Why the Proposed Prescribing Role for Psychologists Matters: Implications for Ontario’s Mental Health Landscape
Ontario’s mental health system is facing unprecedented pressure, with rising demand and long wait lists for care. In 2024, the Canadian Mental Health Association reported that more than one million Ontarians experienced a mental-health or addiction challenge in a single year, and its branches served over 120,000 people (ontario.cmha.ca). The Canadian Institute for Health Information found that half of those seeking community mental-health counselling wait about a month, while 10 percent wait as long as five months (cihi.ca). These delays persist even though Ontario’s psychotherapy workforce is highly trained and tightly regulated: under CRPO standards, Registered Psychotherapist (Qualifying) registrants must complete 100 hours of clinical supervision and 450 direct-client-contact hours, and fully registered RPs must continue receiving supervision until they reach 1,000 client hours and 150 supervision hours (crpo.ca). Against this backdrop of unmet need and rigorous professional standards, the province’s proposal to expand psychologists’ scope of practice has sparked renewed discussion about how best to improve access to timely, effective care.
The Proposal: A New Prescribing Role for Psychologists
In September 2025 the Ontario Ministry of Health launched a public consultation to expand psychologists’ scope of practice. The College of Psychologists and Behaviour Analysts of Ontario (CPBAO) summarised that psychologists with a post‑doctoral Master of Science in Clinical Psychopharmacology (MSCP) could be authorised to prescribe certain psychotropic medications (e.g., antidepressants), order and interpret laboratory tests (such as blood work or electrocardiograms), and would be expected to collaborate with primary‑care providers (cpbao.ca.) These privileges would only apply to practitioners who complete the additional psychopharmacology degree and training. The consultation period runs until 3 November 2025, and the changes are not yet law (cpbao.ca.)
Goals and Rationale
The government framed the proposal as part of a broader initiative to improve access and reduce pressure on family doctors and emergency departments. In a news release, officials said that allowing psychologists to prescribe would integrate therapy and medication management and could relieve pressure on an over‑stretched system (lauriescottmpp.com.) Richard Morrison, CEO of the Ontario Psychological Association (OPA), hailed the move as a “milestone” that could expand access, reduce delays and foster collaboration with family physicians; he added that the ability to adjust or de‑prescribe medication while providing psychotherapy would allow clients to receive comprehensive care (lauriescottmpp.com.) Tony DeBono, Registrar of the CPBAO, remarked that expanding the scope of practice for psychologists with specialised training could improve access to mental‑health services and that the college is prepared to develop regulatory infrastructure to ensure safe practice (lauriescottmpp.com.)
Potential Benefits: Access and Integrated Care
Bridging Medication and Therapy
Currently, clients often navigate separate pathways for care: physicians or psychiatrists prescribe medication, while psychologists and Registered Psychotherapists provide psychotherapy—RPs doing so under the clinical supervision and regulatory oversight of the College of Registered Psychotherapists of Ontario (CRPO). Integrated care—where one practitioner can both prescribe and provide psychotherapy—may reduce the fragmentation that clients experience. Advocates argue that psychologists are uniquely positioned because they have doctoral‑level training in assessment and therapy but currently cannot adjust medications. The proposed role would allow psychologists with an MSCP to monitor medication effects and adjust dosages while maintaining therapeutic continuity, potentially reducing referral delays and miscommunication (lauriescottmpp.com.)
Addressing Wait Times
Advocates also link prescribing authority to improved access. Ontario faces long waits for psychiatrists; adding prescribing psychologists could increase the pool of prescribers. By integrating therapy and medication management, psychologists could free up psychiatrists to focus on more complex cases while reducing delays for individuals with depression or anxiety (lauriescottmpp.com.) For Registered Psychotherapists, partnering with prescribing psychologists might streamline care. Under CRPO supervision, RPs often refer clients to physicians for medication; a psychologist within the same practice who can prescribe may shorten wait times and improve collaboration.
Leveraging Psychologists’ Training
Proponents emphasise that prescribing privileges would only be granted after completing an MSCP and supervised practice, not to all psychologists. In U.S. jurisdictions where psychologists already prescribe, training includes a doctoral degree (PhD or PsyD), a two‑year Master of Science in Clinical Psychopharmacology, supervised clinical practice and a national psychopharmacology exam (pharmacytimes.com.) Legislation in states such as New Mexico (2002), Louisiana (2004), Illinois (2014), Iowa (2016), Idaho (2017), Colorado (2023) and Utah (2024) requires collaboration with physicians and emphasises safe practice (apaservices.org.) These precedents suggest that with rigorous training and oversight, prescribing psychologists can integrate medication management into therapy, particularly in underserved areas (pharmacytimes.com.)
Major Risks and Concerns: Patient Safety and Professional Boundaries
Safety and Diagnostic Complexity
Critics caution that prescriptive authority requires medical expertise beyond most psychologists’ training. The Ontario Psychiatric Association (OPA) observed that the government’s proposal to have professionals without medical training prescribe psychiatric medications and interpret investigations came without consulting psychiatrists (eopa.ca.) The OPA emphasised that independent psychiatric practice requires eight to nine years of training to differentiate between medical and psychiatric diagnoses, understand pharmacokinetics and pharmacodynamics, manage medical comorbidity, conduct physical examinations and interpret tests (eopa.ca.) They warned that shifting prescribing to non‑physicians could introduce risks into an already fragmented system (eopa.ca.) Similarly, the Ontario Medical Association’s president, Dr. Zainab Abdurrahman, cautioned that delegating responsibilities to less‑trained professionals might be unsafe because minor ailments may signal serious diseases; she argued that physicians’ extensive training is essential for safe prescribing (manitoulin.com.)
Inter‑Professional Tension and Oversight
Psychiatrists and physicians are concerned that expanding scopes without comprehensive system planning could create care by patchwork (manitoulin.com.) Psychologists would need clear guidelines about collaborating with physicians, referring complex cases and updating CRPO clinical supervisors. The College of Registered Psychotherapists of Ontario (CRPO) defines clinical supervision as a relationship that promotes professional growth and safeguards client well‑being (crpo.ca.) If psychologists can prescribe, clinical supervisors of RPs may need training on medication management to ensure that supervisees understand when to refer to a prescribing psychologist versus a physician.
Lowering Training Standards at the Wrong Time
Some professional bodies argue that the timing is problematic. A joint letter by the Canadian Psychological Association and the Ontario Psychological Association noted that the government is simultaneously consulting on prescriptive authority and on reducing the training requirements for psychologists, cautioning that “now is not the time” to lower standards because doing so could risk public safety and erode the quality of care (cpa.ca.) If training requirements are shortened while prescribing authority is expanded, regulators like the CRPO supervisor may be pressed to oversee practitioners with divergent competencies.
Historical Precedents: Lessons from the United States
Jurisdictions in the United States provide insight into how prescriptive authority for psychologists can unfold. New Mexico became the first state to grant prescribing authority in 2002, followed by Louisiana (2004), Illinois (2014), Iowa (2016), Idaho (2017), Colorado (2023) and Utah (2024) (apaservices.org.) Psychologists in these states must hold a doctoral degree, complete the MSCP, acquire supervised experience and pass the Psychopharmacology Examination for Psychologists (pharmacytimes.com.) These laws often require collaborative agreements with physicians, and prescribing is limited to psychotropic medications. Proponents argue that rural and underserved areas benefit because psychologists can offer comprehensive care where psychiatrists are scarce (pharmacytimes.com.) However, major medical organisations such as the American Medical Association and the American Psychiatric Association continue to express concerns about patient safety and the complexity of psychiatric cases (pharmacytimes.com.)
Implications for CRPO Supervision and Registered Psychotherapists
Changes to Referral Patterns
If prescribing psychologists become available in Ontario, Registered Psychotherapists may collaborate more directly with them. Under current CRPO supervision requirements, RPs must demonstrate safe and effective use of self in therapy (crpo.ca) and accumulate extensive direct‑client‑contact and supervision hours (crpo.ca.) Because RPs cannot prescribe, they currently refer clients to physicians for medication; the availability of psychologists who can both treat and prescribe may shorten the referral chain. This could benefit clients by reducing wait times and improving continuity of care.
Supervisory Challenges and Opportunities
CRPO clinical supervisors will need to develop competence in collaborating with prescribing psychologists. Supervisors may have to ensure that supervisees understand when to consult a prescribing psychologist versus a psychiatrist, how to monitor medication effects ethically and how to manage dual‑role relationships. The CRPO’s definition of clinical supervision emphasises safeguarding client well‑being and promoting professional growth (crpo.ca;) these responsibilities will extend to understanding medication management. For psychologists seeking prescribing privileges, the CPBAO will likely develop regulatory guidelines and continuing education requirements (lauriescottmpp.com;) supervisors will need to keep abreast of these standards when overseeing RPs who work alongside prescribing psychologists.
Interprofessional Collaboration
The proposal may encourage closer collaboration between psychologists, psychotherapists, physicians and nurses. Integrated care teams could include RPs providing therapy, psychologists managing both therapy and medication for moderate conditions, and psychiatrists focusing on complex or treatment‑resistant cases. For this to work, clear communication channels and respect for each profession’s scope of practice are essential. Supervisors should mentor RPs to work effectively within such teams and to understand the limits of their competency.
Staying Current with CRPO Updates
Navigating these changes requires therapists and supervisors to stay abreast of regulatory updates. OntarioSupervision.ca’s blog Staying Up‑to‑Date With CRPO: What Therapists Need to Know (Fall 2025) offers a practical digest of recent CRPO communications. The post emphasises that keeping up with regulatory updates isn’t optional—it is central to providing ethical care and meeting obligations as a group clinical supervisor (ontariosupervision.ca.) For more details on registration exam changes, practice guidance and supervision standards, see Staying Up‑to‑Date With CRPO: What Therapists Need to Know (Fall 2025). Reviewing such resources can help CRPO supervisors and supervisees integrate new guidance into their practice.
Consultation Process and What Therapists Should Do
The Ministry of Health’s consultation closes on 3 November 2025 (cpbao.ca.) Therapists, supervisors and other stakeholders can submit feedback through the Regulatory Registry. Given the potential impact on practice and client safety, Registered Psychotherapists and CRPO supervisors should review the proposal, discuss it within supervision sessions and provide informed comments. The OPA statement urges the government to consult psychiatrists and physicians (eopa.ca;) similarly, psychotherapists should advocate for policies that improve access without compromising safety. Even if the changes are adopted, the details—such as training standards, formulary limits, collaboration requirements and oversight—will be shaped by stakeholder input.
Conclusion: Towards a Balanced Mental‑Health System
Ontario’s proposal to grant prescribing authority to psychologists marks a significant moment in the province’s mental‑health policy. Proponents see it as a way to integrate care, reduce wait times and empower psychologists to deliver more comprehensive treatment (lauriescottmpp.com.) Critics warn of patient‑safety risks, interprofessional conflict and a patchwork system (eopa.camanitoulin.com.) Historical precedents from the United States suggest that with rigorous training, collaborative agreements and robust oversight, prescribing psychologists can contribute meaningfully to mental‑health care (apaservices.orgpharmacytimes.com.)
For Registered Psychotherapists and their CRPO supervisors, the proposed change could reshape referral pathways and collaboration models. It underscores the importance of ongoing supervision, continuing education and advocacy. As the consultation proceeds, therapists should engage in the discussion to ensure that any expansion of scope enhances access while maintaining the highest standards of safety and competency.
References
Canadian Institute for Health Information. (2024). Wait times for community mental health counselling. https://www.cihi.ca cihi.ca.
Canadian Mental Health Association – Ontario. (2025). CMHA Ontario deeply grateful for 2025 budget investments for community mental health and addictions care. https://ontario.cmha.ca ontario.cmha.ca.
College of Psychologists and Behaviour Analysts of Ontario. (2025). Ministry of Health consultations on proposed changes to certain psychologists’ scope of practice to advance access to certain mental health services in Ontario. https://cpbao.ca cpbao.ca.
College of Registered Psychotherapists of Ontario. (2025a). Clinical supervision requirements. https://www.crpo.ca crpo.ca.
College of Registered Psychotherapists of Ontario. (2025b). Clinical supervision definition. https://www.crpo.ca crpo.ca.
Manitoulin Expositor. (2025). As Ontario expands front‑line powers, critics warn of “care by patchwork”. https://www.manitoulin.com manitoulin.com.
Ontario Medical Association & Ontario Psychiatric Association. (2025). OPA statement on government proposals to expand health‑care scopes of practice. https://eopa.ca/news-updates eopa.ca.
Ontario Ministry of Health (via John Jordan, MPP). (2025). Ontario taking next steps to improve health‑care access [News release]. https://news.ontario.ca lauriescottmpp.com.
Pharmacy Times. (2024). States grant prescribing authority to psychologists. https://www.pharmacytimes.com pharmacytimes.com.
Pope, D., & American Psychological Association. (2023). RxP: A chronology. https://www.apa.org apaservices.org.
Richard Morrison (CEO of OPA). (2025). Quoted in Ontario taking next steps to improve health‑care access [News release]. https://news.ontario.ca lauriescottmpp.com.
Tony DeBono (Registrar, CPBAO). (2025). Quoted in Ontario taking next steps to improve health‑care access [News release]. https://news.ontario.ca lauriescottmpp.com.
Zainab Abdurrahman (President, Ontario Medical Association). (2025). Quoted in As Ontario expands front‑line powers, critics warn of “care by patchwork”. https://www.manitoulin.com manitoulin.com.
OntarioSupervision.ca (2025, September 6). Staying Up‑to‑Date With CRPO: What Therapists Need to Know (Fall 2025). Ontario Supervision. https://www.ontariosupervision.ca/blog/staying-uptodate-with-crpo-what-therapists-need-to-know-fallnbsp2025 ontariosupervision.ca.
