Simulating the Impact of Psychologist Prescribing Authority Policies on Mental Health Prescriber Shortages.

Objective: To simulate the impact of granting prescriptive authority to licensed psychologists on shortages of mental health providers with prescriptive authority. Methods: We used national and state-level secondary data to construct a policy simulation. Mental health prescribing need and the number of mental health prescribers were estimated at the national and state levels, and the provider shortage was calculated as the difference between these two values. The simulated policy intervention added 10% of psychologists to the prescriber group to estimate the associated reduction in prescriber shortages. Probabilistic uncertainty and sensitivity analyses were conducted using 10,000 Markov trials in which all model parameters varied randomly based on their associated uncertainty. The simulated policy value was allowed to vary between 5% and 15%. Results: The prescriber shortage was predicted to fall by 4.34% (95% confidence interval = [0.75%, 16.58%]) nationally, though this varied widely by state, ranging from 1.10% [0.20%, 3.82%] in North Dakota to 26.44% [2.89%, 570.29%] in Washington, D.C. Uncertainty and sensitivity analyses demonstrated that variability in the provider shortage reduction was primarily driven by the percentage of psychologists becoming licensed to prescribe. Conclusions: Our results suggest that granting prescriptive authority to licensed psychologists would reduce the shortage of mental health professionals with prescriptive authority. Further work is needed to examine the potential implications for other mental health providers.