HHS Secretary Robert F. Kennedy Jr. recently announced an action plan aimed at reducing the overprescribing of psychiatric medications.
"Today, we take clear and decisive action to confront our nation's mental health crisis by addressing the overuse of psychiatric medications -- especially among children," he said last week. "We will support patient autonomy; require informed consent and shared decision-making; and shift the standard of care toward prevention, transparency and a more holistic approach to mental health."
HHS agencies are evaluating prescription patterns for psychiatric medications, their benefits and potential harms. They also will emphasize the role of nonmedication treatments and scalable, evidence-based solutions to improve mental health.
"Through a multipronged approach including education and outreach, program and policy actions; and research-to-practice efforts, HHS is working to prevent the unnecessary initiation of psychiatric medications and support the tapering and discontinuation for patients not experiencing clinical benefit," the agency said in a news release.
HHS encourages providers to prioritize informed consent and shared decision-making, and to regularly review the risks and benefits of psychiatric medications with patients. A dear-colleague letter highlights nonmedication approaches such as family support, psychotherapy, nutrition and physical activity when clinically appropriate.
"Psychiatric medications can play an important and, at times, essential role in treatment," the letter said. "For many individuals, such medications reduce symptoms, improve functioning, prevent relapse and support recovery. At the same time, medication should not be understood as the only treatment option, nor should it be initiated, continued or discontinued without a careful and individualized discussion of the risks, benefits and available alternatives."
In addition, the Centers for Medicare & Medicaid Services released guidance for physicians and other practitioners on the importance of deprescribing and related medical care. This guidance clarifies how physicians and other practitioners can be paid for this type of care under Medicare. It directs clinicians toward widely recognized resources for deprescribing, including professional society guidelines, peer-reviewed deprescribing protocols and the Food and Drug Administration instructions for taper schedules.
"Taken together, these activities reflect a shared federal commitment to ensuring that people with mental health conditions have access to the full range of evidence-based care," the letter said. "That includes medication when clinically indicated, but it also includes psychotherapy, family engagement and lifestyle and behavioral interventions, with careful reassessment of ongoing treatment over time. It also includes ensuring that individuals are meaningfully involved in decisions about their care."
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