Monitor - September 2014

46 MONITOR ON PSYCHOLOGY • SEPTEMBER 2014
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res e r v a t i o n How prescribing psychologists are improving access to care at one Indian Health Service facility. BY REBECCA A. CLAY Before prescribing psychology came to the Crow and Northern Cheyenne Reservations of Montana, it wasn’t always easy for the Native Americans who live there to get the psychotropics they needed. For one thing, “Montana winters make for difficult ransportation,” says Earl B.H. Sutherland Jr., PhD, behavioral health director at the Crow/Northern Cheyenne Indian Health Service Hospital. Also, many residents are so poor they often had to choose between buying food or paying for gas to get o an appointment with a psychiatrist. The alternative was to see their primary-care providers, who didn’t necessarily have the time or expertise to prescribe psychotropic medication appropriately. The result? People living with bad side effects or going off their medications altogether. “It was very easy for patients to fall between the cracks,” says Sutherland. Things are different now. Since 2012, Sutherland has been able to prescribe medications himself. He has also recruited two ther prescribing psychologists, making the Crow/Northern Cheyenne Hospital unusually well-equipped. In addition to providing psychotherapy and other traditional psychological services, these psychologists prescribe medications for depression, anxiety and serious mental illness. They also continuously reassess patients to make sure they’re not on medications they don’t need. And they work with primary-care providers at the hospital — which includes a primary-care clinic, emergency room and inpatient unit — to treat such physical concerns as diabetes, dementia and chronic pain. The care these psychologists provide has been life changing, says Sutherland. One patient with serious mental