I submit that psychiatry is in crisis. Having psychologists write
prescriptions is not an economic issue. It is a travesty and a breach of
trust, and I suggest that we, the nation's psychiatrists, are responsible for
the breach. Let me explain: As psychiatrists, since the days of Benjamin Rush,
and later Pinel and Dorothea Dix, we have been given every chance to repair
the deterioriating conditions of patients' access to needed care. There was a
glimpse of hope in the early 1960s with leadership coming from President John
F. Kennedy— and not from the ranks of psychiatrists— in the form
of community psychiatry. We failed to do the right things back then. And we
failed to make care and access available to citizens. Now that the system is
finding an alternative way, as unethical, unacceptable, and outrageous as it
may be, it is really society's validation that psychiatry as a profession has
failed. Two states have passed laws allowing psychologists to write
prescriptions. If the domino theory has its way, the other 48 states will
follow. It is a matter of time!