Ep. 13: Prescriptive Authority (Finally!) Comes to Hawaii

Recorded on-location in Washington, DC, this episode of Psychopharmacology Today features Dr. George Kapalka, joined by Dr. Judi Steinman and Dr. Jim Phelps, to discuss Hawaii’s newly enacted prescriptive authority pilot program for appropriately trained prescribing psychologists. After decades of advocacy, Hawaii has become the ninth state to authorize prescribing psychologists, with the three-year pilot focused on federally qualified health centers on Kauai and Hawaii Island—areas with particularly limited access to psychiatric prescribers.

The conversation explores how prescribing psychologists could help address nationwide mental-health workforce shortages and complement primary care providers who are increasingly called upon to manage psychiatric medications. The guests discuss the importance of combining psychological assessment, psychotherapy, and psychopharmacology training, particularly when evaluating complex presentations such as bipolar disorder that may be overlooked when antidepressants become the default treatment. They also consider the evidence and practical experience surrounding prescribing psychologists, the potential benefits of psychopharmacology training even in states without prescriptive authority, and the remaining challenges—including Hawaii’s current age restrictions and the need to expand access to children and older adults.