A bill that would grant psychologists the authority to prescribe an array of antidepressants is well intentioned, but it's not the right solution.

At the heart of the matter is a prudent concern over patient safety in prescribing these drugs: Psychologists are not medical doctors and lack the more rigorous training a qualified physician, a psychiatrist in particular, would provide.

While both psychiatrists and psychologists deal with mental health, the difference in their training is significant. Psychiatrists are medical doctors with knowledge and expertise in administering the proper drugs to treat medical problems; psychologists are not doctors of medicine, and are not required to have medical training, including training in prescribing medication.

House Bill 2589 tries to make the case for psychologists by targeting a real need in Hawai'i — the serious shortage of psychiatrists to provide mental healthcare, especially on the Neighbor Islands and in rural and poor communities in the state.

The bill would allow psychologists who meet stringent educational and training requirements to prescribe drugs for treatment. A psychologist would need an advanced academic degree, five years of experience as a licensed psychologist, and a post-doctoral master's degree in clinical psychopharmacology.

All of this is substantial. But the standard is still well below that of the rigorous medical education of a doctor of psychiatry, and even below that of a nurse practitioner, thus raising issues of safety.

The bill also requires a psychologist's prescription be given in consultation with a physician, most likely the patient's own doctor. That's a step in the right direction. But ideally, the consulting doctor should be a psychiatrist.

If the real objective is to provide greater mental health services for the Neighbor Islands and rural communities, that can easily be done by expanding the consultation idea. Community health clinics should seek agreements with a team of psychiatrists for regular on-call teleconferencing to meet clinic demand.

Our health professionals can ease the larger problem of adequate access to healthcare by collaborating and putting public health first. That means psychiatrists, who have been opposed to the bill from the start, must step up to the plate and be part of the solution. Psychiatrists and psychologists working together to solve this crisis is a much better solution than the bill before the Legislature.