need to be ordered, and modify their treatment regimen, as appropriate, within the course of the therapy session.
The responsibility to prescribe at times also entails the obligation to consider deprescribing. There have been numerous instances in which soldiers have come to see me while on several concurrent psychotropic medications. When appropriate, we are able to work together to maximize the benefits, reduce side/interaction effects while streamlining their medication regimen.
Addressing such issues within the course of the therapy session promotes a much more expedited and holistic therapeutic encounter, and ensures that patients do not have to wait for several additional weeks to receive much-needed medication intervention.
The reason that I am able to assist my patients through the harmonious integration of psychotherapy and medication management is that I am credentialed to prescribe through the Defense Health Agency. If I were not a part of this agency, I would not be able to provide this valued service, because Colorado has not had a process for psychologists to earn the ability to prescribe behavioral health medications.
Unfortunately, once a service member retires or otherwise gets out of the military, they lose access to such streamlined behavioral health services. Instead of a smooth transition to civilian behavioral health care they now face long wait times to see a prescriber.
If psychologists were able to prescribe in Colorado, this barrier could be eased for our veterans just like it is for the service members whom I currently serve. Fortunately, a bipartisan bill, HB23-1071, was recently sent to the governor’s desk. If he signs this bill, Colorado will join five other states, including New Mexico, Iowa, Idaho, Louisiana, and Illinois, which have expanded access to holistic behavioral health care for countless patients for over 20 years.
I went through rigorous education and training to earn the ability to prescribe. The training required in the bill is nearly identical. HB23-1017 streamlines mental health care for our veterans and gives them faster access to life-saving treatment.
My colleagues who went through medical school value my input and consider me to be an equal counterpart, including covering for their patients when they are out, collaborating on cases, and even being requested to present on prescribing psychotropic medications to military primary care physicians.
States that have prescribing psychologists have seen their suicide rates drop. I’m hoping the Governor signs this important bill that will help our veterans. Time is not on their side.
Brian Seavey, of Colorado Springs, is a board certified, licensed clinical and prescribing psychologist, who practices at Fort Carson. The views expressed in this column are his alone.
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