March 18, 2024
Phil Hughes, Ph.D. candidate in the Division of Pharmaceutical Outcomes and Policy at the UNC Eshelman School of Pharmacy, is conducting research that is actively used in policy discussions.
Hughes’ research was sparked by the growing mental health crisis in the U.S. and the need for additional mental health prescribers. In the early 90s, the Department of Defense began allowing psychologists with specialized training to prescribe medications.
In the years since, six states passed laws to allow psychologists to become licensed prescribers in their states and more states considering the similar laws. Hughes noticed that there was little research done on this policy’s impact and has sought to address this knowledge gap to provide policymakers with the information they need to craft evidence-based policy.
“I got into substance use policy and circled back to this idea that there’s a lack of access to health care resources for substance use treatment and mental health,” he said. “As I started digging into that, one of the things that kept coming up was the severe shortage of psychiatrists, so there’s a clear public health need for additional mental health prescribers.”
Hughes shared that currently, nearly 60% of mental health prescribing is being done through primary care physicians, but that’s not their expertise.
“I was interested in prescriptive authority for psychologists as a way to bridge the gap between people who are primarily trained in prescribing and people who are trained in mental health,” he said.
Hughes has published seven articles on the topic. His first study showed that deaths related to mental health, such as suicides, decreased in New Mexico and Louisiana, the first two state to pass these laws, when psychologists began prescribing. Another one of his studies shows that this policy would likely be cost-effective for reducing suicides, saving more than $12 million per 100,000 people over 20 years.
As a result of his work, he has been asked to testify in Pennsylvania, Washington and Hawaii regarding their prescribing psychology bills. His work has been used in support of similar bills in Arizona, Utah and Florida. Utah recently passed this bill and will become the seventh state to implement this policy.
Hughes defended his dissertation on March 11 and is most proud of the immediate policy relevance of his work and the potential to improve population mental health. In the future, he hopes to become a faculty member in health policy and management.
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