Psychiatrists fight blurring of line with psychologists. Psychiatrists (MDs) say it “feels like an insult” when a psychologist (a Ph.D.) is appointed to head the prestigious Yale University Child Study Center, especially after the controversy (to which I’ve blinked) over psychologists winning the right to prescribe psychiatric medications in New Mexico. Simiar legislation is in the pipeline in at least eleven other states. I agree with the thrust of the article, that this is about jockeying for a shrinking pool of money for mental health care. However, it is an oversimplification to state that prescribing is the ‘last bastion’ of psychiatric monopoly, on two counts. First, clinical nurse specialists have been prescribing for some years. Secondly (and this is precisely why the Child Study Center appointment has shaken the profession), while there is no inherent reason why the discipline with the prescription pad should be in charge of academic, bureaucratic or clinical institutions in mental health, psychiatry’s sense of identity depends on having a traditional edge in such intangible products of medical training as authoritativeness and decisiveness as well. Pained comments in this article include two from (psychiatrist) friends of mine. Boston Globe

☯ And here‘s a letter to the editor of the Globe in response to the above article, of particular interest because it is from someone who has trained and practiced as both a psychologist and a psychiatrist. This is exactly the perspective the public needs to disentangle this messy turf war:

“It is frustrating for psychologists to not have access to a prescription pad, but the public’s well-being should not be put at stake in order to mollify that frustration. Psychologists have many other skills they can offer to mental health.

But they are posing very serious health risks to the public by proposing that they, without medical training, should start engaging in the practice of medicine”,

says Dr. John Brenner Levine.