Important: This toolkit is being actively developed and is likely to be revised through 2026. Please check back regularly for updates. It was last updated on July 2, 2026.
“Psychotropic Stewardship” promotes appropriate and safe psychotropic use, reduces harm, and improves patient outcomes with the goal being that a Board-Certified Psychiatric Pharmacist (BCPP) will review, optimize, and manage medication therapy for any individual with a psychiatric disorder, including substance use disorders (SUDs).1 Most BCPPs providing patient care contribute to psychotropic stewardship.
A “Psychotropic Stewardship Program (PSP)” is a formalized, system-level infrastructure designed to standardize and scale psychotropic stewardship practices across a population.2 Health systems are encouraged to support formal PSPs to improve the quality and reliability of care. A PSP is characterized by the defined core elements:
- A structured, interdisciplinary framework
- Collaboration across the health system and key stakeholders
- Standardized processes for strategic psychotropic review
- Defined governance, accountability, and leadership
- Comprehensive medication management (CMM) practices that optimize psychotropic use
- Supportive technology infrastructure
- Use of data, metrics, and performance tracking to assess outcomes, guide quality improvement initiatives, and support continuous program evaluation
- Ongoing education, policy development, and system-wide interventions.
About Creating a Psychotropic Stewardship Program
WHO is involved: PSPs should be developed and led by a multidisciplinary team with leadership or co-leadership from a BCPP. Team members may include but are not limited to psychiatric prescribers, nurses, administrators, and technology specialists. Patients and caregivers are also essential partners, participating in shared decision making.
WHAT it is: A PSP is a systematic, population-based approach to promoting safe, appropriate, and effective use of psychotropic medications within a health system. The framework for a PSP includes eight core elements: team structure, health system collaboration, strategic psychotropic review, accountability, comprehensive medication management, supportive technology, tracking, and education.
WHERE it can be used: PSPs can be applied across different clinical practice settings, including inpatient and outpatient environments. Programs should be tailored to the structure, resources, and patient populations of each healthcare institution.
WHEN it is interacts with care: PSPs support medication optimization across the continuum of care. Psychotropic reviews can occur at treatment initiation, transitions of care, and ongoing medication review for high-risk medications and/or patients. Implementation typically starts with a needs assessment and pilot phase before broader expansion.
WHY it exists: The purpose of PSPs is to improve patient outcomes and enhance medication safety through appropriate use of psychotropic medications.
HOW to get started: This toolkit provides a guide for implementing and growing a PSP with a structured yet flexible approach. Key steps include assessing organizational needs, defining target populations, establishing a stewardship team, developing workflows and interventions, and measuring outcomes. Continuous quality improvement processes help ensure sustainability, adaptation, and further maturation over time.