Two additional types of mental health professionals may soon be able to treat psychotic disorders, including schizophrenia, should the Legislature approve a bill put forward by a state licensing board.
The legislation, sponsored by the Board of Examiners for Marriage and Family Therapists (MFTs) and Clinical Professional Counselors (CPCs), would remove a restriction in state law barring the two categories of therapists from treating psychotic disorders. Jake Wiskerchen, the board’s president, believes that the legislation will allow Nevada to expand its mental health workforce and meet a demand for mental health professionals able to treat the state’s most seriously mentally ill.
Wiskerchen said that Nevada is the only state that does not currently allow MFTs and CPCs to treat psychotic disorders, work that currently falls to clinical social workers and psychologists. He said that the ability to treat psychotic disorders is more a matter of competence than licensure and that therapists trained to treat psychotic disorders should be able to do so.
“We’re required to be competent in whatever it is we endeavor, whether it’s geriatric care, adolescents, children, toddlers, eating disorders. We want to be competent in it,” Wiskerchen said. “Treating psychotic disorders is just another scope of competence in which you want to make sure you have adequately trained and prepared yourself.”
He said that allowing MFTs and CPCs to treat psychotic disorders may help the state’s mental health agencies, which are currently limited to hiring clinical social workers and psychologists for that work, meet their staffing needs. Most of the mental health agencies have reported ongoing staffing shortages.
“If we actually add that competency back into the license, what we’ll do is we’ll give everyone a bigger applicant pool to treat these folks with psychotic disorders,” Wiskerchen said.
He added that the board is not interested in adding psychometric assessment testing, used to measure an individual’s intelligence, personality, aptitudes, interests or addictions, to the MFT and CPC scope of practice.
The legislation also proposes to allow clinical professional counselors to treat couples and families without limitation. Existing law allows the licensing board to set limits on whether a CPC has demonstrated competency through education, training and experience to treat couples and families, something that in practice meant that CPCs effectively had to become MFTs, Wiskerchen said. The board repealed a related regulation this summer and is now asking lawmakers to remove that authority from the board in order to preserve the ability of CPCs to treat couples and families moving forward.
The legislation would make a number of other smaller changes, including lowering the number of marriage and family therapists on the board and raising the number of public members, changing licenses from annual to biennial, clarifying that the board can use the money it collects to pay employees, and increasing fees paid to the board for licenses and renewals.
Morgan Gleich, executive director of the Board of Psychological Examiners, said in an email that the board has yet to take an official stance on any proposed bills for the upcoming session but that board members are “committed to working in the public’s interest through genuine collaboration with our Clinical Counseling and MFT colleagues.”
Dr. Jordan Soper, secretary of the Nevada Psychological Association, said in an email that psychologists have expressed some concerns about the bill as it relates to the diagnosis of psychosis as well as psychometric testing. She said the association is monitoring the legislation closely, but that the psychological community’s formal response will come from the Board of Psychological Examiners.
“NPA believes it is crucial for the healthcare community to work together to address the mental health crisis in our state,” Soper added. “To that end, NPA supports the MFT-CPC efforts to ensure access to treatment by licensed, qualified, and well-trained providers.”
Wiskerchen is hopeful that the changes, should they be approved by the Legislature, will help the state recruit and retain therapists. He said he has heard anecdotally from both public and private agencies that they face ongoing difficulties recruiting because of the limits placed on mental health professionals.
“There’s no reason to stay if somebody gets a job dangled in front of them in a different area. If that’s your thing and that’s your wheelhouse and you can’t do it here, of course you’re going to leave, not only with the psychotic disorders but the couples and family language,” Wiskerchen said. “That really hurt in recruitment.”