States grant psychologists prescribing authority

Hawaii and Vermont in 2026 became the latest U.S. states to let specially trained psychologists prescribe psychiatric medications, extending a long-running state campaign over who can do what in mental-health care. The change is not national. It depends on state law, state licensing boards and additional training requirements layered on top of a psychology license. (apa.org) Pharmacy Times reported in April 2025 that seven states then allowed the practice; by July 2026, the American Psychological Association said Hawaii and Vermont had raised the total to nine states. (beckersbehavioralhealth.com) The expansion has been framed by supporters as a response to shortages of psychiatric prescribers, especially in underserved areas. Opponents have argued psychologists do not receive the same medical training as physicians and have questioned whether adding medication authority changes the profession’s boundaries too far. (apaservices.org) Those arguments have played out state by state rather than through a single federal rule. ### Which states actually allow psychologists to prescribe? As of July 2026, nine states had enacted some form of prescribing authority for specially trained psychologists: New Mexico, Louisiana, Illinois, Iowa, Idaho, Colorado, Utah, Vermont and Hawaii, according to the American Psychological Association and the Association of State and Provincial Psychology Boards. Federal settings including the Department of Defense, the U.S. (pharmacytimes.com) Public Health Service and the Indian Health Service also allow prescribing by qualified psychologists under their own rules. New Mexico was the first state to enact such a law in 2002, followed by Louisiana in 2004, Illinois in 2014, Iowa in 2016 and Idaho in 2017, according to APA Services’ chronology. Colorado and Utah were added more recently before Hawaii and Vermont moved in 2026. (dictionary.apa.org) ### What does “prescribing authority” mean in practice? APA’s model legislation defines prescriptive authority broadly as the power to prescribe, administer, discontinue or distribute certain drugs or controlled substances used in treating psychiatric and behavioral disorders, and to order related laboratory tests and diagnostic procedures. In practice, each state can narrow that authority by excluding certain drugs, requiring collaboration, or setting supervision conditions. (apa.org) Hawaii’s 2026 law created a three-year pilot in Kauai and Hawaii counties for qualified psychologists working under physician or psychiatrist supervision, according to bill tracking and bill text summaries. Vermont’s 2026 law authorized prescribing by doctoral-level psychologists and directed the state board to write rules covering training, excluded drugs and investigations of unprofessional conduct. (apaservices.org) ### Why are supporters pushing these laws now? The American Psychological Association said Hawaii and Vermont expanded access to comprehensive mental-health care and helped address provider shortages and treatment delays in underserved communities. APA Services says most mental-health medications are prescribed by primary care providers, not psychiatrists, and argues appropriately trained psychologists can combine psychotherapy, testing and medication management for some patients. (apa.org) A 2026 National Register position paper cited studies finding prescribing authority for psychologists was associated with lower suicide-related mortality in New Mexico and Louisiana and could be a cost-effective way to address prescriber shortages. That paper is an advocacy document, but it points to the evidence supporters are using in legislative fights. (legiscan.com) ### What are opponents and skeptics arguing? APA’s dictionary entry on prescriptive authority says opponents contend psychologists lack the medical knowledge required to prescribe safely and worry medication management could displace non-drug treatment. Scholarly debate has also focused on whether psychopharmacology training for psychologists is commensurate with the responsibilities of prescribing. (apa.org) Those objections help explain why laws differ sharply. Illinois, for example, requires advanced psychopharmacology training and a full-time 14-month prescribing psychology residency totaling at least 1,620 hours of supervised clinical medical rotations, APA Services says. ### Why does this matter for students and clinicians planning careers? (nationalregister.org) State law is the key variable because a psychology license alone does not confer prescribing power. APA Services says prescribing requirements sit above and beyond basic licensure, and psychologists moving states must satisfy the receiving jurisdiction’s rules on licensure, mobility and scope of practice. That means the issue is less about a uniform national shift than about where a clinician trains, seeks licensure and plans to practice. (dictionary.apa.org) The next concrete steps are in state boards and legislatures: Hawaii’s board was directed to begin accepting applications on July 1, 2026 under one proposal, and Vermont’s law requires board rulemaking on training standards, drug exclusions and enforcement. (legiscan.com) (apaservices.org 1) (apaservices.org 2)