Andrew, the University of Florida Department of Clinical and Health Psychology established a rural health psychology internship track in 1995 (Rural health psychology specialty, University of Florida, 2000). Faculty and interns from this program have helped train cooperative extension agents in rural areas outside of Florida to deal with provision of mental health services following natural disasters. Current Issues
Three issues concerning the scope of practice of clinical psychologists have surfaced in the states in recent years. Psychologists have attempted (thus far in vain) to obtain independent rights to prescribe medications related to the treatment of mental health problems. In part, the argument in favor of this development is based on the higher penetration of psychologists in rural areas where their ability to prescribe medication would enhance overall access to mental health services. This is particularly the case in those rural communities where the only clinicians with prescriptive rights are family practice physicians who lack comprehensive training in psychopharmacology. The psychiatric profession, arguing that psychologists lack the necessary training in human physiology and pharmacology, has actively opposed this effort (American Psychiatric Association, 2000b). In spite of the fact that the APA’s Council of Representatives voted to support prescriptive rights in 1995, some members of the profession of psychology have also not favored this development. They are especially concerned that such a move would undermine the fundamental distinction between the approaches to treating mental illness taken by psychology and psychiatry (Ax, Forbes, & Thompson, 1997).
Another scope of practice issue of concern is the right of psychologists to admit persons with severe mental illness to inpatient hospital care and to attend those patients while they are hospitalized. As of 1996, 16 states and the District of Columbia had enacted laws allowing psychologists to exercise hospital admitting and attending privileges (Resnick & Morris, 1997). The American Psychiatric Association has opposed this effort, as well (American Psychiatric Association, 2000a).
A third issue of particular concern to rural states is the continued licensing of masters’ level psychologists. Hogan (1979) asserts that the APA has maintained and promulgated a strong commitment to the doctoral degree as the minimum requirement for licensed clinical psychologists as a strategy for assuring the credibility of the profession. Nevertheless, roughly 6.5 percent of the licensed psychologists identified in the psychology board survey mentioned above were trained only at the masters’ level (Robiner & Crew, 2000). This survey identified eight state boards that licensed masters’-level psychologists with some title that included the