IDEAS home Printed from https://ideas.repec.org/a/bla/coecpo/v43y2025i1p116-134.html

Supply of mental health practices after prescriptive authority expansion for psychologists

Author

Listed:
  • Angela Shoulders
  • Alicia Plemmons

Abstract

The prescription‐privileges movement has advocated for state laws enabling trained psychologists to prescribe psychotropic medication. We examine the impact of these laws on healthcare access and outcomes. Using staggered difference‐in‐differences analysis and Data Axle data, we estimate the number of new mental health establishments per 100,000 people after policy implementation. Using CDC data, we analyze the policy's impact on suicide rates. We find the policy increased the number of psychology and counseling practices without decreasing the number of psychiatric practices, implying that these practices are complements rather than substitutes. Quality held steady, with no notable change in the suicide rate.

Suggested Citation

  • Angela Shoulders & Alicia Plemmons, 2025. "Supply of mental health practices after prescriptive authority expansion for psychologists," Contemporary Economic Policy, Western Economic Association International, vol. 43(1), pages 116-134, January.
  • Handle: RePEc:bla:coecpo:v:43:y:2025:i:1:p:116-134
    DOI: 10.1111/coep.12643
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/coep.12643
    Download Restriction: no

    File URL: https://libkey.io/10.1111/coep.12643?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Timmons, Edward Joseph, 2017. "The effects of expanded nurse practitioner and physician assistant scope of practice on the cost of Medicaid patient care," Health Policy, Elsevier, vol. 121(2), pages 189-196.
    2. Roy Choudhury, Agnitra & Plemmons, Alicia, 2023. "Effects of giving psychologists prescriptive authority: Evidence from a natural experiment in the United States," Health Policy, Elsevier, vol. 134(C).
    3. Shishir Shakya & Alicia Plemmons, 2020. "Does Scope of Practice Affect Mobility of Nurse Practitioners Serving Medicare Beneficiaries?," Journal of Labor Research, Springer, vol. 41(4), pages 421-434, December.
    4. Markowitz, Sara & Adams, E. Kathleen & Lewitt, Mary Jane & Dunlop, Anne L., 2017. "Competitive effects of scope of practice restrictions: Public health or public harm?," Journal of Health Economics, Elsevier, vol. 55(C), pages 201-218.
    5. Xifeng Lu & Haijing Yu & Biaoan Shan, 2022. "Relationship between Employee Mental Health and Job Performance: Mediation Role of Innovative Behavior and Work Engagement," IJERPH, MDPI, vol. 19(11), pages 1-12, May.
    6. Alexander, Diane & Schnell, Molly, 2019. "Just what the nurse practitioner ordered: Independent prescriptive authority and population mental health," Journal of Health Economics, Elsevier, vol. 66(C), pages 145-162.
    7. Morris M. Kleiner & Allison Marier & Kyoung Won Park & Coady Wing, 2016. "Relaxing Occupational Licensing Requirements: Analyzing Wages and Prices for a Medical Service," Journal of Law and Economics, University of Chicago Press, vol. 59(2), pages 261-291.
    8. Law, Marc T. & Kim, Sukkoo, 2005. "Specialization and Regulation: The Rise of Professionals and the Emergence of Occupational Licensing Regulation," The Journal of Economic History, Cambridge University Press, vol. 65(3), pages 723-756, September.
    9. Paul E. Greenberg & Andree-Anne Fournier & Tammy Sisitsky & Mark Simes & Richard Berman & Sarah H. Koenigsberg & Ronald C. Kessler, 2021. "The Economic Burden of Adults with Major Depressive Disorder in the United States (2010 and 2018)," PharmacoEconomics, Springer, vol. 39(6), pages 653-665, June.
    10. Patricia Pittman & Benjamin Williams, 2012. "Physician Wages in States with Expanded APRN Scope of Practice," Nursing Research and Practice, Hindawi, vol. 2012, pages 1-5, February.
    11. Fletcher Jason, 2009. "All in the Family: Mental Health Spillover Effects between Working Spouses," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 9(1), pages 1-21, February.
    12. Stange, Kevin, 2014. "How does provider supply and regulation influence health care markets? Evidence from nurse practitioners and physician assistants," Journal of Health Economics, Elsevier, vol. 33(C), pages 1-27.
    13. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    14. Traczynski, Jeffrey & Udalova, Victoria, 2018. "Nurse practitioner independence, health care utilization, and health outcomes," Journal of Health Economics, Elsevier, vol. 58(C), pages 90-109.
    15. Ayyagari, Padmaja & Shane, Dan M., 2015. "Does prescription drug coverage improve mental health? Evidence from Medicare Part D," Journal of Health Economics, Elsevier, vol. 41(C), pages 46-58.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. McMichael, Benjamin J., 2025. "The impact of nurse practitioner scope-of-practice laws on preventable hospitalizations," Journal of Health Economics, Elsevier, vol. 103(C).
    2. Moiz Bhai & David T. Mitchell, 2025. "New evidence on the labor market effects of scope of practice laws for physicians and nurse practitioners," Contemporary Economic Policy, Western Economic Association International, vol. 43(1), pages 31-51, January.
    3. Benjamin J. McMichael, 2025. "Scope‐of‐practice laws and the practice patterns of nurse practitioners and physician assistants," Contemporary Economic Policy, Western Economic Association International, vol. 43(1), pages 9-30, January.
    4. Kihwan Bae & Edward Timmons & Protik Nandy, 2025. "Seeing is believing: The effects of optometrist scope of practice expansion," Contemporary Economic Policy, Western Economic Association International, vol. 43(1), pages 135-160, January.
    5. Sukriti Beniwal & Lauren Hoehn‐Velasco & Diana R. Jolles, 2026. "Public health insurance expansions and non‐physician providers: Evidence from Certified Nurse Midwives," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 45(2), March.
    6. Shishir Shakya & Alicia Plemmons & Kihwan Bae & Edward Timmons, 2025. "The pharmacist will see you now: Pharmacist prescriptive authority and access to care," Contemporary Economic Policy, Western Economic Association International, vol. 43(1), pages 161-174, January.
    7. Hoehn-Velasco, Lauren & Jolles, Diana R. & Plemmons, Alicia & Silverio-Murillo, Adan, 2023. "Health outcomes and provider choice under full practice authority for certified nurse-midwives," Journal of Health Economics, Elsevier, vol. 92(C).
    8. Shishir Shakya & Alicia Plemmons, 2025. "Scope of practice and opioid prescribing behavior of nurse practitioners serving Medicare beneficiaries," Health Economics, John Wiley & Sons, Ltd., vol. 34(2), pages 225-245, February.
    9. Moiz Bhai & David T. Mitchell, 2024. "The effects of occupational licensing reform for nurse practitioners on children's health," Southern Economic Journal, John Wiley & Sons, vol. 91(1), pages 62-91, July.
    10. Laura Barrie Smith, 2022. "The effect of nurse practitioner scope of practice laws on primary care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 21-41, January.
    11. Sara Markowitz & E. Kathleen Adams, 2022. "The Effects of State Scope of Practice Laws on the Labor Supply of Advanced Practice Registered Nurses," American Journal of Health Economics, University of Chicago Press, vol. 8(1), pages 65-98.
    12. Guo, Jiapei & Kilby, Angela E. & Marks, Mindy S., 2024. "The impact of scope-of-practice restrictions on access to medical care," Journal of Health Economics, Elsevier, vol. 94(C).
    13. Tianyuan Luo & Cesar L. Escalante & Carmina E. Taylor, 2021. "Labor market outcomes of granting full professional independence to nurse practitioners," Journal of Regulatory Economics, Springer, vol. 60(1), pages 22-54, August.
    14. Dustin Chambers & Colin O’Reilly, 2022. "The economic theory of regulation and inequality," Public Choice, Springer, vol. 193(1), pages 63-78, October.
    15. Grossman, Daniel & Ray, Arijit & Wadsworth, Allyssa, 2025. "The pharmacist will see you now: Pharmacist prescribed contraceptives and fertility rates," Journal of Health Economics, Elsevier, vol. 100(C).
    16. Jie Chen & Chad D. Meyerhoefer & Edward J. Timmons, 2024. "The effects of dental hygienist autonomy on dental care utilization," Health Economics, John Wiley & Sons, Ltd., vol. 33(8), pages 1726-1747, August.
    17. Andrew J. D. Smith & Sara Markowitz, 2025. "Nurse practitioner oversight ratios and labor market outcomes," Contemporary Economic Policy, Western Economic Association International, vol. 43(1), pages 52-78, January.
    18. Shishir Shakya & Alicia Plemmons, 2020. "Does Scope of Practice Affect Mobility of Nurse Practitioners Serving Medicare Beneficiaries?," Journal of Labor Research, Springer, vol. 41(4), pages 421-434, December.
    19. Owen Fleming & Lilly Springer, 2026. "Nurse practitioner scope of practice law and safety net participation: Evidence from WIC," Contemporary Economic Policy, Western Economic Association International, vol. 44(3), pages 634-655, July.
    20. Kamyar Nasseh & John R. Bowblis & Coady Wing, 2024. "How do dental practices respond to changes in scope of practice regulations?," Health Economics, John Wiley & Sons, Ltd., vol. 33(11), pages 2508-2524, November.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:coecpo:v:43:y:2025:i:1:p:116-134. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: https://edirc.repec.org/data/weaaaea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.