With legislation in New Mexico and Louisiana enabling psychologists to prescribe psychotropic medication for their patients, there is a new opportunity to demonstrate that psychologists can prescribe safely and address the needs of the underserved mentally ill. This article describes one psychologist's first 18 months' experience prescribing psychotropics from a biopsychosocial model of care. Case examples demonstrate that a psychologist with prescriptive authority can effectively assist patients and increase available services to those who have been waiting many months to receive care. The psychologist is in an excellent position to recognize ethnic and individual variation that impacts effective psychotropic intervention. The prescribing psychologist working within the biopsychosocial approach and collaborative primary care model becomes a valuable part of the primary health care team, allowing increased comprehensive patient care for medical and psychological conditions.