Many psychiatrists are unaware of state licensing exemptions that permit them to treat patients who regularly move across state lines, such as college students, according to a study in Psychiatric Services. The findings also revealed that once informed of state exemptions, psychiatrists are split on their willingness to treat patients outside their state.
Rachel Conrad, M.D., of Brattleboro Retreat in Brattleboro, Vermont, and colleagues contacted 901 psychiatrists during the summer of 2023. All these psychiatrists advertised their services on an online platform. The investigators simulated an inquiry from a student who attends college in another state—one that offers exemptions for out-of-state psychiatrists—but wants to initiate treatment for new-onset depression while staying with their parents in the psychiatrist’s home state during the summer.
After extensive phone and email attempts, the researchers established contact with 143 psychiatrists who were accepting new patients. Of these, just seven (5%) were aware of potential state medical licensure and/or telehealth exemptions. In these instances, the “student” offered an overview of the relevant laws that would allow for continuity of care once they returned to campus.
Among the 136 psychiatrists initially unaware of state laws:
- Forty-three (30%) were willing to establish care with students attending college in another state regardless of state laws, while 51 (36%) were unwilling to do so even when permitted by law.
- The remaining 42 (29%) wanted to learn more about licensure exemptions, though nine of this group subsequently declined to provide care to the student.
Conrad and colleagues noted that most of the psychiatrists they attempted to reach were in private practice and may not represent the field as a whole.
Still, the high rates of noncommunication, lack of state legal knowledge, and unwillingness to rely on medical licensure exemptions highlight the many barriers facing college students seeking mental health care, the researchers continued. Citing a federal law passed in 2018 that allows clinicians traveling with a sports team to practice in any other state, they suggested further federal licensure exemptions may be more effective at improving access to care.
For related information, see the Psychiatric Services study “Availability of Outpatient Child Psychiatric Care During COVID-19: A Simulated-Patient Study in Three U.S. Cities.”
(Image: Getty Images/iStock/kali9)
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