Prescribing psychotropic drugs: whose responsibility?

Through the use of a questionnaire it has been ascertained that a significant number of second-year graduate school social work students at the Columbia University School of Social Work are called upon to monitor and dispense psychotrophic drugs in various placements where they receive their practical clinical training. In some instances they may even fill out prescription blanks that are signed by psychiatrists who do not have the time to see the patients personally. This situation not only represents the abdication of medical responsibility, frequently leaving non-medical personnel with functions beyond their training and professional competence, but also raises important ethical and legal problems. Non-medical professionals in mental health settings should receive appropriate instruction in the essentials of psychopharmacology. Such training should not be left to chance as apparently is the case now. Non-medically trained members of the mental health team, if properly instructed, could cooperate more effectively with the psychiatrists who must in any event retain primary responsibility for pharmacotherapy.