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November 19, 1997

Role of the Nurse Practitioner in Mental Health Services-Reply

Author Affiliations

Case Western Reserve University Cleveland, Ohio

JAMA. 1997;278(19):1571-1572. doi:10.1001/jama.1997.03550190035036

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Ms Casson states that nurse practitioners are an important part of the mental health team and that they work, as she says, "in a collaborative agreement with a psychiatrist." Treatment teams of clinicians have augmented the effectiveness of services for many populations, including the underserved, often treatment-resistant mentally ill and chemically dependent.

While advanced practice nurse practitioners are licensed to offer defined services independently in many but not all states, according to 1997 testimony of the Psychiatric Advanced Practice Nurses of Maryland (Maryland House Environment Committee, March 4, 1997), 8 states give psychiatric nurses independent prescribing authority. Many advanced practice nurse practitioners are proficient and provide valuable service in obtaining medical history and in practical counseling skills. However, only a physician's medical education and clinical training qualify a mental health professional to carry out a "comprehensive medical differential diagnosis and evaluation" and to prescribe medication without special restrictions. The psychiatrist can