Arizona psychologists offer to help end mental health crisis

By The National Psychologist Editor
November 1, 2004



The Arizona Psychological Association has intervened in a two-decades-old court case in an attempt to help solve the mental health crisis in Maricopa County, the state’s most populous and home to Phoenix.

In a letter to the judge overseeing the case, known as Arnold v. Sarn, Ellen W. Williams, Ph.D., president of the association, said many of the state’s nearly 1,200 active licensed psychologists could be used to alleviate the shortages of mental health providers cited in a Court Monitor’s Report recently.

The Court Monitor reported that mental health services for indigents in the Arizona Health Care Cost Containment System (AHCCCS) continue to deteriorate despite court orders issued as long ago as 1981 to take steps to insure mentally ill people receive care.

“Our primary concern with the Review is that it recognizes the shortage of health care providers, but fails to consider filling that gap with the state’s available pool of psychologists — professionals with training and background well suited to the needs of AHCCCS,” Williams wrote.

Jack Wiggins, Ph.D., a Maricopa County resident and a former president of the American Psychological Association, said bachelor and master level counselors have frozen psychologists in Arizona out of the market. He said Ph.D. psychologists in their one-year postdoctoral training have not been employed at salaries received by master level counselors.

The Court Monitor said that only 10 percent of the priority clients had an appropriate “clinical team” serving the patient of a psychiatrist, registered nurse and case manager. The report said a psychiatrist was missing in 34 percent of the cases and a registered nurse was missing in 46 percent of the cases.

Williams said that, “Despite these identified shortages, the Review fails to consider the option of utilizing Arizona’s highly qualified pool of available licensed psychologists to alleviate the shortages and expand the network.”

Noting that the Court Monitor may have overlooked the option of utilizing psychologists because of AHCCCS’ heavy reliance on psychotropic medications to treat mental illness, Williams said several studies have reported that a combination of drugs and talk therapy was more effective than when either was used alone. She also noted that many Arizona psychologists have acquired psychopharmacology training, which requires extensive postdoctoral education and training.

During a court hearing in early October, Judge Bernard Dougherty expressed his displeasure at the state’s failure to fix Maricopa County’s broken mental health service delivery system. He was also critical of ValueOptions, which has received millions of dollars to provide mental health services to around 50,000 clients.

Judge Dougherty ordered the state to improve services at five clinics and to report back to him in December with detailed plans on how it will comply with court orders to improve mental health services to the poor

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