Title: An Act to Increase Access to Mental Health Services

H.1801 (Rep. Kay Khan)

What this bill does:

This bill removes the current requirement that physicians supervise psychiatric nurse mental health clinical specialists when they write prescriptions and order tests and therapeutics.

Why this bill is needed:

  • Mental health disorders are prevalent in our society. Psychiatric and substance abuse disorders affect 1 in 4 adults (Reeves et. al., 2011) and 1 in 5 children (Mental Health, Life Stages and Determinants 2012) and account for more disability than any other group including cancer and cardiovascular disease (Reeves. et. al., 2011). For adults, 33% of medically unexplained somatic symptoms in outpatient settings are associated with depression and anxiety disorders (Kroenke, 2003), and 14% of adolescents in primary care are diagnosed with a mental health problem (Burnett-Ziegler et.al. , 2012).

  • Access to psychiatric treatment is more limited in certain geographic areas and among racial and ethnic minorities and lower income Americans. Only 13.4% of all U.S. adults and 51% of children with psychiatric or substance abuse disorders receive treatment (NIMH, 2012).

  • Psychiatric nurse mental health clinical specialists are professionally accountable, educated to practice independently, and have the potential to improve access to mental health care. Because there is a shortage of psychiatrists willing to supervise psychiatric nurse mental health clinical specialists, many patients, especially those who are in underserved populations, don’t have access to mental health services.

  • After 20 years of prescriptive practice, the knowledge and capabilities of psychiatric nurse mental health clinical specialists have significantly expanded, making the original law requiring physician supervision out of date and unnecessary. Studies show no different in prescribing practices between advanced practice psychiatric nurses and psychiatrists (Feldman, Bachman, Cuffel, Friesen and McCabe , 2003; Fisher and Vaughan-Cole, 2003) or no differences in patient adherence to treatment regimens (Jacobs, 2005).  
  • Fewer malpractice claims are associated with no direct physician supervision of nurse practitioners, including clinical nurse specialists (NSO Nurse Practitioner Survey, 2009).

Who are psychiatric nurse mental health clinical specialists?

  • They are registered nurses, educated at the masters level or above in the biological and psychological sciences, and authorized to practice as advanced practice nurses by the Mass. Board of Registration in Nursing.

  • They have sixty years of established role development, clinical effectiveness and regulatory expansion as established by state and national laws.

To read the entire Bill please click on this link. H1801 Fact Sheet-1