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IMAGINE OPENING UP to someone about your most private fears, traumas, and insecurities–things you might never say aloud to your closest friends or family. Now, imagine being forced to abruptly stop speaking with that person, not because the relationship isn’t working, but simply because you moved out of state. For countless individuals receiving behavioral health care in Massachusetts, this is not a hypothetical. It is a painful and destabilizing reality.

That’s because under existing Massachusetts law, a psychologist must be licensed in Massachusetts, and the person receiving services must be in the state when services are provided. Yet residents leave the state routinely: people travel or move for work; children of divorced parents have households in two states; a military family is relocated.

In all of these cases and more, therapy must stop the moment the state border is crossed. The loss of a trusted therapist – someone who knows a patient’s history, struggles, and strengths – is more than an inconvenience. Continuity of care and the therapeutic relationship between psychologists and their patients is the foundation of safe and effective mental health treatment.

Fortunately, there is a solution to this problem. The Psychology Interjurisdictional Compact (PSYPACT) is an interstate agreement that allows licensed psychologists to obtain a credential to offer telehealth services across state borders. Forty-three states already participate, including every other state in New England except for Massachusetts. Legislation now pending on Beacon Hill would allow us to catch up with nearly every state in making this sensible adjustment to modern life.

By joining PSYPACT, Massachusetts residents would gain access to PSYPACT credentialed psychologists across these states. This broader pool of psychologists would increase the likelihood of someone finding a psychologist with clinical, linguistic, and/or cultural competence who could best meet their needs, providing more effective care. It would also allow psychologists to provide care to clients located in other PSYPACT states without forcing them to obtain and maintain dozens of separate licenses, maintaining continuity.

The consequences of interrupting treatment ripple far beyond emotional distress. Suicide is one of the leading causes of death among Massachusetts college students and young adults. In a highly mobile society – particularly in a state with over 250,000 college students – interrupting mental health care because someone crosses a border is not just impractical. It is dangerous.

The horrific shooting in December at Brown University tragically makes the case for PSYPACT. Many students quickly returned home after this traumatic event. Continuity of psychological care during such a challenging time is of utmost importance. Unfortunately, only those students with a PSYPACT credentialed psychologist who returned home to a PSYPACT state could have had seamless care. That opportunity did not exist for a student traveling back from Massachusetts.

Without PSYPACT, too many patients fall through the cracks. When ongoing care is suddenly severed, people in distress often suffer alone or turn to overburdened emergency departments where they frequently wait hours or days for psychiatric beds to become available. These delays are expensive, unsafe, and perilous for individuals in crisis. Others turn to unregulated and unlicensed “coaches” and chatbots for assistance, leaving them without the safeguards, oversight, and recourse that licensed care provides.

PSYPACT offers a straightforward, but rigorously regulated, solution to addressing these problems and increasing access to care. Psychologists who choose to apply to participate in PSYPACT must meet rigorous professional qualifications. These include holding a doctoral degree in psychology from an accredited program, possessing a full and unrestricted license to practice in their home state, and having a clean disciplinary record. Applicants must complete verified documentation of their education and experience and undertake annual continuing education in the ethical use of technology in psychological practice.

Although some might worry that joining PSYPACT opens up complicated legal issues, these fears are unfounded. Massachusetts psychologists who participate in PSYPACT could only practice within the legal scope of practice of the state in which the client is located, and those clients located in Massachusetts continue to be protected by our state’s laws, regardless of where the psychologist is located.

Psychologists can choose which and how many states to practice in to enable them to keep up with rules and regulations across states. Massachusetts psychologists who join PSYPACT would still enjoy the protections of our Shield Laws, in that the Commonwealth is not required to cooperate with out-of-state investigations or disciplinary actions, and the Massachusetts Board of Registration is not required to take action against the clinician’s Massachusetts license.

Some concerns have been raised related to Massachusetts psychologists having to compete with PSYPACT psychologists in other states. If this competition came about, it would push psychologists to continue to strive to provide the best services for those in Massachusetts, benefiting our residents.

Lastly, PSYPACT is essentially budget neutral, given that psychologists pay to join the compact themselves and any added administrative work would be balanced by a reduction in existing administrative work needed to support psychologists in obtaining multiple licenses.

Every psychologist can recount stories of clients who were forced to end care because of geography – stories of progress interrupted, crises compounded, and therapeutic relationships abruptly halted. The American Psychological Association’s ethics code explicitly urges psychologists to minimize disruptions and ensure continuity of care, putting psychologists in a bind. PSYPACT would enable Massachusetts clinicians to meet that ethical obligation.

The issue is not new to Beacon Hill. This is the third time PSYPACT legislation has been introduced.

House and Senate versions have both been reported favorably from committees and sent to the Senate and House Committees on Ways and Means for further review. There is no known opposition to PSYPACT. Competing priorities and legislative inertia are the only reasons Massachusetts has not caught up to the other states that have already taken this step to enhance access and continuity of behavioral health care.

Psychotherapy depends on trust and consistency. Treatment should not end when a patient crosses a state line.

Diana Westerberg is a licensed Massachusetts psychologist and serves as the chair of the Massachusetts Psychological Association Advocacy Committee.