COMMENTARY
Drug authority will help mental heath patients
By Beth Giesting and Paul Strauss
Community health centers across the state and the Hawai'i Primary Care Association strongly endorse Senate Bill 1004 and House Bill 1456, which address prescriptive authority for certain psychologists. We believe that the requirements outlined in these bills regarding psychopharmacological training, supervised practice, standardized testing, board review and authorization, restrictions on what drugs can be prescribed, and practiced only within community health center settings will ensure that patients will be well-served rather than jeopardized.
As primary care providers, community health centers are best able to serve the primary behavioral health needs of patients. Ideally, the behavioral health-care for patients at community health centers would be provided in an integrated manner by a team of professionals. This team would include the primary medical-care clinician who can refer to a licensed clinical social worker or psychologist for behavioral health needs. By "integration" we mean that medical and behavioral health clinicians work from the same set of orders and refer patients back and forth as appropriate to the needs of the patient, and freely communicate with each other about their care and management. The integrated team would be supported by consultation with a psychiatrist on treatment decisions. That pyschiatrist would also be available to provide direct clinical care to patients who are seriously mentally ill and are referred to them. In most community health centers, the specialty services provided by a psychiatrist are needed on a very limited basis.
Why do we think this is the best plan of action for Hawai'i?
Increasingly, community health centers — both in rural and urban areas — are the providers of behavioral health-care in at-risk communities because their patients, who typically have a number of social, educational, economic and health problems, are more likely even than the norm to suffer from depression, anxiety and other mental disorders. At the same time, they are much less likely to have access to any behavioral healthcare providers other than those who work at the health center.
We believe the thousands of underserved patients all over Hawai'i who are cared for by community health centers will appreciate this legislation.
Paul Strauss is chairman of the board for the Hawai'i Primary Care Association and executive director of the Waikiki Health Center. Beth Giesting is chief executive officer of the Hawai'i Primary Care Association. They wrote this commentary for The Advertiser.
