HONOLULU (HawaiiNewsNow) – A key legislative committee advanced a bill Monday that would give psychologists limited power to prescribe mental health medications.
The measure reignites a years-long debate between mental health professionals over who should be allowed to treat patients with drugs.
The Senate Health and Human Services Committee approved Senate Bill 847 despite opposition from psychiatrists who argue the additional training requirements are insufficient for handling potentially dangerous medications.
The conflict between psychiatrists, who can prescribe mental health drugs, and psychologists, who cannot, has persisted for years. Hawaii’s rising suicide rate, particularly on neighbor islands, is putting pressure on lawmakers to find solutions.
Personal stories drive support
Melissa Pavlicek, who was raised on Maui, told the committee she lost two first cousins to suicide.
“Neither was seen by a mental health professional in time to save their life,” Pavlicek said. “That’s a reality for too many families. Care is hard to access, delays are deadly, and people fall through the cracks.”
Kauai Mayor Derek Kawakami, who previously opposed psychologist prescriptions as a state senator, changed his position after losing 10 friends and relatives.
“I am not saying that this measure would have saved them, but all I am saying is that for rural communities, Kauai being the smallest community in the state of Hawaii, something like this I have to believe would help,” Kawakami said.
Bill includes safeguards
Dr. Jack Lewin, the governor’s senior advisor on health care, supported the bill because it requires prescribing psychologists to receive significant additional training and be supervised by a psychiatrist.
“That supervision creates what I think is a healthy thing, which is a team led by a psychiatrist to manage the psychologists who want to do this,” Lewin said.
Psychiatrists oppose measure
The health committee received more than 150 pages of testimony on the bill, much of it from psychiatrists who say the additional training is not enough to understand the challenges of potentially deadly mental health drugs.
“Would you trust your loved one to go get that crash course medication or from one of us that has done this for years?” said Dr. Doreen Fukushima, a Pearl City psychiatrist.
Psychiatrists said the best way to improve access to care is through telehealth visits, reduced medical paperwork, better insurance coverage and incentives to recruit and train more psychiatrists.
“There are other proven solutions to address the mental crisis in this state,” said Dr. Piimauna Kackley, president of the Hawaii Psychiatric Medical Association.
Sen. Joy San Buenaventura, who chairs the Senate Health and Human Services Committee, defended the bill’s requirements.
“This particular bill is more than a crash course. It requires a collaboration,” San Buenaventura said. “We keep seeing the same canned testimony regardless of how much we made restrictions on the bill.”
The bill now goes to the Senate Consumer Protection Committee and must pass the full Senate before moving to the House.
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