Oregon Governor to Veto Psychologist Prescribing Bill

Oregon Gov. Kate Brown (D) announced yesterday she will veto legislation (Oregon HB 3355) that would have authorized the Oregon State Board of Psychologist Examiners to issue prescriptive authority to licensed psychologists who meet specified requirements. 

“Access to appropriate and timely mental health services is a serious issue in Oregon,” Brown said in a statement. “I share the concerns about inadequate services that arose during the debate on this bill, particularly for children, vulnerable populations, and rural communities. Unfortunately, [HB 3355] is not a proven solution. There remains a lack of evidence that psychologist prescribing will improve access or quality of care. While prescription drugs may be appropriate mental health treatment for some patients, there are also significant health risks with some drug therapies. HB 3355 contains several flaws that prevent the policy from being implemented safely.”

Brown’s announcement is a victory for the Oregon Psychiatric Physicians Association (OPPA) and APA’s Department of Government Relations, which advocated against the bill along with state representatives from child psychiatry, academic psychiatry, and patient and community advocates. 

One of those efforts included an op-ed published in the June 24 Register Guard (in Eugene, Ore.)  by leaders of the OPPA, the Oregon Council on Child and Adolescent Psychiatry, and others who called HB 3355 “a reckless experiment.” They wrote, “There is no question that Oregon needs more mental health services, both from trained physicians and other mental health providers. Letting psychologists practice medicine is not the answer. … Not only would HB 3355 fail to deliver more or better care, it would endanger patients’ lives.” 

The op-ed appeared under the byline of Jim Lace, M.D., chair of the Oregon Medical Association’s Legislative Committee, and Martin Rafferty, executive director of the nonprofit Youth M.O.V.E. Oregon. It was co-signed by Jonathan Betlinski, M.D., president of OPPA; David Jeffery, M.D., president of the Oregon Council on Child and Adolescent Psychiatry; Ajit Jetmilani, M.D., director of child and adolescent psychiatry at Oregon Health and Science University; and Sandy Bumpus, executive director of the Oregon Family Support Network.

“We applaud Gov. Brown for her decision to reject this bill as a solution to the problem of access to care, and we congratulate the leaders of the Oregon district branch for their tireless work advocating for patient safety,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “APA will continue to support members in Oregon and elsewhere in their efforts to expand access to care through appropriate means, including expansion of integrated care and telepsychiatry.”

For related information, see the Psychiatric News article “Psychologist Prescribing Bills Defeated in Many States.”

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APA President Calls for Gun Control Measures in Wake of Oregon Tragedy

In a blog post today, APA President Renée Binder, M.D., called for the implementation of “common sense measures” to reduce access to firearms in this country. Her call to action came in response to the mass shooting on Thursday that took the lives of nine people at Umpqua Community College in Roseburg, Ore., as well as that of the 26-year-old gunman. Nine other people were wounded in the attack.

“As physicians,” she wrote, “we have the opportunity to educate our patients about the risks of keeping guns in the home particularly in the presence of children, adolescents, people with dementia, people with mental illnesses, including substance use disorders, who are at risk of harming themselves or others, and people who abuse children or partners. Currently, a number of states prevent physicians from asking questions about guns. This needs to be changed.”

Among the measures that APA supports are background checks and waiting periods before gun purchases, closing gun-show loopholes, product safety regulations, safe storage requirements, and gun-free college campuses and hospitals. Also, Binder noted that temporary firearm restraining orders could be one way to protect potential victims of these tragedies—family members and/or law enforcement could go before a judge and request that guns be temporarily removed from an individual who is likely to be dangerous toward himself and/or others.

To those who want to connect gun violence with mental illness, Binder emphasized that people with mental illness are far more likely to be victims of violence and that the majority of individuals with mental illness will never be violent toward others; the risk of self-harm is far greater. “Stronger indicators of risk include a history of violent behavior, domestic violence, and drug or alcohol abuse” she noted. “We urge states to develop new procedures for the temporary removal of access to guns during periods of elevated risk.”

Echoing President Obama in his address to the nation on Thursday, Binder said, “Our hopes and prayers will not be enough to stem the tide of gun violence in our country. We need decisive action in favor of responsible gun regulation. Until then, gun violence remains a significant threat to America’s public health, and as physicians, we have a vital role in advocating for change.”

For information on the response of the Oregon Psychiatric Physicians Association to the tragedy, see yesterday’s Psychiatric News Alert.

Oregon Psychiatrists Respond to Mass Shooting Incident

America’s latest mass shooting prompted a quick response from the Oregon Psychiatric Physicians Association (OPPA) to help survivors, families, and friends affected by the tragedy yesterday.

The incident took the lives of nine people at Umpqua Community College in Roseburg, Ore., as well as that of the 26-year-old gunman. Another seven people were wounded in the attack.

Dan Bristow, M.D., a psychiatrist with Kaiser Permanente in Portland, Ore., and the public information chair of the OPPA, emphasized the need to engage the news media to help educate the public about the psychological consequences to the community.

It is too soon to understand the motivations of the gunman, said Bristow. “This is a time to support, and be supported by, the ones we love—friends, family, neighbors, and fellow Oregonians.”

The OPPA posted messages on its website urging just that and suggesting ways that adults could discuss such traumatic events with children.

Bristow said he plans to travel to Roseburg, 180 miles south of Portland, later today to provide perspective on the event to local media and coordinate a longer-term response with area psychiatrists in that underserved area of the state.

The goal, he said, was to be attuned to the needs of the community and offer OPPA’s assistance as needed.

Look for a full report on the tragedy and OPPA's response in a future issue of Psychiatric News.

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